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Optimizing task-sharing in abortion care in Ghana: Stakeholder perspectives.

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Summary

Ghana expanded abortion care providers, but access remains difficult. Task-sharing, involving midwives, was implemented due to high maternal mortality from unsafe abortions, yet further expansion is needed.

Keywords:
AbortionGhanaMaternal mortalityMedical abortionMidwifeSurgical abortionTask-sharingTask-shiftingUnsafe abortion

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Area of Science:

  • Public Health
  • Reproductive Health
  • Healthcare Policy

Background:

  • Ghana faces challenges in accessing abortion care despite progress in provider expansion.
  • Unsafe abortion significantly contributes to maternal mortality in Ghana.
  • Task-sharing strategies are being explored to improve service delivery.

Purpose of the Study:

  • To explore stakeholder perspectives on task-sharing in abortion care in Ghana.
  • To identify opportunities for optimizing task-sharing to improve access to abortion services.

Main Methods:

  • Purposive sampling of 12 key informants from agencies involved in abortion care expansion.
  • Key informant interviews were audio-recorded, transcribed verbatim, and analyzed thematically.

Main Results:

  • Stakeholders cited high maternal mortality and advancements in medicine as drivers for task-sharing, including midwives.
  • The Ghana Health Service collaborated with NGOs to implement task-sharing.
  • Despite progress, access to abortion care remains poor, with provider stigma contributing to conscientious objection.

Conclusions:

  • Further task-sharing is recommended to include medical assistants, community health officers, and pharmacists.
  • Expanding the scope of practice can enhance women's access to safe abortion care.
  • Addressing provider stigma is crucial for effective task-sharing in abortion care.