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Integrating Post-Abortion Family Planning Services into China's existing abortion service in hospital settings

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Unintended pregnancies no more!

China is one of the countries with the highest number of abortions in the world. Considering the adverse physiological and psychological effects of multiple abortions, family planning services must be implemented.

Health

In China, the majority of induced abortions come as a result of contraceptive failure or the lack of contraception. The EU-funded INPAC (Integrating post-abortion family planning services into China's existing abortion service in hospital settings) project wished to reduce unwanted pregnancies and repeat abortions by introducing post-abortion family planning (PAFP) services in hospitals in China. European partners worked in close collaboration with the Chinese Society for Family Planning and the Chinese Medical Association to review current policies and develop new ones. The obtained information was utilised to conduct a detailed situation analysis, including a qualitative study and quantitative research, which provided great input into intervention design tailored to local conditions. A randomised controlled trial was performed with 90 hospitals from 30 provinces in China participating. These integrated PAFP into existing abortion services and offered relevant advice to over 17 000 women who were enrolled in the study. To ensure a successful monitoring process, the consortium implemented monitoring plans, PAFP training, a large-scale hospital sampling framework, and an electronic data capture system. Qualitative assessment of monitoring identified a number of facilitators and barriers to the implementation of PAFP interventions from the providers’ side. From a quantitative perspective, INPAC interventions demonstrated the capacity to reduce unintended pregnancy rates and repeat induced abortion rates. At the same time, these interventions improved contraception knowledge in women and increased the use of modern contraceptive methods. Considerable effort also went towards translating research findings into policy recommendations on health system organisation. Advice focused on amending the current reproductive health policies in China to enhance equitable access to reproductive healthcare and decrease long-term costs related to abortion. Overall, the INPAC project successfully demonstrated the efficacy of integrated PAFP advice in reducing unwanted pregnancies and abortions. Improving reproductive knowledge will also reduce sexually-transmitted diseases as well as HIV.

Keywords

China, abortion, contraception, INPAC, family planning

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