Impact Case Study: Understanding barriers to post-abortion care in humanitarian settings

Complications from miscarriage and unsafe abortions account for 8% of maternal deaths globally, with fragile settings like South Sudan facing significant barriers to lifesaving post-abortion care (PAC). This mixed-methods study, conducted between 2017–2020 by Columbia University and International Medical Corps, highlighted major barriers to PAC, including inadequate service provision, lack of training and stigma, while also revealing community support for PAC despite these challenges.

The study led to the implementation of revised PAC registers in South Sudan, improved training materials, contributed to attitudinal shifts among healthcare providers and raised awareness among the UK’s Foreign, Commonwealth, and Development Office (FCDO) advisers. While direct policy impact was limited, the study enhanced research skills, benefited over 200 trainee midwives and nurses, and influenced clinical practices benefitting up to 300,000 people, with international recognition driving further research.

R2HC captures detailed case studies through a process that triangulates and validates evidence on uptake and impact. The case study methodology and full version of this summary case study including references are available on request. Outputs and resources from this study are available on the project page.