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Guidance of WHO on safe Guidance of WHO on safe abortionabortion
Guidance of WHO on safe Guidance of WHO on safe abortionabortion
FIAPAC, Moscow October 28, 2005
G. LazdaneRegional Adviser RHR
WHO Regional office for Europe
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The WHO global reproductive The WHO global reproductive health strategy adopted by health strategy adopted by WHO's 191 Member States WHO's 191 Member States during World Health during World Health Assembly in May 2004Assembly in May 2004
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Core aspects of the WHO Global Reproductive Core aspects of the WHO Global Reproductive
Health StrategyHealth Strategy Core aspects of the WHO Global Reproductive Core aspects of the WHO Global Reproductive
Health StrategyHealth Strategy
•Family planningFamily planning
•Maternal and perinatal healthMaternal and perinatal health
•Sexually transmitted infections Sexually transmitted infections (including (including HIVHIV and cervical and cervical cancer) and reproductive tract cancer) and reproductive tract infectionsinfections
•Unsafe Unsafe abortionabortion
•Sexual healthSexual health
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Global WHO Reproductive Global WHO Reproductive Health Strategy Health Strategy
Global WHO Reproductive Global WHO Reproductive Health Strategy Health Strategy
Annually in the world:
•19 million unsafe abortions
•40% in the age group less than 24 years
•Due to unsafe abortion ~ 68 000 women die t.i. 13% of all death cases due to pregnancy
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Resolution of 58Resolution of 58thth WHA (2005) WHA (2005)Resolution of 58Resolution of 58thth WHA (2005) WHA (2005)
URGES Member States:1. to commit resources and to accelerate national
action towards universal access and coverage with maternal, newborn and child health interventions, through reproductive health care
2. … to establish monitoring mechanisms for measuring progress towards the achievement of agreed goals, particularly the target on universal access to reproductive health care by 2015
3. …
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WHO Priorities of SRH for 2006-2007 in EUROPEWHO Priorities of SRH for 2006-2007 in EUROPE WHO Priorities of SRH for 2006-2007 in EUROPEWHO Priorities of SRH for 2006-2007 in EUROPE
• Maternal and perinatal mortality and morbidity
• Prevention of unwanted pregnancy and ensuring safe abortion
• Improving SRHR of young people, also through the provision of YFHS, emphasising the needs of vulnerable and underserved groups
• Promoting the role of the health sector in addressing gender based violence
• Planning of the family in the new Europe
• Chapter 1: Safe abortion services: the public health challenge
• Chapter 2: Clinical care for women undergoing abortion
• Chapter 3: Putting services in place
• Chapter 4: Legal and policy considerations
Structure of the guidance
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Methods of abortion
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Up to 9 completed weeks since LMP
200 mg mifepristone followed 36-48 hours by:
1.0mg vaginal gemeprost or 800 g vaginal misoprostol
or 400 g oral misoprostol up to 7 completed weeks
After 12 completed week since LMP
200 mg mifepristone followed after 36-48 hours by:
1 mg vaginal gemeprost (repeated every 3 hours up to maximum of 4 doses)
or
400 g misoprostol every 3 hours up to 5 doses
or
800 g vaginal misoprostol followed by
400 g oral misoprostol every 3 hours up to a maximum of 4 doses
Medical methods of abortion
Mifepristone plus prostaglandin regimens
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WHO Safe abortion guidance WHO Safe abortion guidance (2003)(2003)
WHO Safe abortion guidance WHO Safe abortion guidance (2003)(2003)
•Available in English, Russian, French, Polish, Portuguese, Spanish
(www.who.int/reproductivehealth/publications/-safe_abortion/safe_abortion.html)
•Implementation:o Workshop – in combination with Strategic approacho IPPF EN + Ipas + WHO EUROo Strategic Approach of improvement of services – MDA
(RUS, UKR, LVA, LIT)o Development of National guidelines
The issue is co-published with the
IPPF European Network
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European protocols for RH European protocols for RH services for PLWHA services for PLWHA (2006)(2006)
European protocols for RH European protocols for RH services for PLWHA services for PLWHA (2006)(2006)
•WHO Regional Office for Europe
•Contraception
•Termination of pregnancy
•МАR
•RTI
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Future development of policies Future development of policies and programmesand programmes
Future development of policies Future development of policies and programmesand programmes
• EUROPEAN Strategy for Child and Adolescent Health and Development – RC 2005
• A framework for implementing the WHO global RH strategy (in development)
• STI Global strategy (in development – WHA 2006)
• EUROPEAN Strategy for Improving Maternal and Perinatal Health (in development – RC 2006)
• Assistance to the countries in development their national strategies and policies
•
WHO guideline in FP/STI WHO guideline in FP/STI
• 3rd ed. Medical Eligibility Criteria for Contraceptive Use (2004) – Russian translation (2005)
• 2nd ed. Selected Practices Recommendations for Contraceptive Use (2005) - Russian translation (in print)
• STI/RTI: a guide for essential practices (2005)– Russian translation (in print)
