Transcript Slide 1
Promoting access to medical abortion in the context of safe abortion worldwide…
Rodica Comendant MD, PhD, ICMA Coordinator
ICMA – Ipas Meeting
“Developing an African network on safe/medical abortion”
11-13 March, 2009, Johannesburg, SA
Safe abortion services are essential for women
Unsafe abortions are a major public health problem. Of 210 million pregnancies yearly, an estimated 46 million end in induced abortion. Of the estimated 19 million unsafe abortions in the world each year, 18.5 million occur in developing countries. About 68 000 women die each year from unsafe abortion. Abortion-related complications cause up to 50% of obstetrical-gynaecological hospital admissions for women in some developing countries.
Safe abortion services are essential for women
Young and unmarried women are often afraid to tell anyone they are pregnant and are more likely to seek terminations from unqualified practitioners.
They account for a disproportionate share of death and illness from the complications of dangerous abortions.
What is medical abortion?
“Medical abortion” is the use of drugs to terminate a pregnancy. It is sometimes also called non-surgical abortion. The regimen for first trimester medical abortion, registered in more than 35 countries, consists of two drugs, included in 2005 on the WHO Essential Medicines list: mifepristone the hormone necessary to sustain a pregnancy), followed 1–3 days later by (an anti-progestogen that blocks progesterone, misoprostol (a prostaglandin that makes the uterus contract). These drugs can be taken to cause a miscarriage to occur, starting from the time a woman misses her period. Where mifepristone is not available, misoprostol can be used alone to cause the miscarriage.
WHO: Safe Abortion: Technical and Policy Guidance for Health Systems, 2004
Methods of abortion
Why medical abortion is important?
Medical abortion can make abortion: earlier, more accessible, safer, less traumatic, less medicalised and less expensive.
It has increased access to safe abortion and reduced maternal mortality, including in legally restricted settings.
Why medical abortion is important?
Medical abortion has been shown to be safe and effective in both the first and second trimesters of pregnancy, with efficacy rates as high as 95
98%.
Acceptability among women is high, because medical abortion does not involve surgery or anaesthesia, and is a simple procedure that happens entirely in the woman’s body.
Acceptability among providers is high too, because they feel that it is safe and offers women an alternative to surgical abortion, and is a choice that many women prefer.
ICMA ICMA was formed in June 2002 with the aim: to promote access to medical abortion in the context of support for safe abortion worldwide, focusing on the needs of women in developing countries, especially those where safe abortion is not easily accessible.
ICMA
International non-governmental, non-profit organization
Growing number of international networks:
Latin-American network CLACAI established in 2006.
Asian network, ASAP, March 2008
Eastern European network, EEARC, May 2008
African network, 2009?
SC with the chair and co-chair, WHO observer, coordinator, advisory group, networks liaison officer
ICMA Activities: International Conference in SA in 2004. Conference accomplishments:
The sharing of information on the use of medical abortion internationally, An analysis of the influence of alternative policies, programmes and services on access to medical abortion in a range of country settings, The identification of strategies for improving women's access to medical abortion, in the context of safe abortion, with a focus on developing countries and countries in transition, The creation of a forum for dialogue and networking to broaden the constituency working for medical abortion worldwide. The creation of a Consensus Statement advocating for wider availability of medical abortion.
ICMA Activities: Information Package on Medical abortion
Comprehensive information package in seven languages that can be adapted and used in many settings, addressed to: • women • health service providers • women’s organizations, NGOs • policymakers and parliamentarians, and • selected recourses on MA.
Available on the web and on CDs
ICMA Activities: ICMA website,
www.medicalabortionconsortium.org
Created in 2003 and expanded and updated in 2007, French, Spanish and Russian sections have been added. The site provides up-to-date information on developments and events related to medical abortion worldwide as well as current and upcoming ICMA activities. It has links to references, resources and articles on medical abortion and to the web pages of other organizations working in the same field.
ICMA Activities: Conference on Second
Trimester, London, March 2007
Conference Recommendations: “…access to good quality second trimester services is an essential part of comprehensive safe abortion services.
Advocates must work to build support for safe, legal abortion in the second trimester of pregnancy. This work should include: developing better data on the occurrence and need for second trimester abortion, the elimination of legal, regulatory and social barriers to second trimester abortion, a commitment of resources to training clinicians to provide later abortions, and research on the best medical methods in different settings…” RHM/ICMA Supplement , based on the conference presentations
ICMA Activities: the third Conference,
February 2010. Objectives:
To share information on the current situation of access to MA in different situations with an emphasis on lessons learned and challenges faced in expanding access. To examine strategies that have succeeded in improving access. To examine barriers to access and how they have been addressed. To discuss issues causing contention within the MA community.
The outcome
at the end of the conference is expected to be a “consensus” statement highlighting strategies and means of expanding access to MA. The statement is expected to be used to motivate action at national and local levels.
African network ???
The other regional networks associated with ICMA are independent entities, choose their own staff and steering committees, and develop their own activities.
We envisage that any such network in Africa would do the same.
ICMA