Non-physician clinicians can safely provide first trimester medical abortion

Yarnall, Jillian; Swica, Yael; Winikoff, Beverly

doi:10.1016/s0968-8080(09)33445-x

Cited by 59 publications

(38 citation statements)

References 35 publications

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“…68 MLWs have also been shown to provide safe and effective abortion and anaesthetic services. [69][70][71] There a re data to indicate that MLWs are an effi cient as well as effective investment. Surgery by MLWs in Mozambique produced the same outcome as doctors whose training cost ten times that of the técnicos de cirugía.…”

Section: Quality Of Carementioning

confidence: 99%

Workforce Resources for Health in Developing Countries

Bangdiwala

Fonn

Okoye³

et al. 2010

Public Health Rev

116

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With increased globalization and interdependence among countries, sustained health worker migration and the complex threats of rapidly spreading infectious diseases, as well as changing lifestyles, a strong health workforce is essential. Building the human resources for health should not only include healthcare professionals like physicians and nurses, but must take into consideration community health workers, mid-level workers and strengthened primary healthcare systems to increase coverage and address the basic health needs of societies. This is especially true in low and middle-income countries where healthcare access is a critical challenge.There is a global crisis in the health workforce, expressed in acute shortages and maldistribution of health workers, geographically and professionally. This massive global shortage, though imprecise quantitatively, is estimated at more than 4 million workers. To respond to this crisis, policies and actions are needed to address the dynamics of the health labour market and the production and management of the health workforce, and to strengthen the performance of existing health systems. Schools of public health need to develop the range of capacity and leadership in addition to the traditional training of healthcare managers and researchers. Countries should fi rst identify their health problems in order to properly address their health worker needs, retention, recruitment and training, if they are to come close to reaching the Millennium Development Goals (MDGs) for health.

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Section: Quality Of Carementioning

confidence: 99%

Workforce Resources for Health in Developing Countries

Bangdiwala

Fonn

Okoye³

et al. 2010

Public Health Rev

116

View full text Add to dashboard Cite

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“…Similarly, the cost and availability of liability insurance may prevent many family physicians from offering medical abortion: they may be refused coverage for abortion, or they may be charged the same liability insurance premiums for providing medical abortions as for providing surgical abortion procedures [20]. Finally, it was anticipated that the use of telemedicine (i.e., the delivery of health care services at a distance using information and communication technology) and the provision of early medical abortion by advanced practice clinicians (i.e., physician assistants, nurse practitioners and certified nurse-midwives) would increase the availability of abortion services in remote areas with relatively few physicians and surgical facilities [21,22]. However, most states have laws preventing advanced practice clinicians from providing abortion services, and these laws have been applied to medical as well as surgical abortions [23].…”

Section: Discussionmentioning

confidence: 99%

Trends in use of medical abortion in the United States: reanalysis of surveillance data from the Centers for Disease Control and Prevention, 2001–2008

2012

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Background-With changing patterns and increasing use of medical abortion in the United States, it is important to have accurate statistics on the use of this method regularly available. This study assesses the accuracy of medical abortion data reported annually to the Centers for Disease Control and Prevention (CDC) and describes trends over time in the use of medical abortion relative to other methods.

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“…It would also lead to an increased role for certified GPs and a new role for nonphysicians as abortion services providers, thus reducing pressure on physicians at public hospitals. Indeed, studies in other countries have shown that mid-level providers, such as nurses and midwives, can safely provide MA after receiving appropriate training [14,15]. However, some physicians have remained skeptical about MA and others have opposed its provision in Turkey, fearing that the drugs would be misused and cause serious complications.…”

Section: Discussionmentioning

confidence: 99%

Introducing medical abortion in Turkey: Perspectives of physicians

Akın¹,

Doğan²,

Özvarış³

et al. 2012

Intl J Gynecology & Obste

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Objective: To better understand the knowledge, attitudes, and perspectives on medical abortion (MA) held by physicians in Turkey. Methods: The study was conducted in 4 provinces. Pretested, structured, self-administered questionnaires were answered by 187 obstetricians-gynecologists (ob-gyns) and 268 general physicians (GPs). Results: Although MA is not yet available at reproductive health facilities in Turkey, 96% of the ob-gyns and 82% of the GPs said they had heard about it. Moreover, 60% of the former and 5% of the latter said they had performed MAs, most commonly using misoprostol alone. More than 90% of the ob-gyns and 13% of the GPs had performed surgical abortions, and most (71% and 78%) thought that MA should be offered in the country. Conclusion: Most physicians in Turkey are aware of MA, with a large majority supporting its wider use. However, their concerns about the method and the incorrect understanding of its risks and possible complications may explain the reluctance of some physicians to provide MA services. These issues should be covered in physician training programs before the formal introduction of MA, while advocacy efforts press for registering mifepristone and misoprostol for its use.

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Non-physician clinicians can safely provide first trimester medical abortion

Cited by 59 publications

References 35 publications

Workforce Resources for Health in Developing Countries

Workforce Resources for Health in Developing Countries

Trends in use of medical abortion in the United States: reanalysis of surveillance data from the Centers for Disease Control and Prevention, 2001–2008

Introducing medical abortion in Turkey: Perspectives of physicians

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