Article type
Abstract
Background: The World Health Organization (WHO) Abortion Care Guideline (2022) is an updated consolidated guideline that replaces all the previous WHO guidelines on abortion care. This updated guideline reflects recent evidence on clinical management, service delivery, and law and policy related to abortion care. In particular, the service delivery recommendations focused on the health worker types who can provide interventions related to comprehensive abortion care. However, there is limited published literature on many of the health worker types in performing an abortion care intervention.
Objectives: To incorporate the competencies framework into the evidence-to-decision framework to facilitate the recommendation formulation for each health worker.
Methods: The WHO guideline development process was followed, and for all health worker recommendations, given the limited evidence for many of the health worker–task combinations, the discussions of the expert panel focused on the competency framework in WHO’s 2011 publication, Sexual and reproductive health (SRH): core competencies in primary care, which provides information on the competencies (including skills and knowledge) required for each task, and also the WHO-INTEGRATE criteria, in particular on the feasibility, equity, and acceptability of the intervention and women’s values and preferences. An additional criterion to the WHO-INTEGRATE was featured by using this SRH competency framework as a basis.
Results: An adapted competency framework resulted from the recommendation formulation discussions with the expert panel. For most of the clinical interventions, the recommendations resulted in an expansion of health workers who can provide their respective clinical service. This means that a wider range of providers are now included in the recommendations—sometimes introduced in the recommendation for the first time or, in other cases, upgraded from being a weaker recommendation (indicated by “suggest”) to a stronger recommendation (indicated by the word “recommend”).
Conclusions: This systematic approach using the required competencies resulted in an expansion of which abortion services different types of health workers can provide. This in turn increases access to quality comprehensive abortion care.
Objectives: To incorporate the competencies framework into the evidence-to-decision framework to facilitate the recommendation formulation for each health worker.
Methods: The WHO guideline development process was followed, and for all health worker recommendations, given the limited evidence for many of the health worker–task combinations, the discussions of the expert panel focused on the competency framework in WHO’s 2011 publication, Sexual and reproductive health (SRH): core competencies in primary care, which provides information on the competencies (including skills and knowledge) required for each task, and also the WHO-INTEGRATE criteria, in particular on the feasibility, equity, and acceptability of the intervention and women’s values and preferences. An additional criterion to the WHO-INTEGRATE was featured by using this SRH competency framework as a basis.
Results: An adapted competency framework resulted from the recommendation formulation discussions with the expert panel. For most of the clinical interventions, the recommendations resulted in an expansion of health workers who can provide their respective clinical service. This means that a wider range of providers are now included in the recommendations—sometimes introduced in the recommendation for the first time or, in other cases, upgraded from being a weaker recommendation (indicated by “suggest”) to a stronger recommendation (indicated by the word “recommend”).
Conclusions: This systematic approach using the required competencies resulted in an expansion of which abortion services different types of health workers can provide. This in turn increases access to quality comprehensive abortion care.