Medical Abortion Training in Asia: Innovative Approaches Case studies from Ipas’s experience Phan Bich Thuy, MD, MPH Protecting women ’ s health Advancing women ’ s reproductive rights

What makes MA services different? Medical abortion is a process like a miscarriage that women experience over several hours /days and often outside of the clinic setting Different needs for training

Training includes… Clinical sites /Providers MA service Women in need Community Clinical training Experience sharing Peer education IEC materials Women group’ activities Street dramas IEC materials

Who are trainees/audiences? Doctors Midwives Nurses Auxiliary nurse, midwives Counselors Administrators Community intermediaries People in the community

Nepal Train Female Community Health Volunteers Conduct pregnancy tests - early pregnancy detection Refer to prenatal care or safe abortion sites Provide family planning counseling Distribute condoms /contraceptive pills

Vietnam Women Clubs’ activities Provision of MA information Questions & answers Role playing Poems/songs Visits to clinical sites

India Street drama Acting troupe went to small villages and enacted skits or short dramas Experts in medical abortion helped to develop the script. IEC materials Inform woman about safe abortion

Clinical Training Vietnam, Nepal, India & Cambodia Whole site training First, train a small group of providers Trained providers go back to their sites and train everyone Person who answers the phone is the one who first answers the patient’s questions - needs to be trained

Clinical Training (cont.) Practice Observe medical abortion counseling on client’s first visit, second visit, and follow-up visit Observe expulsion phase of medical abortion Learn about patients’ experiences with MA

Clinical Training (cont.) Training methods Case studies Group work Debates Role playing Observation Practice on real patients Values clarification Blended learning

Training Follow-up Mentoring new providers Quality of care monitoring using measurable monitoring tool Experience-sharing meeting with providers Sending providers updated research

Lessons learned Educate both sides: providers & women/people at community Use different training methods & content based on training purposes & background of trainees/audiences Use a comprehensive training model to ensure effective practices Share experiences: learn from each other Frequently update knowledge

Lessons learned (cont.) Link training with: Drug availability Monitoring quality of care Managing changes at clinical sites IEC material development Community activities Policy changes

Thank you!