Background
Abortion has been legal in Nepal since 2002, but many women still face challenges when it comes to accessing safe abortion services. Long distances to service providers, high fees and social stigma are a few reasons why unsafe abortions continue to exist. At the Scheer Memorial Hospital in Banepa, post-abortion care has mainly been performed by using a sharp, metallic curette, instead of the cheaper and safer option called manual vacuum aspiration (MVA). On the few occasions that MVA has been used, it has only been performed by the gynaecologist, which led to long waiting hours. Negative attitudes towards abortion among the health care providers also meant that the women who came in for post-abortion care didn’t receive family planning counselling after their procedure.

About the project
This project was created to provide comprehensive post-abortion care services at Scheer Memorial Hospital, by establishing a specific unit for manual vacuum aspiration. The project team trained both midwives and doctors on how to perform MVA, both through theoretical sessions and practical demonstrations. The MVA unit was established and opened in April 2009, after which MVA became the routine procedure in the hospital’s post-abortion care. The women who came to the unit for treatment also received counselling and access to family planning methods, free of charge.

Results
By the end of the project, the number of MVAs performed at the hospital increased by 66% and the number of women accessing family planning methods after their procedure went from 0% to 66%. Nurses and midwives have been empowered with the knowledge and skills to perform MVA at the hospital, which has reduced the waiting time and enabled the majority of the patients to go home the same day. The health workers’ attitudes have improved and they now agree that MVA is the best method, both for the patients and the hospital.

Year: 2009