Safe abortion:

standard search strategies. Additionally, three systematic
reviews were conducted outside of the
Cochrane Database of Systematic Reviews and were
published in peer-reviewed journals (15–17). The
search strategies and the specific criteria for including
and excluding trials identified by the search are
provided in the corresponding systematic reviews.
The available evidence was appraised and graded
following the GRADE approach (18–22), reflecting the
priority comparisons and outcomes; comparisons
and outcomes not relevant to the recommendation
were excluded. As a result, evidence profiles
(GRADE tables) were prepared (available from
http://apps.who.int/iris/bitstream/10665/75840/1/
WHO_RHR_12.10_eng.pdf) - date accessed 14
February 2013. Standardized criteria for grading the
evidence using GRADE are presented in Annex 3.
For each selected comparison, data for available
priority outcomes have been assessed and presented
in the evidence profiles (if data for priority outcomes
were not available in specific comparisons, they were
omitted in the GRADE tables). Based on the evidence
profiles, recommendations were drafted by the WHO
Secretariat.
For Chapter 3 on establishing and strengthening safe
abortion services, two issues were identified (indicators
of safe abortion and competencies for providing
safe abortion) for which recent WHO guidance
was already available. Therefore, the steps taken to
address the topics in Chapter 3 were to adopt and
reference recent WHO guidance, and to conduct an
extensive literature review of the issues presented for
the existing recommendations from the first edition of
the document, while updating the references.
For Chapter 4 on legal and policy considerations,
WHO contracted the Programme on International
Reproductive and Sexual Health Law in the Faculty
of Law at the University of Toronto, Toronto, Canada,
to assist the revision, including proposing changes
to the existing content, based on international and
regional human rights treaty provisions and the work
of international and regional human rights bodies.
Staff at the programme also produced a series of
research briefs providing human rights and legal
research and analysis on selected issues of particular
concern (for example, elaboration of the health indication
for safe abortion, conscientious objection, and
legal and regulatory barriers).
In order to review the draft recommendations and
the supporting evidence, a technical consultation
was organized at WHO headquarters in Geneva,
Switzerland. The members of a guidelines development
group – a subset of the international panel that
participated in the initial online consultation and other
experts – were invited to participate in this consultation
(see Annex 4 for a list of participants and their
affiliations). Draft recommendations, revised chapters
and supporting documents were shared with the participants
before the consultation for their review.
Declarations of interest were obtained from the
participants in the technical consultation using a
standard WHO form prior to their participation in the
meeting. These declarations were reviewed by the
WHO Secretariat and, when necessary, by the WHO
Office of the Legal Counsel before the consultation.
Two consultation participants (Dr Laura Castleman
and Dr Helena von Hertzen) declared that they were
employed by organizations that have or might appear
to have commercial conflicts of interest. For recommendations
that were directly relevant to their organizations’
work, they left the room during final recommendation
making. No other participants declared
any conflicts or potential conflicts of interest.
Safe abortion: technical and policy guidance for health systems 11