Unsafe abortion is a significant yet to preventable cause of maternal mortality accounting for approximately 8 percent of the maternal deaths. Lack of accessibility to safe abortion services by qualified providers in hygienic condition is one of the important reasons for this. Recognizing the fact that unsafe abortion is a major concern, providing access to safe abortion services in the public sector health facilities is one of the key focus areas under National Health Mission.
Comprehensive Abortion Care strives to:
- Provide safe, high-quality services, including abortion, post abortion care and family planning
- Decentralize services so they are closer to women
- Be affordable and acceptable to women
- Understand each woman's particular social circumstances and individual needs and tailor her care accordingly
- Address the needs of young women
- Reduce the number of unintended pregnancies and abortions
- Identify and serve women with their sexual or reproductive health needs
- Be sustainable to health systems.
State initiatives on Comprehensive Abortion Care (CAC) Services are as follows
- Training of Trainers: Total 88 Medical Officers (O&G) are trained as Master Trainers. 10 Medical Officers (O&G) trained as Master Trainer in 2018 – 2019.
- CAC Training Centre: Total 23 Training Centers have been strengthened to provide CAC training at district level.
- Training of Medical Officers (MO-MBBS): Total 547 Medical Officers have been trained as CAC service provider at district level. 114 Medical Officers trained during 2018-2019.
- Orientation of Nursing staff: Total 361 Nursing Staff have been oriented to provide assistance in offering CAC services. 114 Nursing staff oriented during 2018–2019.
- Clinical Mentors: 7 Medical Officers are identified as clinical mentors to provide technical support to the CAC trained providers as and when required.
- District Level Committee: All the 27 districts have District Level Committee on CAC to review & strengthen safe abortion services including approval of private site for MTP services.
- Post Abortion Family Planning Workshop: Every year one District level PAFP workshop is organized to review and orient service providers on Post Abortion Family Planning services.
- ASHA incentive: Rs. 150/- is given to ASHA as incentive for accompanying client to the public health facility for safe abortion services
- Post Abortion IUCD Incentives: For PAIUCD insertion; incentive of Rs. 300/- is given to beneficiary, Rs. 150/-to ASHA and Rs. 150/- is given to provider.
- ASHA orientation: Regular orientation of ASHA on CAC and family planning including referral to the service delivery sites is organized.
- IEC Materials: Different IEC materials are developed on CAC services for the facility and for the community
- Model CAC Centre: Assam Medical College and Hospitals, Dibrugarh has been established as Model CAC Centre in the state. It is an ideal set up to strengthen CAC services leading to improved quality of CAC training and CAC service provision as per the standardized norms so that women seeking CAC services receive quality care. The PG students are also regularly oriented on CAC to improve the quality of CAC service delivery.
- New Initiative- strengthen post abortion contraceptive: 2 days on-site orientation of IUCD Trained Providers is organized focusing on improving providers’ knowledge & techniques of insertion for PAIUCD, infection prevention, waste management, FP counselling, record keeping, etc. The training is conducted at the facility of service providers which enhances their confidence for providing quality service in their own settings. Since the inception of the training program in 2018, 467 service providers have been oriented on PAIUCD. The orientation has resulted in insertion of PAIUD, record maintenance, and reporting of CAC and PAFP services.