Task sharing in delivering safe abortion services: experience from Africa
Chilanga Asmani1, Karthik Srinivasan2 1International Planned Parenthood Federation, Africa Regional Office, Nairobi, Kenya, 2International Planned Parenthood Federation, Central Office, London, UK - firstname.lastname@example.org
Globally, Africa is hardest hit by the current healthcare worker crisis with a shortage of over 800,000 staff primarily among physicians and specialists. As an effort to overcome this shortage and expand access to critical health services, task sharing and task shifting has been promoted in the different health sectors by governments and civil society organizations. This approach has been adopted by IPPF to ensure universal access to sexual and reproductive health services. In many of its Member Associations (MA), IPPF has utilized this approach to expand access to safe and comprehensive abortion care and contraceptive services. A range of health workers comprising non-physicians, clinical officers, nurses and midwives currently provide pre and post abortion counselling, induced medical and surgical abortion and contraceptive services. As a result of these efforts, provision of abortion services by IPPF in the Africa region has increased by 42% between 2012 and 2013. Among the five MAs implementing the Global Abortion Care Initiative in Burkina Faso, Cameroon, Ethiopia, Ghana and Kenya, safe abortion service provision has increased from 6,477 to 14,653; treatment of incomplete abortion services has increased from 1,709 to 2,125 between 2011 and 2013. Although community awareness and acceptance for abortion services has increased and assessments indicate high level of quality of care and satisfied clients, the challenge of abortion stigma and staff attrition still persist. Task shifting and sharing the provision of safe abortion and contraceptive services has proven to be an extremely safe, well-accepted and feasible strategy to expand access to safe abortion care and contraception even in low-resource settings. Looking ahead, IPPF aims to conduct pre-service and in-service trainings and updates for midlevel providers, conduct operational research and develop strategies to increase access to safe abortion and contraceptive services in a stigma-free environment.