Improving manual vacuum aspiration service delivery, introducing misoprostol for cases of incomplete abortion, and strengthening postabortion contraception in Bangladesh

Abstract

The Obstetrical and Gynaecological Society of Bangladesh was an important advocate in mobilizing government authorities to adopt new techniques for postabortion care and provide long-acting contraceptives post abortion. With the support of the International Federation of Gynecology and Obstetrics (FIGO), the Society provided commodities and training to increase the use of these techniques in 7 private and public hospitals and clinics. Data from two of these institutes for the January 2012 to June 2013 period showed a rapid decrease in the use of dilation and curettage, an increase in the use of manual vacuum aspiration (MVA) and misoprostol, and the progressive adoption of long-acting reversible contraceptives, permanent contraception, and injectable contraceptives in one of these two hospitals. The Directorates General of Health and Family Planning incorporated training in the use of MVA and misoprostol in their national operation plans. The success in these hospitals shows that the proposed changes have been well accepted by providers and clients.

Effects of an intervention initiated by a national society to improve postabortion care in rural facilities in Burkina Faso

“…This society has built the PAC capacity of seven public and private health facilities in Bangladesh, leading to a significant reduction in the use of dilation and curettage, coupled with an increase in the use of MVA and misoprostol. The adoption rate of modern methods of postabortion family planning has also been significantly improved . These findings show that professional health associations can contribute to the improvement of PAC in their country, especially in rural areas.…”

“…The experience of SOGOB is similar to that of the Obstetrics and Gynaecology Society of Bangladesh acting with support from the International Federation of Gynecology and Obstetrics to improve PAC . This society has built the PAC capacity of seven public and private health facilities in Bangladesh, leading to a significant reduction in the use of dilation and curettage, coupled with an increase in the use of MVA and misoprostol.…”

“…In 2015, this achievement by the SOGOB helped to convince the Ministry of Health to include misoprostol in the essential drugs list to improve its availability and use in PAC. Other initiatives have also seen in misoprostol a way to diversify management methods of incomplete abortion …”

Achievements of the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences in South‐Southeast Asia

“…In the Institute of Maternal and Child Health in Mutuail, Bangladesh, MVA use increased from 0% to 13.9%, while misoprostol use rose from 10.6% to 25.5%, and dilation and curettage decreased from 89.4% to 60.6%. In addition, postabortion contraception was provided to over 90% of women at both hospitals [37].…”

“…In 2012, the Bangladesh Drug Administration legalized a combination of mifepristone and misoprostol for medical abortions [37].…”