The Bixby Center for Population, Health, and Sustainability
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Africa: Comprehensive Abortion Care and Post Abortion Care

Our research in safe abortion is designed to decrease abortion-related morbidity and mortality in conjunction with family planning to reduce unwanted pregnancy.

The Health Burden of Unsafe Abortion
One in 5 pregnancies worldwide end in abortion. Half of all abortions performed in developing countries are considered unsafe and can lead to severe health complications, including infection, infertility, and death. One in four women having an unsafe abortion are likely to face severe complications; hundreds of thousands of disabilities worldwide are attributed to unsafe abortion annually. The WHO estimates that 13% of all maternal deaths are due to unsafe abortion, meaning that more than 50,000 women die each year from this preventable cause.

The complications of unsafe abortion are not only perilous for women and their families, but also cause untold costs to health care systems.  Treating the complications that result from unsafe abortion costs Africa and Latin America a total of approximately $280 million each year.

Bixby Center’s Approach
The Bixby Center, Venture Strategies Innovations, and the Tigray Regional Health Bureau have worked together to reduce morbidity and mortality due to unsafe abortion in Tigray, Ethiopia though a pilot comprehensive abortion care (CAC) program.  This pilot program introduced a CAC strategy that sought to reduce risks to women’s health at all levels of the health care system – health post, health center, and hospital – at select health facilities in three zones of Tigray. The program also trained lower level providers at health posts to appropriately deliver uncomplicated abortion and post-abortion care while making referrals to higher levels of care for more complicated cases. At all levels of the system, high quality contraceptive counseling and on-site provision of a range of family planning choices are a priority.

The goal of the CAC program is to provide safe, high-quality services that are affordable and acceptable to women as close to their homes as possible, with the long-term goal of reducing the number of unplanned pregnancies and abortions. The services are designed to effectively reach the majority of women in need of care, by tailoring available services to the existing capacity of the health care system at various levels of care.

To view the final report on the CAC Program in Ethiopia, please click here.

Expanding to Other Countries

The success of the CAC project in Ethiopia has led the Bixby Center and Venture Strategies Innovations to partner with health systems in Angola, Mozambique, and Rwanda to implement similar programs. This work demonstrates the importance of delivering safe post-abortion care, making appropriate referral linkages within the health system, and offering family planning counseling and services, even in settings where abortion is illegal or highly restricted.

To view the final report on the PAC program in Mozambique, please click here.

To view a summary of the PAC program in Angola, please click here.

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  • Core Research
    • Global Population
    • Family Planning
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    • Safe Abortion
      • Africa: Comprehensive Abortion Care and Post Abortion Care
      • Rwanda Expanding Abortion Access: Scaling Up of the Operationalization of the Penal Code of 2012
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The Bixby Center for Population, Health, and Sustainability is dedicated to helping achieve slower population growth within a human right framework by addressing the unmet need for family planning. Learn more

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