Comprehensive Abortion Care (CAC) in Assam

The Comprehensive Abortion Care is a project of the Government of Assam. It comes under the Family Welfare plan of the National Health Mission. The main objective of this project is to offer safe and high-quality services in relevance to maternal mortality, abortion, post abortion care, and so on. 

Backstory of the Comprehensive Abortion Care (CAC) Project 

Unsafe abortion has been one of the biggest reasons behind maternal mortality and it accounts to up to 8% of the maternal deaths. The abortion services provided are not up to the mark and that leads to the untimed maternal deaths as well. 

The main idea of the Comprehensive Abortion Care (CAC) project is to recognise the core of this problem and provide better abortion services in the health facilities under the public sector. 

Objective of the Comprehensive Abortion Care (CAC) Project 

The objectives of the Comprehensive Abortion Care project can be listed as follows: 

  • Offering high quality and safe services related to abortion and post-abortion. 
  • Offering high quality services in relation to family planning. 
  • Decentralisation of the services to make sure that they are closer to women. 
  • Provide personalised services to women belonging to different social backgrounds and individual requirements. 
  • Be affordable and acceptable for the women. 
  • Be sustainable to health systems. 
  • Work towards the reduction of unwanted pregnancies and abortions. 
  • Identify and serve the need of women with their respective reproduction and sexual health requirements. 
  • Addressing the needs of young women. 

State Initiatives on Comprehensive Abortion Care (CAC) project 

The initiatives of the state about the Comprehensive Abortion Care (CAC) project are as follows: 

  1. CAC Training Centre: 

    A total of 23 Training Centres have been set up to offer CAC training at district level. 

  2. Trainers’ training programme: 

    At present, a total of 88 Medical Officers (O & G) have been trained as Master Trainers. In 2018-19, a total of 10 Medical Officers (O & G) have also been trained as Master Trainers. 

  3. Training of Medical Officers (MO-MBBS):

    Total 547 Medical Officers have been trained as CAC service provider at district level. 114 Medical Officers trained during 2018-2019. 

  4.  Clinical Mentors:

    There are 7 identified medical officers who act as clinical mentors and provide the CAC trained providers with the necessary technical support as per requirement. 

  5. Orientation of Nursing Staff:

    A total of 361 nursing staff has been appointed with the task of providing assistance for offering CAC services. During the year 2018-19, a total of 114 nursing staff has been oriented for the same. 

  6. ASHA incentive:

    An amount of Rs.150 is given to ASHA in the form of incentive for accompanying clients to the public health facility for safe abortion services. 

  7. ASHA orientation:

    Regular orientation of ASHA on CAC and family planning including referral to the service delivery sites is organized. 

  8. District Level Committee:

    All 27 districts in Assam now have District Level Committee on CAC which is responsible for reviewing and strengthening the safe abortion services including the approval of private site for MTP services. 

  9. Post Abortion Family Planning Workshop:

    A District Level PAFP workshop is organised every year to help review and orient the service providers about the Post Abortion Family Planning services. 

  10. IEC Materials:

    For the betterment of the community and the facilities, a number of different IEC materials are developed on CAC services. 

  11. Post Abortion IUCD Incentives:

    For PAIUCD insertion; incentive of Rs. 300/- is given to beneficiary, Rs. 150/-to ASHA and Rs. 150/- is given to provider. 

  12. New initiative to strengthen post abortion contraceptive:

    An on-site orientation of IUCD Trained Providers is organised for a duration of 2 days which mainly focuses on the improvement of the provider’s knowledge as well as the techniques of insertion for PAIUCD, prevention of infection, FP counselling, waste management, record keeping, and so on. 

  13. Model CAC Centre: 

    In the state, Assam Medical College and Hospitals in Dibrugarh has been established as a Model CAC centre. The setup has been arranged for strengthening the CAC services. This leads to the improved quality of CAC training and CAC service provision. This is taken care of in regard to the standard norms of the CAC project. 

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