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In July 2002,a group of four doctors and two nurses were sent to
Kenya with support from PPFA for training in Post-Abortion Care
(PAC). This group was actually composed of senior health
providers that expected to initiate PAC services in Sudan. After
the training and technical assistance from PPFA, the six
providers formed the Post-Abortion Care Group in Sudan. The
group of providers has continued to meet regularly to plan
activities, share information and advocate for PAC services.
Some of the activities that the
Post-Abortion Care Group has conducted since inception include:
A survey on the advantages of using the manual vacuum aspiration
(MVA) kit Vis a Vis traditional surgical method to treat
incomplete abortions. The findings of this survey were presented
at a conference of the Sudanese Obstetrics and Gynecological
Society. This was the turning point for post-abortion care in
Sudan and triggered a series of discussions and workshops with
several stakeholders, including the Federal Ministry of Health (MOH).
As a result, MOH and the Sudanese Obstetric and Gynecology
Society agreed to allow the first training course on PAC in
Sudan, including practical training at the Academic Charity
Hospital in December 2003. The course was organized by the PAC
Group with support and technical assistance from PPFA. Twelve
doctors, mainly working in rural areas of Khartoum State,
participated in the course.
The medical director of the Academic Charity Hospital under the
auspices of the PAC Group carried out a study on the efficiency
and the safety of the MVA procedure after the training. The
results of the study were presented at the Conference of
Sudanese Obstetrics and Gynecology Society in 2005 and
highlighted the principles of PAC using MVA and that MVA is a
safe, efficient and cost effective method for treating
abortions. The activities of the PAC group contributed to the
MOH adoption of the concept of PAC / MVA as the treatment of
choice for incomplete abortions. The MOH thereafter trained a
big number of providers with the technical assistance from PPFA
and Safe International.
The group advocates for
provision of PAC at all levels of health system within
government sector and private sector as well.
The group initially faced
resistance from the government and medical practitioners.
However, the resistance slowly changed when the group presented
the findings of study on use of MVA at the Conference of the
Sudanese Obstetrics and Gynecology Society in 2003.
The efforts of the group have
resulted in the training of health providers, and
institutionalization of PAC into the health policies to treat
incomplete abortions and complications of unsafe abortion. In
addition, the Ministry of Health has instituted manual vacuum
aspiration kits into the medical supply list and purchased 600
kits in 2006. In addition, there exists a strong network of
post-abortion care providers, consisting of doctors and nurses
from the public and private sector.
There is need, however, to further
strengthen the PAC group through the restructuring and
formalizing of a PAC network. A more structured network will
enhance information sharing; provide technical updates for the
PAC providers, including updates on infection prevention;
harmonize data collection; establish a monitoring team, update
and institutionalize policies, standards and guidelines for
abortion and post-abortion care; and ensure availability of MVA
kits. The network will also ensure routine documentation of its
activities and carry out surveys and researches on unsafe
abortion in Sudan. These activities will contribute to
increasing access to quality post-abortion
care services.
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