MAPnet network expands access to medical abortion in India

Source: http://www.ipas.org

09.05.08

Despite relatively progressive abortion laws, safe, effective abortion services are out of reach for millions of women in India. Services are unavailable in many areas, especially in rural regions, and many facilities face shortages of supplies and staff. Additionally, many women are unaware that abortion services are available or even legal.  As a result, close to 18,000 women die from unsafe abortion every year, and many more are injured, demonstrating a compelling need for solutions. Expanding women’s access to medical abortion in India may be one of them.

Not only does providing medical abortion (also sometimes referred to as medication abortion) services offer women more choices and increase their access to safe abortion services, but it also has great potential to reduce deaths by expanding the use of safe, simple and effective abortion care in India. However, because of a lack of knowledge, resources and training among India’s medical community, this potential so far has gone mostly untapped, especially in India’s rural areas, where it is needed most.

MAPnet, an Ipas-sponsored physician network in India’s Maharashtra state, may provide an answer to expanding the availability of medical abortion in the world’s second-most populous country. MAPnet provides doctors with technical training about medical abortion, training about how to inform women about medical abortion and a supported network to communicate and share experiences with other doctors. “Progress and prospects of MAPnet,” a new study examining the progress and effectiveness of MAPnet, was recently published.

The study found that 92 percent of MAPnet members were offering medical abortion at follow up, while only 62 percent of members had offered medical abortion in 2005. Additionally, the percentage of members providing recommended drug protocols for medical abortion grew from 30 percent in 2005 to 82 percent at follow up.

“Progress and prospects of MAPnet” also examined the characteristics of women visiting providers in the network; these characteristics will be used to improve provision and quality of services. In India, the recommended protocol is for women to make two follow-up visits after first receiving medical abortion. The study results found that approximately 72 percent of visiting women received contraceptive methods from their providers, while the remaining 28 percent received postabortion counseling.

Ipas worked with the Federation of Obstetrics and Gynecology Societies of India (FOGSI) to create MAPnet in 2005. This network consisted of 87 private doctors in two districts of Maharashtra state who expressed interest in expanding women’s access to medical abortion.

Medical abortion is a nonsurgical intervention to terminate unintended, early pregnancies. It is based on a tested regimen registered in more than 30 countries. Patients receive a combination of two drugs, mifepristone (also known as RU-486) and misoprostol. The combination of these two drugs is effective in 95-99 percent of cases, and when provided safely, complications are rare and usually not serious.

“Progress and prospects of MAPnet,” was written by a team of authors from FOGSI and Ipas, including lead author Sushanta K. Banerjee, Ipas research and evaluation associate, and Vinoj Manning, country director for Ipas India. This study details an early assessment conducted among all network members in December 2006. This assessment detailed participating physicians’ knowledge, behaviors and perceived benefits of the network. The results of the study will be used to refine the existing network and to further expand.

“I am very pleased with the MAPnet’s progress so far and the results of this study,” says Manning. “Given the fact that this is the first network initiative in India to promote quality abortion services through medical abortion, this assessment offers a fruitful source of information and provides interesting insight to outline a future course of action. Encouraged by the success of the pilot initiative, FOGSI and Ipas are planning to expand this initiative to five more districts.”

Medical abortion offers enormous potential for women in India because it requires relatively limited resources and can be easily offered in small clinics. However, providing the medical community more information on medical abortion and method-specific counseling skills will help expand the use of this important technology.

3 July 2008, Canada
Canadian abortion crusader says he deserves award

3 July 2008, USA
South Dakota's unbelievable new abortion law.

3 July 2008, Middle East
Los Angeles Times Examines Apparent Increase In Abortions In Middle East

2 July 2008
World Publics Reject Criminal Penalties for Abortion

2 July 2008
Comment: Beyond the dogma - the real abortion debate

2 July 2008, UK
Abortion - the fight continues