Nepal: Outpatient Second Trimester Medication Induction in Public Sector Facilities

A study evaluating the potential for outpatient second trimester (13-18 weeks) medication induction to limit inpatient care and overnight stays in public sector facilities highlights the efficiency of an outpatient model. The study documents areas where operational adjustments might facilitate even higher abortion completion during outpatient clinic hours. The evidence could help support a guidelines update in Nepal.

In this study, most of the 120 participants (82%) avoided hospitalization. Successful outpatient completion was lower than that observed (89.6%) in a similar study in private hospitals in the Kathmandu Valley where outpatient clinic hours were longer and more flexible. Among the participants who were admitted as inpatients, none presented clinical concerns or required specialized care. Acceptability was high. The two participating hospitals, both located beyond the Kathmandu Valley where accredited facilities are more dispersed, have since introduced the outpatient model into routine care to help reduce crowding in the maternity ward and strengthen the quality of care for all obstetrics and gynecology patients.

In October, we hosted an in-person meeting in New York to showcase the latest in medication abortion services, research, products, and policies. Returning after a three-year hiatus, the meeting opened with a round-robin of key updates from attendees and was followed by concurrent breakout meetings on five trending themes: integrating self-managed abortion into the abortion care ecosystem; digital strategies to support medication abortion; pathways to increasing abortion medication access; abortion needs in humanitarian, migration and conflict settings; and, patient-centered medication abortion. The final part of the program featured panel presentations delivered by expert speakers on the latest innovations in telemedicine provision for medication abortion, new regimens to ensure non-pregnancy, and legal issues affecting abortion access in the U.S. and Latin America. 

We extend gratitude to the 70+ physicians, researchers, health advocates, policymakers, pharmaceutical representatives, and donors representing some 40 domestic and global agencies for their high levels of engagement and important insights and thank them for making the event a success.

We accepted an invitation to take part in a regional consultation convened to help identify and prioritize evidence gaps related to sexual and reproductive health and rights in conflict, forced displacement, and humanitarian settings. Funded by Elrha and implemented by Avicena and the University of Geneva’s Centre of Humanitarian Studies, the resulting research agenda will inform and guide investments into future studies that support and accelerate changes in policy and practice. You can read more about the project here. 

Feasibility and Acceptability of Outpatient Medical Induction at 13-18 Weeks’ Gestation in Public Sector Hospitals in Nepal: A Prospective Cohort Study Tamang A, Dzuba IG, Tuladhar H, Raut BB, KC S, Shrestha A, Bracken H, Platais I, Winikoff B; Eur J Contracept Reprod Health Care; 2024 Oct 30:1-7. doi: 10.1080/13625187.2024.2416054 

Preferences for Induction of Labor Methods in India: A Qualitative Study of Views and Experiences of Women, Clinicians, and Researchers Hawker LA, Mundle S, Tripathy JP, Deshmukh P, Winikoff B, Weeks AD, Kingdon C, Lightly K; AJOG Glob Rep; 2024 Aug 17;4(4):100389. doi: 10.1016/j.xagr.2024.100389

Maximizing Impact: Our Plan of Action for 2025 to 2030 Gynuity Health Projects, 2024

We share our refreshed organizational strategy detailing the next steps we will be taking in our continued journey to strengthen reproductive and maternal health care access. The refresh builds on the accomplishments and key learnings from our 2018-2023 Strategic Plan and signals our intent to continue doing what we do best to advance choice, scientific understanding, and safe innovation. Developed following a process that involved staff, board members and external stakeholders, the end result takes stock of everyone’s input and ideas, conveys the priority areas of engagement on which the organization will focus over the next five years, and encapsulates what we need to do to accomplish what we want to do.  

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