Annotation:
This World Health Organization policy
brief assesses the safety and
acceptability of using mid-level health
care providers as an alternative to
doctors for the provision of safe first-
trimester abortion. This is considered as
a potentially cost effective solution for
countries aiming to increase access to
safe first-trimester abortion while also
preserving scarce health-care resources.
The brief reports on a study comparing the
safety of first-trimester abortion (manual
vacuum aspiration method) by type of
provider (nurses, midwives, mid-level
health-care providers, and doctors) in
South Africa and Vietnam. After
considering both the complications that
arise with each type of health care
provider, and the satisfaction patients
report with the quality of care they
received, the authors conclude that
countries seeking to expand safe abortion
services can consider training and
accrediting mid-level health care
providers for this purpose.