March 3, 2017

Using evidence—and on-the-ground expertise—to improve abortion care quality

When it comes to ensuring women and girls receive high-quality
abortion care, Ipas combines the latest evidence with lessons learned in
collaboration with health professionals globally to produce broadly
relevant and useful clinical recommendations.

“Ipas’s clinical staff, trainers and partners are continuously
learning from the unique challenges and opportunities they encounter in
Ipas-supported health facilities—often in low-resource settings—across
Africa, Asia and Latin America,” says Dr. Dalia Brahmi, medical editor
of Ipas’s Clinical Updates in Reproductive Health. “We
synthesize scientific research and programmatic innovations
from diverse settings to form Ipas’s clinical recommendations.”

Ipas’s 2017 Clinical Updates provide the most up-to-date
recommendations on comprehensive abortion care in English and Spanish
(with French coming soon). Continuous revisions are based on a thorough
review of published scientific evidence and ongoing feedback from
professionals who use the recommendations in training, advocacy and as a
reference guide.

“I use the Ipas Clinical Updates in order to provide evidence-based, woman-centered reproductive
health care in different countries around the world,” says Dr. Manisha
Kumar with Médecins Sans Frontières in the Democratic Republic of
Congo. “I use them to stay up to date in my clinical practice as well as
for developing protocols and training staff so women will receive the
best possible care.”

Three ways Ipas’s Clinical Updates are improving care for women

1. Timeliness: Ipas’s recommendations are consistent
with the World Health Organization (WHO) 2012 and 2014 guidance on
abortion care, with the addition of evidence published since the last
WHO update.

“Our annual revision process means we’re able to incorporate the
latest research findings as soon as they are published,” explains Dr.
Emily Jackson, Ipas’s senior clinical consultant who works on the
Clinical Updates. “Research and clinical practice in the abortion-care
field are quickly evolving, so annual revisions are incredibly helpful
for our staff and partners to be able to provide women and girls with
top-quality care.”

2. Relevant in low-resource settings: Health
facilities operating with few resources have unique needs. “Ipas draws
on extensive networks of clinicians and trainers to help us tailor our
recommendations so they’re useful and easy to implement for providers
working to serve even the hardest-to-reach women,” Jackson says.

For example, facilities may struggle to maintain misoprostol product
quality with proper packaging and storage conditions, may need to resort
to an alternative method of instrument sterilization when supplies run
low, or may only be able to obtain a certain concentration of lidocaine
for use in pain management. All these potential challenges, flagged by
colleagues in low-resource settings, are addressed in the 2017 version
of Ipas’s Clinical Updates.

3. Clinical questions answered while evidence builds:
Despite rapidly accumulating evidence on safe abortion care, there are
often still gaps. To provide high-quality services, Ipas-supported
clinicians and trainers often need practical information that isn’t yet
available in global guidance documents.

“For example, a paracervical block is broadly recommended for pain
management, however the ideal technique is still being determined,”
Jackson explains. “Ipas uses the best available evidence to provide our
programs with reliable guidance, while highlighting areas for future
research so these questions can be answered definitively.”