IPAS Indonesia organized a capacity building activity for master trainers for comprehensive and women-centered Post Abortion Care (PAC) training. The event was held on October 11-13, 2022 at Artotel Suites Bianti Yogyakarta in collaboration with the Faculty of Medicine and Public Health (FKKM) of Gajah Mada University (UGM).
The availability and capacity of qualified health workers, obstetricians and gynecologists, general practitioners, and midwives, is an important aspect to expand community access to PAC services. Therefore, IPAS Indonesia in collaboration with FKKM UGM provides strengthening and capacity building of comprehensive and women-centered PAC training master trainers.
This training activity aims to improve the skills (capacity) of master trainers in facilitating PAC training of trainers. This training is also expected to strengthen the skills (capacity) of master trainers in developing comprehensive PAC clinical training curriculum/agenda and curriculum both face-to-face and online (online) or a combination of offline and online.
The main facilitators of this activity are Prof. Alison Edelman from Oregon Health and Science University (OHSU) USA and Nadia Piedrahita. The two main facilitators will be assisted by master trainers from FKKM UGM.
IPAS Indonesia Foundation is committed to supporting the implementation of PAC services. It is known that Indonesia is still faced with reproductive health problems characterized by the high maternal mortality rate of 305 per 100,000 live births (SUPAS, 2015).
Based on the analysis of the determinants of maternal mortality conducted in 2012 by the Health Research and Development Agency of the Ministry of Health, it is known that 4% of maternal death cases occur in pregnancies less than 20 weeks caused by abortion / miscarriage. Therefore, it is important for every health worker, especially doctors and midwives, to understand and be able to provide PAC services according to standards, based on their competence and authority.
Although miscarriage is a very common condition among pregnant women, PAC services in Indonesia are still not optimally organized. PAC services often still focus only on medical management of miscarriage. Other aspects such as psychosocial support through counseling, post-miscarriage contraceptive services, and referrals to other needed services are still not common. The 2010 Riskesdas report states that safer methods of evacuating the remains of conception such as medication (14.3%) or vacuum aspiration (2.4%) were used less frequently than curettage (57.4%).
Research conducted by the Guttmacher Institute in Java in 2017 found that only 2% of health centers that had been trained and were PONED capable provided post-miscarriage care services. These services should have been included in the PONED training guidelines and curriculum for health centers.
Meanwhile, miscarriage management using vacuum aspiration, which is safer than curettage, was only available in 65% of health facilities, and contraceptive counseling was only provided in 68% of health facilities. The main barriers to service delivery include a lack of trained health workers, lack of tools and equipment, and limited availability of needed medicines.
Since the issuance of the Minister of Health Regulation No. 21 of 2021 concerning the Implementation of Health Services for the Pre-Pregnancy Period, Pregnancy, Childbirth and Postpartum Period, Contraceptive Services, and Sexual Health Services, as well as the launch of the PAC National Guidelines document as a derivative of the policy in the same year, IPAS Indonesia has always supported its implementation. One of them is by providing strengthening and capacity building for PAC training master trainers. (*)
