 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Victor Huapaya-Loyaga, MD, Training and Service Delivery Improvement, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC NC 27516, 919-960-5570, huapayav@ipas.org, Kelvin Espinoza, Departamento de Obstetricia y Ginecologia, Hospital Maria Auxiliadora, Paseo del Prado Mz. A Lt. 20, Las Lomas de La Molina Vieja, La Molina, Lima 12, Peru, and Janie Benson, MPH, Division of Health Systems Research, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516.
PAC programs have demonstrated to be an effective intervention to address unsafe abortion. PAC started as pilot studies, but now most countries are in the process of scaling up, which requires an effective and efficient approach for decentralization and quality assessment. This paper presents the results of implementing a model to scaling up PAC services in a large, rural, impoverished area in Peru.
The project was conducted applying the TEAM approach (train, equip, advocate and measure). Site training for general practitioners and midwives from 92 rural facilities (8 hospitals, 29 health centers, and 55 primary level centers) was complemented by provision of basic medical equipment, health service reorganization and quality of care continuous monitoring using simple screening tools.
By the end of the project, 100 % of hospitals and 78% of health centers had staff trained to offer PAC. Manual vacuum aspiration (MVA) was use to perform uterine evacuations in 65% of indicated cases of incomplete abortions, delay in providing surgical treatment was reduced from 23.3 to 4.1 hours, and postabortion contraceptive acceptance was increased from 21.1% to 42.8% of PAC patients treated.
Our results showed how an inexpensive and innovative model of intervention supported by information was effective for PAC scaling up. Monitoring tools identified gaps in service provision and quality, and also provided useful data for advocacy and system planning.
Learning Objectives:
Related Web page: www.ipas.org
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Victor Huapaya is a Program Associatte in the Training and Service Delivery Improvement Ipas Division