Project period: 2015-2018
Increasing access to contraceptive choice and quality abortion services can improve health outcomes and reduce preventable deaths related to pregnancy and childbirth.
The immediate postpartum period can be an important window of opportunity to provide contraceptive counselling, and potentially offer contraception to women who want to avoid another pregnancy too soon. But it is one that is frequently missed or neglected.
The RCOG ran Leading Safe Choices (LCS) in South Africa and Tanzania as a way to address this unmet need in postpartum family planning (PPFP). In South Africa, the programme also focused on improving the delivery of comprehensive abortion care (CAC) services. In Tanzania, on comprehensive post-abortion care (CPAC) services.
The programme was implemented in partnership with various partners, including the Health Foundation, Western Cape Department of Health and Development for Health in South Africa and the Ministry of Health, Community, Development, Gender, Elderly and Children in Tanzania.
Underpinning it all was the need to address attitudes, raise awareness of the importance of PPFP and promote respectful and quality care to meet women’s reproductive healthcare needs, among policy and decision makers, managers, and individual healthcare providers, as well as patients.
The core components of the programme were:
- evidence-based guidelines for healthcare providers, through the creation of LSC Best Practice Papers
- training materials, training and supportive supervision for mid-level healthcare providers (nurses and midwives) in postpartum family planning, comprehensive abortion care in South Africa and comprehensive post-abortion care in Tanzania
- assessment and certification of competency in the clinical setting – the programme adopted a Training the Trainers approach to establish training and support systems in South Africa and Tanzania. It also facilitated mentorship for healthcare providers to ensure modern methods of contraception and C(P)AC became a routine part of reproductive healthcare services.
- More than 1,000 healthcare professionals were trained in postpartum family planning and postpartum family planning counselling.
- 20 new termination of pregnancy clinics opened in the Western Cape.
- Women going home with a contraceptive method of their choice increased from 1% to 57% across 10 facilities in Tanzania.
Over the lifetime of the programme
- Best Practice Papers
- RCOG and FSRH Safe abortion key messages
- Making Abortion Safe RCOG eLearning Courses (abortion care and abortion advocacy)
- Making Abortion Safe abortion summary sheets (downloadable at the end of each tutorial) - link