The safety and availability of abortion has improved across the globe, but the quality of abortion services varies widely. There is currently little agreement about indicators to measure and improve abortion quality, and while we know that poor-quality care can impact health outcomes, well-being, and future healthcare seeking, a universal metric used across service-delivery models is still needed.
The Abortion Service Quality (ASQ) Initiative is a three-year project launched in April 2018 by Ibis, Metrics for Management, and Ipas. The Initiative focuses on developing, validating, and championing the widespread adoption of a common metric that can be used to assess abortion quality in and out of facility settings. We aim to develop a set of measures that are standardized, actionable, simple, timely, and valid by addressing the following components:
- Identify current quality indicators by collecting and collating existing measurement tools from organizations, clinics, and national health ministries across more than 80 countries
- Develop new client-centered indicators based on qualitative data collected from people seeking abortion across a range of service delivery and support models of care in Argentina, Bangladesh, Ethiopia, and Nigeria
- Field test and simplify a combined list of 111 indicators and assess associations with clinical and client-based outcomes
Following field testing and validation in Bangladesh, Ethiopia, and Nigeria, we launched the ACQTool, a set of 29 indicators developed by an international panel of experts, through extensive research and usability testing, to provide an accurate assessment of the abortion quality. The tool is designed for use in facilities, pharmacies, and hotlines and we hope will be useful to measure and improve abortion quality in settings around the globe.