title: Can nurses perform manual vacuum aspiration (MVA) as safely and effectively as physicians? Evidence from India.
abstract: BACKGROUND
  Although legal, access to safe abortion remains limited in India. Given positive experiences of task-shifting from other developing countries, there is a need to explore the feasibility of expanding the manual vacuum aspiration (MVA) provider base to include nurses in India.
  
  
  METHODS
  A prospective, two-sided equivalence study was undertaken in five facilities of a non-government organisation in Bihar and Jharkhand to explore whether efficacy and safety rates associated with MVA provided by newly trained nurses were equivalent to those provided by physicians. Eight hundred and ninety-seven consenting women with gestation ages of ≤ 10 weeks were recruited.
  
  
  RESULTS
  Nurses were as skilled as physicians in assessing gestation age and completed abortion status, performing MVA and obtaining patient compliance. Overall failure and complication rates were low and equivalent between the two provider types, and both provider types were equally acceptable to women who underwent the procedure (98%).
  
  
  CONCLUSIONS
  Findings of the study make a compelling case for amending existing laws to expand the MVA provider base in order to increase access to safe abortion in India.
authors.affiliation: Population Council, New Delhi, Zone 5A, India Habitat Centre, New Delhi-110003, India. sjejeebhoy@popcouncil.org
authors.forename: Shireen J
authors.initials: SJ
authors.lastname: Jejeebhoy
authors.forename: Shveta
authors.initials: S
authors.lastname: Kalyanwala
authors.forename: A J Francis
authors.initials: AJ
authors.lastname: Zavier
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Shuchita
authors.initials: S
authors.lastname: Mundle
authors.forename: Jaydeep
authors.initials: J
authors.lastname: Tank
authors.forename: Rajib
authors.initials: R
authors.lastname: Acharya
authors.forename: Nita
authors.initials: N
authors.lastname: Jha
mesh_terms: D000027:Abortion, Incomplete / Q000453:epidemiology; D000029:Abortion, Legal / Q000009:adverse effects* / Q000331:legislation & jurisprudence / Q000451:nursing* / Q000523:psychology; D000328:Adult; D000554:Ambulatory Care Facilities; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D059012:Lost to Follow-Up; D024802:Nurse's Role; D009938:Organizations; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D017060:Patient Satisfaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D014619:Vacuum Curettage / Q000009:adverse effects / Q000523:psychology