Spatial and socio-economic correlates of effective contraception among women seeking post-abortion care in healthcare facilities in Kenya

Abstract

Introduction Information, counseling, availability of contraceptives, and their adoption by post-abortion care (PAC) patients are central to the quality of PAC in healthcare facilities. Effective contraceptive adoption by these patients reduces the risks of unintended pregnancy and repeat abortion. Methods This study uses data from the Incidence and Magnitude of Unsafe Abortion Study of 2012 to assess the level and determinants of highly effective contraception among patients treated with complications from an unsafe abortion in healthcare facilities in Kenya. Highly effective contraception was defined as any method adopted by a PAC patient that reduces pregnancy rate by over 99%. Results Generally, contraceptive counseling was high among all PAC patients (90%). However, only 54% of them received a modern family planning method—45% a short-acting method and 9% a long-acting and permanent method. Adoption of highly effective contraception was determined by patient’s previous exposure to unintended pregnancies, induced abortion and modern family planning (FP). Facility level factors associated with the uptake of highly effective contraceptives included: facility ownership, availability of evacuation procedure room, whether the facility had a specialized obstetric-gynecologist, a facility that also had maternity services and the number of FP methods available for PAC patients. Discussion and conclusion For better adoption of highly effective FP, counseling of PAC patients requires an understanding of the patient’s past experience with contraception and their future fertility intentions and desires in order to meet their reproductive needs more specifically. Family planning integration with PAC can increase contraceptive uptake and improve the reproductive health of post-abortion care patients.

Facilitating Uptake of Post-abortion Contraception for Young People in Kenya

“…Eighty-five percent of SA and PAC clients served by the project accepted same-day contraception, with the vast majority—including 90% of clients aged 24 and under—receiving LARCs. This represents a departure from other research findings on post-abortion contraceptive uptake in low- and middle-income countries, including Kenya, where more clients received short-acting methods ( 32 – 34 ), and providers reported inadequate counseling time available to cover LARCs ( 35 ). Similarly, prior to the start of the CTG intervention, providers working in supported health facilities were hesitant to counsel on and administer LARCs to adolescent or youth clients.…”

Cross-sectional study to predict subnational levels of health workers’ knowledge about severe malaria treatment in Kenya

“…The spatially unstructured random variables ignore the geographical location of the analysis units by capturing the unobserved non-spatial heterogeneity. [44][45][46] The spatial maps provide subnational knowledge level estimates that can be used for focused interventions.…”

Post-abortion family planning use, method preference, and its determinant factors in Eastern Africa: a systematic review and meta-analysis

“…Regarding the study design, all studies were cross-sectional. Fifteen of the studies were from Ethiopia [15][16][17][18][28][29][30][31][32][33][34][35][36][37][38], five studies were from Kenya [20,[39][40][41][42], four studies were from Tanzania [43][44][45][46], and the rest five studies were from Malawi [47], Mozambique [48], Zimbabwe [49], Somalia [50], and Rwanda [51]. Regarding the quality scores, the quality score of each original study ranged from a low of six to a high of eight (Table 2).…”