Federation of Obstetric and Gynaecological Societies of India, Mumbai, India.
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Int J Gynaecol Obstet. 2024 Feb;164 Suppl 1:42-50. doi: 10.1002/ijgo.15335.
In a historic move to ensure comprehensive abortion care, India amended the 1971 Medical Termination of Pregnancy (MTP) Act in 2021, creating an unprecedented opportunity for accelerating safe, respectful, and rights-based abortion services. The Federation of Obstetric and Gynecological Societies of India (FOGSI), together with World Health Organization (WHO) India and the Ministry of Health and Family Welfare, set up a flagship initiative "Respectful Abortion Care" (RAC) to provide training to obstetricians and gynecologists on the new Act, and also address their values and biases.
Virtual training sessions were organized during the COVID-19 pandemic to disseminate the amendments made under the MTP Act and address provider values and biases. The primary focus was on private providers as they account for more than half of all abortion services in India (52.9%). The RAC modules were systematically designed and delivered by 690 Master Trainers, trained by FOGSI and WHO.
A total of 9051 FOGSI members (22%, with 50% from private clinics) completed the RAC trainings. Pretests and post-tests were conducted for impact assessment. Significant improvement was seen on knowledge of criteria for termination of pregnancy for significant birth defects (52%-83%). The post-training survey showed a high level of commitment to promote RAC: >95% were strongly motivated to perform or assist in abortion; 89% reported that the WHO value clarification exercises were helpful in facilitating open discussions on sensitive topics in a comfortable manner; 96% expressed a strong commitment to addressing the issue of respect and confidentiality in abortion care.
RAC was a unique initiative around the MTP Act amendment 2021 in India, which demonstrated that collaboration and leadership by professional associations can help motivate providers and lead to improved knowledge and commitment from public and private sector providers.
为确保全面的堕胎护理，印度于 2021 年修订了 1971 年的《终止妊娠医疗办法》，为加速安全、尊重和基于权利的堕胎服务创造了前所未有的机会。印度妇产科学会联合会（FOGSI）与世界卫生组织（WHO）印度分部和卫生与家庭福利部一起发起了一项旗舰倡议“尊重的堕胎护理”（RAC），为妇产科医生提供关于新法案的培训，并解决他们的价值观和偏见问题。
在 COVID-19 大流行期间，组织了虚拟培训课程，传播《终止妊娠医疗办法》修正案，并解决提供者的价值观和偏见问题。主要重点是私人提供者，因为他们占印度所有堕胎服务的一半以上（52.9%）。RAC 模块由 FOGSI 和 WHO 培训的 690 名主培训师系统地设计和交付。
共有 9051 名 FOGSI 成员（22%，其中 50%来自私人诊所）完成了 RAC 培训。进行了前测和后测以评估影响。终止妊娠的标准知识显著提高，重大出生缺陷的比例从 52%提高到 83%。培训后调查显示，促进 RAC 的承诺很高：超过 95%的人强烈有动力进行或协助堕胎；89%的人报告称，世界卫生组织的价值观澄清练习有助于以舒适的方式就敏感话题进行公开讨论；96%的人表示强烈承诺在堕胎护理中解决尊重和保密问题。
RAC 是印度围绕 2021 年《终止妊娠医疗办法》修正案的一项独特倡议，表明专业协会的合作和领导可以帮助激励提供者，并导致公共和私营部门提供者的知识和承诺得到提高。
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