Ibis Reproductive Health

Increasing access to medication abortion in South Africa

We are working with a coalition of local non-governmental and university-based colleagues in South Africa to support introduction of mifepristone-misoprostol medication abortion into public sector termination of pregnancy services in South Africa. Mifepristone was approved for use in South Africa in 2001 and is currently available in private sector, but not free government, health services. Ibis has conducted research to explore interest in medication abortion among women and providers, and to assess whether women currently attending public sector abortion services would be eligible for medication abortion. In addition, we have evaluated the feasibility of offering the mifepristone-misoprostol regimen in public surgical termination services, and private sector provision of medication abortion. We have also specifically assessed the use of clinical exam for assessing gestational age to provide evidence to support provision of medication abortion services that may not have routine access to ultrasound.

We are continuing to work with our local colleagues to help develop guidelines for medication abortion provision, support plans for roll-out of services, and identify critical clinical and operations research questions to inform service delivery and support widespread access to medication abortion. Our collaborators include Gynuity Health Projects, Ipas South Africa, the National Abortion Federation, the Reproductive Health and HIV Research Unit of the University of the Witwatersrand, the University of the Witswatersrand School of Public Health, and the Women’s Health Research Unit at the University of Cape Town, among others.

Resources:

Blanchard K, Brown H, Cooper D, Dickson K, Cullingworth L, Mavimbela N, von Mollendorft C, van Bogaert, B Winikoff. A comparison of women’s, providers’ and ultrasound assessments of pregnancy duration among termination of pregnancy clients in South Africa. BJOG An International Journal of Obstetrics and Gynaecology. May 2007; 114(5):569-575. Request article
Blanchard K, Schaffer K, McLeod S, Winikoff B. Medication abortion in the private sector in South Africa. European Journal of Contraception and Reproductive Health Care. December 2006; 11(4):285-290. Request article
Cooper D, Dickson K, Blanchard K, Cullingworth L, Mavimbela N, von Mollendorf C, van Bogaert L, Winikoff B. Medical Abortion: The Possibilities for Introduction in the Public Sector in South Africa. Reproductive Health Matters. 2005; 13(26):35-43. Request article
Cooper D, Dickson K, Blanchard K, Cullingworth L, Mavimbela N, von Mollendorf C, van Bogaert L, Winikoff B. Medical Abortion: The Possibilities for Introduction in the Public Sector in South Africa. Reproductive Health Matters. 2005; 13(26):35-43. Request article

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