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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 serviceWomen in
needCommunity
• 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/songsVisits 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 TrainingVietnam, 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!
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