The 130th Annual Meeting of APHA

Abstract #39684

Richard S. Hughes, MA¹, Velepi Mtonga, MD², and Martha Ndhlovu, RM, MSc². (1) Zambia Country Office, JHPIEGO Corporation, 1615 Thames Street, Baltimore, MD 21231, 011-260-1-254555, rhughes@jhpiego.org, (2) Department of Obstetrics & Gynaecology, University Teaching Hospital, P/Bag RW 1, Lusaka, Zambia

The Central Board of Health in Zambia, recognizing the importance of providing comprehensive postabortion care (PAC) services, established a National PAC Task Force with a mandate to expand PAC services to 100 district sites. While manual vacuum aspiration (MVA) was introduced to Zambia in 1989, it had been discontinued at all sites except the University Teaching Hospital (UTH) due to lack of equipment. A needs assessment found that PAC services were limited to the treatment of complications without integration of quality counseling, family planning services, or linkages to other reproductive health services. Despite difficulties in securing adequate funding, the implementation team has successfully established national PAC training capacity at central and provincial hospitals. Sustainability and institutionalization are key concerns for the implementing team. An intensive effort to sensitize stakeholders at provincial, district, and site levels, to secure a commitment to sustaining PAC and budgeting for necessary supplies and equipment, has visibly increased local ownership and buy-in to the program. The use of an individualized learning package for both on-the-job training and for training small numbers of clinicians in a self-paced program, designed to reduce the burden on the trainers / facilities and to maximize practical experience with the available caseload, has allowed more flexibility in the program, and has also contributed demonstrably to the sustainability of PAC training. This presentation reviews the sensitization and training approaches and tools employed, and the lessons learned regarding scale-up and issues of institutionalization and sustainability.

Learning Objectives: At the end of this session, participants will be able to

• understand the importance of the sensitization of key stakeholders prior to introducing PAC programs;
• discuss the advantages and disadvantages of using the individualized PAC training package; and
• incorporate approaches employed and lessons learned in Zambia into programs in other settings

Keywords: Post-Abortion Care, Training

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.