The quality improvement approach applied at 5 facilities over about 1 year increased family planning counseling to postabortion clients from 31% to 91%. Of those counseled provision of a contraceptive method before discharge increased from 37% to 60%. Oral contraceptives remained the most popular method, but use of injectables and implants increased. The country-driven approach, which tended to use existing resources and minimal external support, has potential for sustainability and scale-up in Togo and application elsewhere.

Before providers were trained in offering youth-friendly postabortion care (PAC), including provision of voluntary contraceptive methods, no youth PAC client chose a modern method before leaving the facility. After training, over a 6-month period 41% of youth PAC clients chose a modern method, most commonly oral contraceptive pills followed by implants and injectables.

Lessons learned when adapting the evidence-based global family planning training resource package included the need to: (1) engage key nursing and midwifery educators for buy-in; (2) update the technical skills of educators in contraceptive technology and competency-based training methods; and (3) adapt to the local context including condensing the global content for the time-limited preservice education context.

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