ISLAMABAD - A report on post-abortion care in Pakistan has highlighted the need for expanded access to high quality family planning services and provided recommendations for promoting safer post-abortion care, and building capacity among healthcare providers to help achieve these goals.

The Population Council, Friday, released a latest research report titled "Post-Abortion Care in Pakistan: A National Study." This study has outlined the ongoing gaps in the quality of post-abortion care following unsafe abortion procedures, societal stigmas and inequities in the healthcare system, burden of post-abortion complications, and the significant role of private and public sectors in ensuring access to care.

Launching ceremony of the report took place in a meeting in which included Saira Afzal Tarar, Minister of State, National Health Services, Regulations and Coordination, as chief guest and keynote speaker among a panel of experts from leading national institutions and professional organisations. People from different walks of life including representatives from the government of Pakistan, donor organisations, health professionals, academics, NGOs and civil societies participated in the event and shared their views on timely topics shaping the reproductive health and socio-economic climate in Pakistan and determined the best way forward for helping women and communities achieve optimal health outcomes.

This research study has founded that in 2012, nearly 700,000 women in Pakistan went to health facilities for treatment of complications resulting from spontaneous abortions or induced abortions using unsafe methods or with the assistance of an unskilled provider.

While safe procedures for post-abortion care were found to be more widely used in 2012 than they were in 2002, health facilities still rely on unnecessarily invasive procedures such as dilation and curettage (D&C). Additionally, many facilities do not have adequate equipment and supplies to provide quality care for complications and a majority are not equipped to provide around-the-clock services to manage severe complications. Lastly, the private sector plays an important role in the provision of care, as more than 60 per cent of all cases were treated by private sector providers.

The report has also highlighted that in Pakistan, 25 per cent of women like to avoid or delay pregnancy, but are not using contraception, and therefore are at risk for unintended pregnancy. As a result, many women resort to induced abortion to end unintended pregnancies. The current law in Pakistan permits abortion to save a woman's life and to provide "necessary treatment."

Due to some legal restrictions and the lack of clarity among women and healthcare providers in interpreting the law, women may be forced to seek abortion by untrained providers. The resulting morbidity and mortality places a heavy burden on women, their families, communities and the national health system.

Minister of State, National Health Services, Regulations and Coordination Saira Afzal Tarar in her keynote address on the occasion pointed out the urgent need for policies and planning at the highest levels to tackle the issues raised in the report. She also stressed to focus on actual implementation of the plans and policies. 

"It gives us great cause for concern that nearly 700,000 women in Pakistan needed treatment annually for complications of induced or spontaneous abortion," Saira Afzal Tarar said, adding, "Many facilities do not have adequate equipment if complications occur. Lack of well-trained staff, stigma and financial constraints also pose inherent barriers to good service delivery. Coordinated efforts of Health and Population Welfare Departments must augment other actors together as a community to address these issues that threaten the lives of women in Pakistan each and every day." She also suggested that a pool of nurses, LHVs and other midlevel providers be trained and specialized in the provision of post abortion care.

It is worth mentioning that the study was funded by the Research an Advocacy Fund (RAF), UK Department for International Development (DFID) and the Australian Agency for International Development (AusAID) and was conducted by the Population Council in collaboration with the Guttmacher Institute and the National Committee for Maternal and Neonatal Health. The Population Council and the Guttmacher Institute collected data through two quantitative surveys and several qualitative methods, including surveys of 266 health facilities and 102 healthcare professionals; in-depth interviews of 44 women who had an induced abortion in the past six months; and 10 focus groups involving women with at least three children to gain an understanding of community norms regarding abortion and post-abortion care.