The extent of task-sharing implementation as a strategy to expand abortion services in Colombia

Abstract

Objective: To analyze the extent to which task-sharing to midlevel providers has been implemented as a strategy to increase access to abortion provision in Colombia, and examine the factors that have affected decentralization of services.

Methods: We conducted a case study based on the World Health Organization's 2015 guideline: Health Worker Roles in Providing Safe Abortion Care and Post-abortion Contraception. Documentation was collected on the standard and epidemiological landscape of abortion in Colombia, followed by semistructured discussions with groups and individual stakeholders.

Results: Task-sharing as a distinct policy to increase access to abortion services has not been implemented in Colombia. However, role distribution toward nonspecialist physicians has been used as a strategy to ensure access. Other professionals, such as nurses, have limited tasks in abortion care despite evidence to support a more expanded role.

Conclusion: The implementation of task-sharing as a strategy to increase access to safe abortion services in Colombia is influenced by a wide range of factors and, although it is not policy, nonspecialist and diverse healthcare professionals supervise abortion care. Knowing the evidence-based guidelines to safely and successfully include other healthcare professionals in abortion provision is a fundamental step in implementing this strategy.

Keywords: Abortion services; Accessibility; Colombia; Decentralization; Induced abortion; Primary healthcare; Task-sharing; Women's health services.