Assessing Management Sciences for Health's Postabortion Care Decentralization Program
Council researchers with the FRONTIERS program assessed the successful introduction of postabortion care in Senegal by the Ministry of Health.
Over the past decade, Senegal's Ministry of Health (MOH) has introduced postabortion care (PAC) throughout the country; and since 2003 the country has been designated a “focus country” receiving support for decentralization of PAC services from USAID’s PAC Working Group. Between 2003 and 2005, the MOH worked with Management Sciences for Health (MSH) to extend PAC services to urban and rural facilities in 23 heath districts in a series of phases and interventions, including one conducted by FRONTIERS to test the feasibility of providing PAC services in rural areas. This assessment was commissioned by the PAC Working Group to provide information on the outcome of their investments in Senegal.
The assessment (formally titled "Assessment of the MSH PAC Decentralization Program in Senegal"), undertaken in four regions and Dakar city, showed that PAC services had been successfully extended to rural health facilities. Health posts are able to provide emergency treatment with digital curage (a method whereby the forefingers are used to manually explore the uterus and evacuate identified contents), while health centers have the staff and infrastructure to provide PAC using manual vacuum aspiration (MVA). However, numerous problems were identified, including low client loads in many facilities—an impediment for training—incomplete public understanding of PAC, and weak pre-service and on-the-job training in PAC.
Recommendations from the assessment team include incorporating PAC within the health sector reform process, testing the use of MVA in selected health posts, involving the community in the development of PAC services, and developing new strategies for in-service and on-the-job training, including focusing on improving quality of care.
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Duration: 9/2006 - 1/2007
Population Council researchers:
Centre de Formation et de Recherche en Sante de la Reproduction (CEFOREP)
Management Sciences for Health
Senegal Ministry of Health