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. 2024 May 17;20(Suppl 1):191.
doi: 10.1186/s12978-024-01791-4.

Strengthening regional commitment to ensuring access to medical abortion medicines in WHO's South-East Asia region: report of a participatory assessment and workshop

Meera Thapa Upadhyay  1 , Terence Fusire  2 , Ulrika Rehnström Loi  3 , Annik Sorhaindo  3 , Mohammed Salahuddin  4 , Mohammed Ayub Hossain  4 , Tashi Tshomo  5 , Erna Mulati  6 , Lovely Daisy  6 , Dian Putri Anggraweni  7 , Tumiur Gultom  8 , Fitri Indrawati  9 , Mariyam Jenyfa  10 , Myint Myint Than  11 , Bharat Bhattarai  12 , Loshan Moonasinghe  13 , Chaminda Mathota  13 , Anchalee Jitruknatee  14 , Celeste Cham  15 , Bela Ganatra  3 , Neena Raina  2
Affiliations

Strengthening regional commitment to ensuring access to medical abortion medicines in WHO's South-East Asia region: report of a participatory assessment and workshop

Meera Thapa Upadhyay et al. Reprod Health. .

Abstract

Background: In 2019, the World Health Organization identified improving access to safe abortion as an important priority toward improving sexual and reproductive health and rights and achieving Sustainable Development Goals. One strategy for addressing this priority is strengthening access to medicines for medical abortion. All 11 countries in the South-East Asia Region have some indications for legal abortion and permit post-abortion care. Therefore, strengthening access to medical abortion medicines is a reasonable strategy for improving access to safe abortion for the Region.

Methodology: We applied an adapted version of an existing World Health Organization landscape assessment protocol for the availability of medical abortion medicines at the country-level in the South-East Asia Region. We collected publicly available data on the existence of national health laws, policies, and standard treatment guidelines; inclusion of medical abortion medicines in the national essential medicines list; and marketing authorization status for medical abortion medicines for each country and verified by Ministries of health. The findings were once more presented, discussed and recommendations were formulated during regional technical consultation workshop. Each country teams participated in the process, and subsequently, the suggestions were validated by representatives from Ministries of Health..

Results: Few countries in the Region currently have national policies and guidelines for comprehensive safe abortion. However, either mifepristone-misoprostol in combination or misoprostol alone (for other indications) is included in national essential medicines lists in all countries except Indonesia and Sri Lanka. Few countries earmark specific public funds for procuring and distributing medical abortion commodities. In countries where abortion is legal, the private sector and NGOs support access to medical abortion information and medicines. Several countries only allow registered medical practitioners or specialists to administer medical abortion.

Conclusion: Following this rapid participatory assessment and technical consultation workshop, the World Health Organization South-East Asia Regional Technical Advisory and Sexual and Reproductive Health and Rights technical committee recommended priority actions for policy and advocacy, service delivery, and monitoring and evaluation, and indicated areas for support.

Keywords: Access model; Comprehensive abortion care; Medical abortion; Medical abortion medicines; National essential medical list; WHO South-East Asia Region.

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Conflict of interest statement

The views expressed in this article are those of the authors and do not necessarily represent the views of, and should not be attributed to, the World Health Organization. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted; the names of proprietary products are distinguished by initial capital letters.

Figures

Fig. 1
Fig. 1
Number of market authorized MA medicines in countries of the Southeast Asia Region. *Note: these are actual numbers. Legend: Misoprostol 100/200mcg (Blue colour in the graph). Mifepristone 200 mg (Green colour in the graph). Combi pack (Mifepristone 200 mg + Misoprostol 200mcg) (Yellow colour in the graph)
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