Findings and Lessons Learned From Strengthening the Provision of Voluntary Long-Acting Reversible Contraceptives With Postabortion Care in Guinea

Abstract

Integrating voluntary long-acting reversible contraceptive (LARC) methods within postabortion care (PAC) in Guinea has increased LARC uptake among PAC clients, compared with non-PAC clients. With aid from government champions and leveraging of resources, Guinea has incorporated PAC into national policies and guidelines and trained providers on PAC and LARCs to expand service provision.

Postabortion Care and the Voluntary Family Planning Component: Expanding Contraceptive Choices and Service Options

“…LARCs—contraceptive implants and intrauterine devices—represent a common postabortion family planning choice among women served in the PAC programs reported in this supplement 6 – 9 , 12 . This finding is understandable, given that implant use is rising rapidly across many sub-Saharan African countries and sociodemographic sectors.…”

“…The authors also document that misunderstanding and misconceptions about contraceptives remain a major stumbling block in providing the family planning component of PAC to clients; that training in counseling and values clarification is much needed; and that engaging men to support family planning for their partners is important and can be challenging 6 – 10 , 12 , 14 – 16 …”

“…This finding is understandable, given that implant use is rising rapidly across many sub-Saharan African countries and sociodemographic sectors. Women in challenging life circumstances (e.g., humanitarian crisis settings) as well as youth are choosing highly effective methods according to their needs to determine the timing and spacing of subsequent pregnancies 6 – 9 , 12 . Contributing to this expansion is increased commodity availability, trained and competent providers committed to broadening method choice, and recognition of the reproductive realities of women 17 .…”

“…The authors in this supplement highlight several components needed for sustainable postabortion family planning success, including links with postpartum family planning. To be effective, national programs need to monitor voluntary postabortion family planning counseling and provision in their national health management information systems 8 , 12 , 13 . Performance monitoring includes documenting the numbers of PAC patients, those counseled, and the number and percentage of women receiving voluntary contraception by specific method.…”

Strengthening Social and Behavior Change in Postabortion Care: A Call to Action for Health Professionals

“…Similarly, attention to expanding the contraceptive method mix offered to PAC clients has increased voluntary uptake of highly effective methods. Programs in Ethiopia and Guinea enhanced access to long-acting reversible contraceptives for PAC clients and noted that a broader method mix can satisfy clients with a variety of needs 33 , 34 . To support sustained improved practice, some Latin American PAC programs incorporated complementary provider behavior change approaches, such as the use of peer opinion leaders to promote best practices and strategic placement of visual reminders of clinical guidelines 35 .…”