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Guidance of WHO on safe abortion

This WHO guidance provides comprehensive information on safe abortion services. It includes clinical care, policy considerations, and methods of abortion. The guidance aims to improve reproductive health and reduce unsafe abortions globally.

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Guidance of WHO on safe abortion

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  1. Guidance of WHO on safe abortion G.Lazdane Regional Adviser RHR WHO Regional office for Europe FIAPAC, Moscow October 28, 2005

  2. The WHO global reproductive health strategy adopted by WHO's 191 Member States during World Health Assembly in May 2004

  3. Core aspects of the WHO Global Reproductive Health Strategy • Family planning • Maternal and perinatal health • Sexually transmitted infections (including HIV and cervical cancer) and reproductive tract infections • Unsafe abortion • Sexual health

  4. Global WHO Reproductive Health Strategy Annually in the world: • 19 million unsafe abortions • 40% in the age group less than 24 years • Due to unsafe abortion~ 68 000 womendie t.i. 13% of all death cases due to pregnancy

  5. Resolution of 58th WHA (2005) URGES Member States: • to commit resources and to accelerate national action towards universal access and coverage with maternal, newborn and child health interventions, through reproductive health care • … to establish monitoring mechanisms for measuring progress towards the achievement of agreed goals, particularly the target on universal access to reproductive health care by 2015 • …

  6. WHO Priorities of SRH for 2006-2007 in EUROPE • Maternal and perinatal mortality and morbidity • Prevention of unwanted pregnancy and ensuring safe abortion • Improving SRHR of young people, also through the provision of YFHS, emphasising the needs of vulnerable and underserved groups • Promoting the role of the health sector in addressing gender based violence • Planning of the family in the new Europe

  7. Structure of the guidance • Chapter 1: Safe abortion services: the public health challenge • Chapter 2: Clinical care for women undergoing abortion • Chapter 3: Putting services in place • Chapter 4: Legal and policy considerations

  8. Methods of abortion

  9. Up to 9 completed weeks since LMP 200 mg mifepristone followed 36-48hours by: 1.0mg vaginal gemeprost or 800 g vaginal misoprostolor 400 g oral misoprostol up to 7 completed weeks After 12 completed week since LMP 200 mg mifepristone followed after 36-48hours by: 1 mg vaginal gemeprost (repeated every 3 hours up to maximum of 4 doses) or 400 g misoprostol every 3 hours up to 5 doses or 800 g vaginal misoprostol followed by 400 g oral misoprostol every 3 hours up to a maximum of 4 doses Medical methods of abortion Mifepristone plus prostaglandin regimens

  10. WHO Safe abortion guidance (2003) • Available in English, Russian, French, Polish, Portuguese, Spanish (www.who.int/reproductivehealth/publications/-safe_abortion/safe_abortion.html) • Implementation: • Workshop – in combination with Strategic approach • IPPF EN + Ipas + WHO EURO • Strategic Approach of improvement of services – MDA (RUS, UKR, LVA, LIT) • Development of National guidelines

  11. The issue is co-published with the IPPF European Network

  12. European protocols for RH services for PLWHA (2006) • WHO Regional Office for Europe • Contraception • Termination of pregnancy • МАR • RTI

  13. Future development of policies and programmes • EUROPEAN Strategy for Child and Adolescent Health and Development – RC 2005 • A framework for implementing the WHO global RH strategy(in development) • STI Global strategy (in development – WHA 2006) • EUROPEAN Strategy for Improving Maternal and Perinatal Health(in development – RC 2006) • Assistance to the countries in development their national strategies and policies

  14. WHO guideline in FP/STI • 3rd ed. Medical Eligibility Criteria for Contraceptive Use(2004) –Russian translation (2005) • 2nd ed. Selected Practices Recommendations for Contraceptive Use (2005) - Russian translation (in print) • STI/RTI: a guide for essential practices (2005)–Russian translation (in print)

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