Overcoming challenges to accessing quality post‐abortion care in humanitarian crises

Grant awarded: £490,286

Lead organisation: Mailman School of Public Health, Columbia University

Partnering organisations: International Medical Corps, UK

Project length: 2017 - 2019

Study locations: South Sudan and Afghanistan

Principal Investigator: Sara Casey


Unsafe abortion is a major cause of maternal mortality in humanitarian settings. Post-abortion care (PAC) is a life-saving intervention that includes treatment of complications of spontaneous and unsafe abortion, counselling to identify and respond to a woman’s health needs and the provision of contraception and other sexual and reproductive health (SRH) services. However, PAC services are only sporadically available in humanitarian settings. Furthermore, stigma and misconceptions about PAC and abortion among communities, health care providers and program staff inhibit women’s and girls’ access to and utilization of PAC services. Because of these challenges, little evidence exists on effective strategies for providing PAC in humanitarian settings.

This research seeks to understand the factors that influence access to, use and provision of PAC services in South Sudan and Afghanistan, and will provide guidance on how humanitarian actors can improve PAC programming in humanitarian settings.

Expected outcomes:

This research, along with findings from a similar study conducted in the Democratic Republic of the Congo, will help us better understand barriers and facilitators of access to and use of PAC services in humanitarian settings, enabling humanitarian actors to improve access to and quality of PAC programmes. The study will provide evidence from diverse settings with different cultures and religions, including demand-side barriers to service utilization and community perceptions of abortion that can be used to improve abortion-related programming guidance.

Findings from the mixed-methods study will be integrated into capacity building activities and service provision by IMC South Sudan and IMC Afghanistan, improving PAC services in the study sites.

Study findings will contribute to the limited evidence base and existing guidelines for PAC service provision in humanitarian crises


Elrha is a registered charity in England and Wales (1177110).

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