Incomplete abortion can be treated more safely and less expensively in Malawi

Incomplete abortion is one of the main causes of obstetric complications in Malawi. Surgical management with curettage is the most common treatment, despite WHO’s recommendation to use manual vacuum aspiration (MVA). Researchers are looking to see whether training health personnel in MVA can increase the use of this method.

Misoprostol is the most commonly used treatment for incomplete abortion, including in many African countries. This option has not previously been available in Malawi, however, due to conservative opposition. There is a fear that misoprostol could be deliberately used to induce abortion. Health facilities in Malawi are left with no other option than surgical treatment.

According to WHO, the preferred surgical treatment for incomplete abortion is manual vacuum aspiration (MVA), which can be done using local anaesthesia.

However, researchers have recently shown that MVA is used less frequently than dilatation and curettage (D&C). In fact, the use of MVA is actually decreasing at several Malawian health institutions that have been studied.[i] D&C has to be performed by a physician, requires general anaesthesia and entails greater risk of complications. It is also more expensive.[ii]

To try to reverse this trend, Maria Lisa Odland and her collaborators are training midwives, physicians and clinical officers in MVA at three different hospitals in Malawi. The purpose is to improve post-abortion care and maternal health outcomes. They are using a simple training module for MVA in low-resource settings which was developed by Ipas, and conducting qualitative interviews in order to find out more about the perceptions and attitudes of health personnel towards such training.

The ultimate goal is to provide constructive input to the Malawian Ministry of Health to determine whether implementation of a national training programme would be feasible in the future.

This is a shortened version of this article.

SOURCE + VISUAL: Health Canal