Does NGO In-Service Training Explain Abortion Method Mix in Brazil?

Emily Keyes, University of North Carolina at Chapel Hill
Ellen M.H. Mitchell, Ipas

Objective: To determine the extent to which in-service clinical training of medical professionals increases the use of vacuum aspiration (VA) in post-abortion care (PAC) in Brazilian in-patient facilities. Background: VA is preferred to dilation and curettage (D&C) and has been a reimbursable PAC procedure since November 2001. Despite thirteen years of clinical training in VA, the proportion of VA to all uterine evacuations in Brazil remains very low in almost all states. Methods: The preliminary study uses exploratory and graphical analyses to relate national and state-level VA proportions with number of trained providers from November 2001 until December 2005. Future analyses using a mixed-model matched control analysis will help identify the effect of training on the proportion of uterine evacuations using VA. Expected Results: Clinical training appears to explain some increases in VA proportion but the relationship is not strong and likely varies with health and social system characteristics.