Quality of post-abortion care in public health facilities in Ethiopia

Abstract

Background: Comprehensive quality Post Abortion Care (PAC) is one of the important strategies to save lives where access to safe abortion is restricted by Law and services are inaccessible. Objective: The objective of the study was to assess the status of quality of PAC in health facilities of Amhara and Oromiya regional states. Methods: The study was cross-sectional by design and was conducted from November 2002 to March 2003. Patient interview, provider interview and direct service delivery observation were utilized to capture different aspects of care. Eleven health facilities (five in Oromiya and six in Amhara Regions), 103 post-abortion patients and 87 health service providers were included in the study. Results: although facilities were found to be prepared to manage abortion complications, some patients were delayed from receiving services because of requirement to pay before getting services, and to buy drugs and supplies from other sources. Patient-provider interaction was generally satisfactory as viewed by the respondents. Majority (88.3%) of patients felt that PAC services maintained confidentiality. Patients were not informed about the steps of each procedure. Nearly two-third of service providers informed the patients about the cause of their problem, but only 50.5% of them told the outcome of treatment. Information provision regarding important precautions and warning signs was uniformly very low in all study facilities. Only 53.4% of patients left the facilities counseled about family planning and 44.7% with contraceptives. But, 84.5% of women do not plan pregnancy within three months following the abortion. Great majority of the patients responded that they were satisfied with services they have obtained. Dissatisfaction included maltreatment by service providers, and inconvenient setup of service delivery. Patient assessment was principally based on last menstrual period and bimanual pelvic examination in most of the facilities. Service providers do not usually stick to infection prevention and universal precautions. Conclusion: the study has shown areas of improvement for better services to respond to various needs of the postabortion patients.

Assessment of Quality and Determinant Factors of Post-Abortion Care in Governmental Hospitals of Tigray, Ethiopia, 2013

“…Meanwhile, most of them except one provider did not wear goggles and protecting boots. This finding goes in agreement with studies conducted in other part of the country [14]. This could be due to negligence and partially due to lack of some facilities like water and functioning sink.…”

“…It is encouraging that the current study finding showed that range for waiting time to get the actual treatment was found to be 1 hour to one full day where as findings in other studies showed that the waiting time to be 1-7 days [15]. However, it is disheartening that finding of this study indicated that client satisfaction on PAC service delivery was lower as compared to previous studies done in the country where the majority (79.6% ) expressed their satisfaction with the services they received [14].…”

“…The approach included emergency treatment of incomplete abortion and its complications, family planning counseling and services, and linking the emergency treatment along with other reproductive health services. Recently, the post-abortion care consortium developed an expanded and updated model which includes two more elements, i.e., providing appropriate counseling based on individual needs and community-provider partnership in prevention of unsafe abortion and care [14]. Ethiopian Parliament passed one of Africa's most progressive abortion laws.…”

“…Besides, Posters containing different messages on STI (sexually transmitted infections), HIV/AIDS, PAC, and family planning should be posted at visible places. Provision of such materials is equally important as other component of care as they contain important lifesaving information [14]. However, data obtained through observation indicated that IEC materials were available only in two of the health facilities despite of their proper use.…”

Utilization of post-abortion care services in three regional states of Ethiopia

“…Problems related to abortion were neglected and access to quality post-abortion care was very limited (4,5,6,7). Complications resulting from unsafe abortion are major public health problem in the country which affects all women in reproductive age.…”