Unsafe abortions kill thousands of women in the Democratic Republic of Congo (DRC) each year. In legally restricted countries like the DRC, access to midwife-led post-abortion care (PAC) is recommended by global health authorities as an innovative solution to effectively manage arising complications. Recently, the Association of Congolese Midwives trained three-hundred members in the use of manual vacuum aspiration, the life-saving component to PAC. The literature points to numerous barriers when integrating competencies to practice, yet anecdotally, some trained Congolese midwives have found feasible solutions to practicing manual vacuum aspiration within challenging environments. The chosen research approach, positive deviance (PV), assumes that (1) midwives, or positive deviants, have departed from local norms by adapting their practice to include manual vacuum aspiration and play a critical role in fostering change, and (2) their experiences and strategies can be drawn upon to propose an applicable initiative to increase the rates of integration. The mixed methods design contains: (1) a descriptive survey to determine the variations of post training integration of midwife-led manual vacuum aspiration; and (2) a case-control study analysis of a sample of midwives performing manual vacuum aspiration (positive deviant cases) and a sample of normative ‘controls’ to understand what factors enable the cases to adopt change and how these factors differ amongst controls. In collaboration with Association of Congolese Midwives, this research will be used to draft an intervention aiming to increase the rate of midwife-led manual vacuum aspiration, especially in remote and war-torn provinces in the DRC. Strengthening the capacity of the Association to integrate manual vacuum aspiration, a global midwifery standard of care, will potentially accelerate the diffusion of this life-saving skill.

La Formation Continue de la Sage-Femme et L’intégration de la Prise en Charge de L’aspiration
Manuelle Intra-Utérine (AMIU) pour les Soins Post-Avortements: République Démocratique du Congo

La Formation Continue de la Sage-Femme et L’intégration de la Prise en Charge de L’aspiration Manuelle Intra-Utérine (AMIU) pour les Soins Post-Avortements: République Démocratique du Congo