Chapter 3. Recommendations and best practice statements across the continuum of abortion care

Underlying principles and assumptions relating to recommendations on health worker roles (3.1.2)

Health workers are all people engaged in actions whose primary intent is to enhance health (100). This includes all categories of health workers listed and described in Annex 5, from community health workers all the way through to specialist medical practitioners (e.g. obstetricians and gynaecologists), and including traditional and complementary medicine professionals (i.e. non-allopathic physicians). Abortions can be done safely using tablets (medical abortion) or a simple outpatient procedure, such that most no longer require a specialist or even a general practice doctor. The recommendations presented in this guideline provide guidance on how to involve a wider range of health workers and pregnant individuals themselves in the provision or self-management of abortion care, to encourage optimization of the available health workforce, address health system shortages of specialized health-care professionals, reduce costs and improve affordability, improve equity and equality in access to health care and increase the acceptability of health services for those who need them.

The following principles and assumptions apply to all health workers:

  • The recommendations are appropriate for and intended for all resource settings, i.e. high-, middle- and low-resource settings.
  • The recommendations refer to a range of types of health workers who can safely, effectively and satisfactorily perform some or all of the specific abortion-related tasks mentioned. The options for who can perform the same task are intended to be inclusive and do not imply either a preference for or an exclusion of any particular type of health worker. The choice of health worker for a specific task will depend upon the needs, preferences and conditions of the individual, and the local context.
  • Training of health workers must ensure that they have the competencies to provide good-quality, gender-sensitive care in accordance with national standards and guidelines and human rights. Ensuring quality abortion care requires ongoing supervision, quality assurance, monitoring and evaluation, as well as access to the necessary equipment and commodities.
  • It is assumed that any health worker discussed in this guideline has the basic training required of that type of health worker (and in the case of individuals acting as their own provider – i.e. self-management – that they have the appropriate information and understanding). In addition, the recommendations all assume that health workers who are in a category that is recommended or suggested to perform specific tasks will have received the appropriate task-specific training and information prior to performing that task.