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Medical Abortion Self-Care: Tele-Abortion

Background

Abortion was made legal in Nepal on September 2002. Since March 2004, the Government of Nepal (GoN) has been providing comprehensive abortion care services. Safe
Abortion Service (SAS) up to 12 weeks with women’s consent has been listed in the basic health service package, 2075.[4] On 21st May 2020, the GoN endorsed Interim guidelines for Reproductive, Maternal, Newborn, and Child
Health (RMNCH) Services during the COVID-19 Pandemic.[5] which includes guidance on SAS such as:

  • Induced safe abortion and PAC services including post-abortion contraception will be provided as per the National protocol and strict Inter Personal Communication (IPC) and Personal Protective Equipment (PPE) guidelines.
  • Female Community Health Volunteers (FCHVs) will be mobilized to provide information and referral services for SAS including MA.
  • Trained health service providers from NGOs and the private sector can be mobilized to provide home-based MA services.

A cohort study conducted in England to analyze the effectiveness, safety and acceptability of no-test medical abortion provided via telemedicine and in-person service showed a success rate of MA provided through telemedicine was higher than in-person service (99.2% versus 98.1%).[6] The mean waiting period and mean gestational age at treatment were also lessened when the MA service was provided through telemedicine. The study also conveyed high (96% satisfied) acceptability of telemedicine and high (80%) future preference by the service receivers. [6]

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