Task-sharing in menstrual regulation services: Implementation efforts and lessons learned in Bangladesh.

Abstract

ObjectiveTo explore the strategies undertaken to decentralize menstrual regulation services and implement task‐sharing, including barriers and facilitators, with nonphysician providers in Bangladesh.MethodsWe conducted a desk review of relevant policies and health service information from grey and published literature on task‐sharing in menstrual regulation services, plus stakeholder interviews with 19 representatives of relevant health organizations to investigate facilitators for and barriers to the implementation of task‐sharing of these services.ResultsTask‐sharing in menstrual regulation began in 1979 as part of the national family planning program. The Ministry of Health and Family Welfare has guidelines for menstrual regulation services provided by a wide range of healthcare workers using manual vacuum aspiration and the medications misoprostol and mifepristone. Despite government approval, implementation of task‐sharing is challenging owing to lack of skilled providers, lack of facility readiness, and unmet need for family planning.ConclusionThe government needs to implement effective planning for skills building of nonphysician providers and ensuring facility readiness for provision of menstrual regulation services to reduce unsafe abortion in Bangladesh.