MAX (Maximizing Healthcare Provider Performance) supports practitioners in Kenya and South Africa to provide high-quality abortion services and long-acting reversible contraception (LARC) immediately after abortion.
Although abortion is legal in Kenya and South Africa, high rates of unsafe abortion continue to contribute to life-threatening complications (e.g. uterine perforation, hemorrhage, and sepsis) as well as maternal mortality among women in these contexts. To help address this issue, in June 2012, WomanCare Global began the MAX program (Maximizing Healthcare Provider Performance) that supports practitioners to provide high-quality abortion services and long-acting reversible contraception (LARC) immediately after abortion. The MAX program model utilizes trained representatives who support providers by sharing scientific information, convening local providers with one outstanding provider who provides high-volume abortion care and LARC, supporting provider attendance at conferences which focus on LARC, organizing meetings with district hospitals and providers, and organizing one-to-one training for insertion of contraceptive implants and IUDs.
This project involves UCSD collaboration with WomanCare Global in the evaluation of WomanCare Global’s MAX abortion provider follow-up program. MAX representatives collect data on all abortion procedures provided by practitioners (n=300), including information on the patient’s age, parity, educational level, gestational age, type of procedure, and type of contraception if provided. Data collected also include qualitative data from the MAX field representatives about barriers and successes experienced in supporting healthcare professionals.
The evaluation of the MAX program involves: 1) assessment of change over time on primary outcome variables (caseload of abortions, provision of contraceptive methods at follow-up), 2) determination of whether these outcomes vary by service site/provider factors (e.g. type of service site, training of provider), 3) analysis of the impact of component variables on the primary outcomes, and 4) exploratory analysis to understand barriers to providers’ service provision and, if possible, to determine which interventions have the most impact to reduce or eliminate barriers.