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Safe abortion care at MSF | Collections | MSF Science Portal

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.


To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

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TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis
TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.
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Costs, cost-effectiveness, and financing of tuberculosis trea...

Tuberculosis (TB) is the world's deadliest infectious disease, and the leading killer of people with HIV. TB is curable, but it can be difficult to diagnose and tough to treat, especially for increasingly prevalent drug-resistant TB. In 2023, 22,700 people started TB treatment in MSF programs. Understanding the costs and cost-effectiveness associated with TB treatment and innovations, ranging from TB diagnostics and medications to TB care models, can help to plan resource needs and allocate resources effectively. Analyzing financing mechanisms can support developing sustainable funding models for TB control.

This collection spotlights articles by MSF and collaborators to analyze and document the costs of care, particularly diagnostics and medications.

Power & communities (MSF Scientific Days International 2022)
Power & communities (MSF Scientific Days International 2022)
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Journal Article
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Research

Self-managed abortion as a humanitarian revolution: Accounts of a telehealth pilot in the Middle East

Lasserre L, Staderini N, Hasan M, Rossi V
2025-02-11 • Conflict and Health
2025-02-11 • Conflict and Health

BACKGROUND

Access to safe abortion care (SAC) should be improved in fragile and humanitarian settings, and the implementation of interventions in that regard ar...

Journal Article
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Research

Assessing post-abortion care using the WHO quality of care framework for maternal and newborn health: a cross-sectional study in two African hospitals in humanitarian settings

Pasquier E, Owolabi OO, Powell B, Fetters T, Ngbale R,  et al.
2024-08-05 • Reproductive Health
2024-08-05 • Reproductive Health

BACKGROUND

Abortion-related complications remain a main cause of maternal mortality. There is little evidence on the availability and quality of post-abortion c...

Journal Article
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Research

Reasons for delay in reaching healthcare with severe abortion-related morbidities: Qualitative results from women in the fragile context of Jigawa state, Nigeria (AMoCo)

Moore AM, Fetters T, Williams T, Pasquier E, Kantiok J,  et al.
2023-12-01 • SSM - Qualitative Research in Health
2023-12-01 • SSM - Qualitative Research in Health
Maternal near-miss events are a key measure of maternal health; abortion-related complications are one source of near-miss events. To understand the pathway to care of women with severe ...
Technical Report
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Evidence Brief

The magnitude and severity of abortion-related complications: Referral Hospital in Jigawa State, a fragile setting - Results of the AMoCo study

Fotheringham C, Moore AM, Owolabi OO, Fetters T, Chen H,  et al.
2023-08-01
2023-08-01

A dearth of evidence on abortion complications in fragile settings limits the understanding of women’s needs in access to comprehensive abortion care in contexts like Jigawa state. Th...

Journal Article
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Pre-Print

Lessons learned conducting abortion research in fragile contexts: Reflections from a mixed methods study in Africa (the AMoCo study)

Moore AM, Pasquier E, Williams TN, Fetters T, Powell B,  et al.
2023-03-20 • Research Square
2023-03-20 • Research Square
BACKGROUND
Conducting abortion research in fragile settings presents challenges, many of which are present in other low-resourced settings to various degrees but when appearing all t...
Journal Article
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Research

High severity of abortion complications in fragile and conflict-affected settings: a cross-sectional study in two referral hospitals in sub-Saharan Africa (AMoCo study)

Pasquier E, Owolabi OO, Fetters T, Ngbale RN, Adame Gbanzi MC,  et al.
2023-03-04 • BMC Pregnancy and Childbirth
2023-03-04 • BMC Pregnancy and Childbirth
BACKGROUND
Abortion-related complications are one of the five main causes of maternal mortality. However, research about abortion is very limited in fragile and conflict-affected set...
Journal Article
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Research

Catalyst for change: Lessons learned from overcoming barriers to providing safe abortion care in Médecins Sans Frontières projects

Kumar M, Schulte-Hillen C, De Plecker E, Van Haver A, Marques SG,  et al.
2022-10-23 • Perspectives on Sexual and Reproductive Health
2022-10-23 • Perspectives on Sexual and Reproductive Health
CONTEXT
Despite instituting a policy in 2004, Médecins Sans Frontières (MSF) continuously struggled to routinely provide safe abortion care (SAC). In 2016, the organization launched ...
Conference Material
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Poster

Provision of safe abortion care: a multicentre descriptive mixed-methods analysis, MSF OCB 2018-2020

Van Haver A, Lagrou D, Van der Bergh R, Lynen M, Vaquero M,  et al.
2021-05-18 • MSF Scientific Days International 2021: Research
2021-05-18 • MSF Scientific Days International 2021: Research
Journal Article
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Commentary

Now is the time: a call for increased access to contraception and safe abortion care during the COVID-19 pandemic

Kumar M, Daly M, de Plecker E, Jamet C, McRae M,  et al.
2020-07-20 • BMJ Global Health
2020-07-20 • BMJ Global Health
SUMMARY BOX

• The COVID-19 pandemic has begun to severely limit access to sexual and reproductive healthcare, including contraception and safe abortion care (SAC), which have h...
Conference Material
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Video

Overcoming barriers to provision of safe abortion care in MSF projects: Task Force approach

Kumar M
2019-05-10 • MSF Scientific Days International 2019
2019-05-10 • MSF Scientific Days International 2019
Journal Article
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Letter

Why Médecins Sans Frontières (MSF) provides safe abortion care and what that involves

Schulte-Hillen C, Staderini N, Saint-Sauveur JF
2016-09-21 • Conflict and Health
2016-09-21 • Conflict and Health
MSF responds to needs for the termination of pregnancy, including on request (TPR); it is part of the organization's work aimed at reducing maternal mortality and suffering; and preventi...
Safe abortion care at MSF

Safe abortion care at MSF