Provision of Quality Services for Safe Abortion – Maternal Health Strategy

Government of West Bengal
Department of Health & Family welfare
State Family Welfare Bureau
Swasthya Bhavan, GN 29, Sector V,
Salt Lake, Kolkata 700091

No.: H/SFWB/21S-05-2013/2035(26) Dated: 03.12.2013

To
1-25) The Chief Medical Officer of Health, All Health Districts,
26) The DFWO, Kolkata

Subject: Provision of quality services for Safe Abortion.

You are aware that increasing access to and provision of quality service for Safe Abortion is part of Government of West Bengal’s maternal health strategy to reduce maternal mortality and morbidity in the state as unsafe abortion is still one of the leading causes of maternal mortality and morbidity.

To ensure provision of quality Safe Abortion Services throughout the state, a roadmap outlining the key steps to be taken for the same has been formulated as stated below. You are instructed to go through the contents of the roadmap and to implement the steps immediately,

Roadmap for provision of quality Comprehensive Abortion Care Services

1. State/ District Nodal Officer for safe abortion services:– ADHS (Maternal Health) in the state & DMCHO in the districts are responsible as nodal officer for the services.

2. District Level Committee for certification, regulation & monitoring of the services in public sector:– The CMOH of the districts are asked to constitute the District Level Committee for the same in the respective district as per provision laid in the MTP Act, 1971, MTP Rules, 2003 & MTP Regulation, 2003, as follows:

i) The CMOH of the district shall be the Chairperson of the committee,

ii) The Committee shall consist of not less than three and not more than five members including the chairperson

iii) One member of the committee shall be the Gynecologist/ Surgeon/ Anesthetist and other members from local medical profession, Non-Government Organization and Panchayeti Raj Institution of the district

iv) Provided that at least one of the members of the committee shall be a woman

v) Tenure of the Committee shall be for two calendar years and the tenure of the Non-government member shall not be more than two terms,

The CMOHs are asked to constitute the DLC within next 15 days and to intimate the state accordingly.

Constitution of DLC in districts should be followed by:-

i) Wide publicity on constitution of DLC and availability of Form A for application for approval of a place under clause (b) of Section 4 of MTP Act, 1971

ii) Ensure availability of Form A in sufficient quantities

iii) Verification of sites applied for and submission of report to DLC by verification team

iv) Approval of sites (if verification team is satisfied) in Form B

v) Conduct meeting with all licensed CE of the district providing Maternity services for dissemination of MTP ACT, Rule & Regulation and constitution of DLC

3. Inclusion of Medical abortion drugs in Essential Drug list: – MMA drugs [Tab Mifepristone, 200 mg (CAT No 35.13(A)/T & Tab Misoprostol, 200 mcg (CAT No 35.09 (A)/T & Tab Misoprostol, 100 mcg (CAT No 35.09 (B)/T)] have already included in CMS approved Drug catalogue of the state. The CMOH of the districts will ensure supply of the drugs to all health facilities of the district where services are being provided,

4. Training of Medical Officers in safe MTP technique:– Already 46 Specialist MO (G & Obs.) and 6 GDMO in the year 2011-12, 70 Specialist MO (G & Obs.) and 50 GDMO in the year 2012-13 and 7 Specialist MO (G & Obs.) and 13 GDMO in the year 2013-14 (total of 192 MOs) have been trained in safe MTP technique throughout the state with technical support and assistance from Ipas,

The CMOH of the districts will ensure that there is at least one CAC trained MO at each BPHC/ CHC/ RH of the district.

The CMOH of the districts are asked to supervise and monitor the performance of the trained MO regularly through District Nodal Officer for the same.

5. Post training mentoring of the service provider:– As per MOU signed between Dept of H & FW, Govt. of WB and Ipas to collaborate in increasing access to safe abortion care in the state including implementation of safe abortion component in RCH II project, which is valid from 1st January, 2012 to 31st December, 2014, Ipas will continue periodic tracking of the trainees and assess the extent of service provision, programme progress and evaluate the impact of the intervention. This organization is doing the same. The CMOH/ Nodal Officer of the district will keep close liaison with the organization and cooperate with the organization for carrying out the activities effectively. (Contact persons: Paramita Aich, State Programme Officer, Ipas, Mb no. 9334196224, Aveek Dey, Associate-Programm, West Bengal, Ipas, Mb no 9378143552)

6. Monthly reporting of progress of CAC services in standard format:– The CMOH will use District Monitoring Format (Monthly) for CAC services to monitor the programme in the district and submit the report to ADHS (Maternal Health) regularly (on monthly basis) by post & email (adhsmh@gmail.com).

The CMOH of the districts will instruct every head of the public facilities and owner of the approved private facilities to maintain a register in Form III as per regulation 5 of MTP Regulations, 2003 for recording therein the details of the admissions of women for termination of their pregnancies and to keep such register for a period of five years from the end of the calendar year it relates to.

The CMOH of the districts will share the “Comprehensive Abortion Care (CAC)- Training & Service Delivery Guideline”, which has been already sent to them through email, and this Roadmap with every head of the public and private facilities in the district.

An action taken report in this regard will be sent by the CMOH of the districts within one month from issuing of this letter to the undersigned.

Commissioner, Family Welfare & Secretary to
Govt. of West Bengal

No. H/SFWB-2035 dated 03.12.2013, Source