Medicinal Plants with Abortifacient Activity from Ayurvedic Medicine

   RoshniAgriBiotech                       India

Traditional medicinal plants and herbs used in Ayurvedic medicine have been used for many gynaecological disorders for thousands of years, but scientific evidence on their pharmacological properties is lacking. The ultimate objective of this project is to develop a pill from medicinal plants that are scientifically validated using modern biological approaches and cost effective for marginalized rural women. During the project period, the team will do a review of the literature to identify medicinal plants used in traditional Ayurvedic medicine with potential to induce abortions. The use of these plants as abortifacients will be further assessed by interviewing folk medicine practitioners, and a shortlist of the five most promising candidates will be investigated for their biological, pharmacological and chemical properties. Standardized extracts of these plants will be taken to generate chemical phenotypes and carry out detailed chemical fingerprinting using various chromatography techniques. Plants showing potential abortifacient properties will be further tested in laboratory animals.


Expanding access to mifepristone in humanitarian settings

   University of Ottawa                       Bangladesh, Jordan, and Niger

The project team will work to address the challenge of supplying mifepristone to women and girls in humanitarian settings. They will design, implement, and test strategies in Bangladesh, Niger and Jordan to supply service delivery agencies working with both urban- and camp-based refugee populations with mifepristone. Where needed, they will also work to fortify the misoprostol supply chain. Lessons learned from this diverse set of countries will be used to develop tools to facilitate supply chain management of mifepristone and misoprostol in other conflict-affected settings.


Opportunities and early access to abortion services in Profamilia, Colombia

  Asociación Pro-bienestar de la Familia Colombiana (Profamilia)                       Colombia

Women in Colombia, especially in areas affected by armed and drug trafficking conflict face significant barriers accessing safe abortion services. This innovation will use the International Planned Parenthood Federation’s (IPPF) social franchise toolkit to improve access to safe abortion care in conflict-affected Colombia, specifically Mitú and Inirida. This will include: (i) developing a quality-assured network of health care providers trained in medical abortion and manual vacuum aspiration, stigma reduction, and legal training; (ii) dissemination of information on safe abortion services amongst people in these communities; and (iii) community empowerment education activities.


At the Reach of Women

  Fundación Oriéntame                      Colombia

A telemedicine service, will be implemented and tested for women and girls in remote, rural areas to have access to sexual and reproductive health (SRH) services including safe and legal medical abortion up to 10 weeks of gestation. This will be facilitated by a registered nurse based in a countryside area of Colombia under the remote assistance of a physician from the Oriéntame Clinic. The nurse will use an information and communications technology platform to communicate with the physician, therefore meeting the local requirement that abortion medication be prescribed by a physician and overcoming the barrier of care being centralized in urban centres. In addition to medical abortion, the team will provide contraceptive counselling and screening for sexually transmitted infections.


CHOICE: Communicating to HER Options via Information, Care Coordination & Empathy

  DoctHERs                      Pakistan

CHOICE will provide personalized information and guidance around safe abortion services to underserved women, including female factory workers across rural and peri-urban village communities in Sind and Punjab, Pakistan. CHOICE will deploy trusted, up-skilled frontline care coordinators, who will use tablets with 4G internet connectivity to connect marginalized women and girls to a nationwide network of safe abortion providers and family planning services via HD video-consultation. The care coordinators refer women to a network of safe abortion clinics operated by established service providers.


Addressing barriers to young people access to MR/PAC services and De-stigmatizing Uterine Evacuation/Post Abortion Care (PAC)

  Rahnuma – Family Planning Association of Pakistan                     Pakistan

Young people in Pakistan face significant barriers and stigma when seeking uterine evacuation/post abortion care (PAC). This innovation will provide menstrual regulation and post-abortion care services to clients at five functional clinics based in semi-urban areas of Karachi and through monthly mobile camps. The clinics will provide safe uterine evacuation/post abortion care (PAC) services to women and girls, including pre- and post- counseling, medical and surgical uterine evacuation, treatment of complications, and post-abortion contraceptive services. Service providers at the clinics will be trained on value clarification and attitude transformation (VCAT) and de-stigmatization. In addition, the innovation will reduce stigma related to these services through active engagement of community members. Training workshops of youth peer educators will be held on VCAT and de-stigmatization. The trained youth peer educators will then organize sensitization sessions with local youth and sensitization sessions with community members.


Improving Access to Abortion in Georgia

  Center for Information and Counseling on Reproductive Health – Tanadgoma

In Georgia, 3 visits to a health facility are required to have an abortion: an initial consultation; a second visit after a minimum five-day waiting period for the abortion procedure or prescription of medical abortion pills; and a follow-up visit to confirm the abortion was successful. This creates unnecessary barriers for women seeking abortion, especially those living in rural areas. The team will address this challenge by implementing and testing a simplified one-visit service delivery model. Through this model, women only require one visit to a health facility for pregnancy diagnosis and counselling. Five days later, the health provider will distantly get confirmation from the patient, then mail medical abortion pills and two multi-level urine pregnancy tests to the patient, so that the medical abortion can be self-administered, and the success can be confirmed without an in-person assessment.


Teenage and Youth Refugee’s Abortion Care Project

  Rwanda Youth Organization for Development                     Rwanda

This innovation will provide friendly abortion care services for women and adolescents in five refugee camps in Rwanda. This will be facilitated through (i) focus groups on safe abortion, misoprostol, and contraceptive use; (ii) an android application, Menyapplication, to disseminate information on safe abortion and sexual and reproductive health and rights; (iii) a documentary film, that will be developed and shown in all 5 camps. One camp, assessed to have particularly high need, will receive monthly training on clinical management of abortion complications; and twenty public boxes for access to misoprostol and contraceptives will be established across all five camps.


Medical Abortions on Outreach

  Marie Stopes International                    India

In rural India, there is a huge gap in demand for abortion services and qualified providers. This is due to a lack of accessible, economical and safe abortion services in the public sector, coupled with lack of information and awareness on the subject. To bridge this gap, Foundation for Reproductive Health Services India will provide accessible, affordable and quality safe abortion services in Ajmer and Jaipur districts of Rajasthan. The services will be delivered through the Clinical Outreach Team (COT model) to reach the most underserved and vulnerable. The COT teams are operated by a team of surgeons, nurses and counsellors who are already trained and equipped to deliver safe abortion services. The teams working on this project are already offering safe abortion services in FRHS India clinics. Women who wish to terminate their pregnancy will be counselled and provided with a choice of safe abortion services and post-abortion contraception. We will not only reach the women who are ineligible for FP services due to on-going pregnancy, but also the women in the larger community who need these services, besides increasing the general awareness of the community regarding safe abortion. The project team, in collaboration with the Department of Health, will develop protocols for provision of safe abortion in outreach and equip two of the existing COTs for safe abortion service provision in public healthcare facilities. The team will also seek to improve accredited social health activists’ knowledge on abortion and provide tools to communicate effectively with women in their communities. Additionally, women in the community around Jaipur and Ajmer would benefit from the project as they will be reached with information of the services, their awareness on legality of abortion would also witness a substantial growth.


Medical abortion via telemedicine for women and adolescents in rural Moldova: breaking barriers with technology

  Reproductive Health Training Center                  Moldova

Women and girls in Moldova, especially those in rural areas, must travel to regional medical centres to obtain an abortion from a certified gynecologist. This creates barriers to accessing safe abortion that disproportionately affect poor women and girls, through loss of wages due to missed work and accrued costs due to transportation. This innovation is a novel service delivery model that allows self-management of medical abortion (MA) with remote guidance from a provider. After confirming their pregnancy, women seeking MA will receive counselling from an obstetrician/gynecologist via a videoconference and will subsequently obtain the necessary medication at a participating pharmacy. Follow-up will occur 1-2 weeks later via phone/videoconference (with referral to a doctor if necessary) to confirm MA success and assess the patient’s and provider’s satisfaction with the service. We hope to demonstrate the feasibility, effectiveness and acceptability of telemedicine MA services in Moldova so that it can thus be integrated into the national public healthcare system. As a result, this project will serve as a model that could be adapted and implemented in nearby countries within the Eastern Europe and Central Asia region