Task-sharing: Abortion care access expansion through training midwives and nurses to provide first trimester abortion in a sub-Saharan setting: A multicenter pre-post study.

Objectives: To determine the effect of training midwives and nurses on access to first trimester abortions and post-abortion family planning.

Methods: This was a pre-post study on first trimester abortion care and post-abortion contraceptive services expansion by training midwives and nurses(task-sharing) from 14 catchment health centers of St. Paul's Hospital Millennium Medical College (Ethiopia). The study period was January 2022 to August 2023. Data were collected by reviewing records of first trimester abortion and post-abortion family planning at the health centers. Data were analyzed using SPSS version 23. Simple descriptive statistics were employed to analyze the data. Proportions and frequencies were used to present the results.

Results: A total of 2690 first abortions were performed during the study period. The number of first trimester abortions provided jumped from 790 in the pre-intervention period to 1900 in the post-intervention period (a rise of 140%), of which 624 (32.8%) were surgical (manual vacuum aspiration) and the remaining 1276 (67.2%) were medication abortions. Similarly, post-abortion family planning uptake increased from 35.3% (279/790) during the preintervention period to 71.6% (1360/1900) in the post-intervention period, an increment of 36.3%.

Conclusions: Training midwives and nurses to provide first trimester abortion and post-abortion family planning had more than a doubling effect in expanding access to both first trimester abortion and post-abortion family planning.