Barriers and facilitators in the provision of post-abortion care at district level in central Uganda – a qualitative study focusing on task sharing between physicians and midwives

Abstract Background In China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young womenhave limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing it’s uptake among adolescents and young women in Guangzhou, China. Methods A cross-sectional study was performed from 1st March 2020 to 30th September 2020 using anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services. Results The magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized. Conclusions The study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged sub-groups of women in the study setting.

Download Full-text

MEETING THE NEEDS OF ADOLESCENT POST-ABORTION CARE PATIENTS IN THE DOMINICAN REPUBLIC

Journal of Biosocial Science ◽

10.1017/s0021932010000015 ◽

2010 ◽

Vol 42 (4) ◽

pp. 493-509 ◽

Cited By ~ 7

Author(s):

DONNA R. McCARRAHER ◽

MARIO CHEN-MOK ◽

ANA SOPHIA ORONOZ ◽

SONIA BRITO-ANDERSON ◽

THOMAS GREY ◽

...

Keyword(s):

Dominican Republic ◽

Older Women ◽

Contraceptive Method ◽

Public Hospitals ◽

Time Of Arrival ◽

Abortion Care ◽

Post Abortion Care ◽

Provider Knowledge ◽

Post Abortion ◽

Counselling Intervention

SummaryCounselling on contraception and contraceptive method provision are key components of post-abortion care (PAC). Some studies have suggested that adolescent PAC patients receive worse care than older women seeking these services. This study aimed to evaluate an intervention whose goal was to improve the counselling and contraceptive uptake of PAC patients, with special attention given to the needs of adolescent patients, in the four public hospitals in the Dominican Republic where PAC services were not being routinely offered. The counselling intervention effort included provider training and the development of adolescent-friendly information, education and communication (IEC) materials. Eighty-eight providers were interviewed at baseline and 6 months after the intervention was implemented. Six months after providers were trained, 140 adolescent PAC patients (≤19 years of age) and 134 older PAC patients (20–35 years) were interviewed about the contraceptive counselling messages and contraceptive methods they received before they were discharged from hospital. The adolescent and older PAC patients were matched on study hospital and time of arrival. Significant improvements were noted in provider knowledge and attitudes. No changes were noted in provider-reported PAC counselling behaviours, with close to 70% of providers reporting they routinely assess patients' fertility intentions, discuss contraception, assess STI/HIV risk and discuss post-abortion complications. Adolescent and older PAC patients reported receiving PAC counselling messages at similar rates. Forty per cent of adolescent PAC patients and 45% of older PAC patients who wanted to delay pregnancy were discharged with a contraceptive method. Adolescents were more likely to receive an injectable contraceptive method whereas older women were discharged with a variety of methods. The PAC counselling intervention increased provider knowledge and improved their attitudes and benefited both adolescent and older patients.

Download Full-text

Clinical issues in post-abortion care

The Nurse Practitioner ◽

10.1097/01.npr.0000396475.68812.06 ◽

2011 ◽

Vol 36 (5) ◽

pp. 35-40 ◽

Cited By ~ 3

Author(s):

Joyce D. Cappiello ◽

Margaret W. Beal ◽

Katherine E. Simmonds

Keyword(s):

Clinical Issues ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion

Download Full-text

Improving post-abortion care in a public hospital in Oaxaca, Mexico

Reproductive Health Matters ◽

10.1016/s0968-8080(97)90002-1 ◽

1997 ◽

Vol 5 (9) ◽

pp. 20-28 ◽

Cited By ~ 8

Author(s):

Ana Langer ◽

Cecilia Garcia-Barrios ◽

Angela Heimburger ◽

Karen Stein ◽

Beverly Winikoff ◽

...

Keyword(s):

Public Hospital ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion

Download Full-text

“Fear, Shame and Embarrassment”: The Stigma Factor in Post Abortion Care at Komfo Anokye Teaching Hospital, Kumasi, Ghana

Asian Social Science ◽

10.5539/ass.v9n10p134 ◽

2013 ◽

Vol 9 (10) ◽

Cited By ~ 7

Author(s):

Eva Tagoe-Darko

Keyword(s):

Teaching Hospital ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion

Download Full-text

Delays in access to care for abortion-related complications: the experience of women in Northeast Brazil

Cadernos de Saúde Pública ◽

10.1590/0102-311x00168116 ◽

2018 ◽

Vol 34 (6) ◽

Cited By ~ 1

Author(s):

Thália Velho Barreto de Araújo ◽

Estela M. L. Aquino ◽

Greice M. S. Menezes ◽

Maria Teresa Seabra Soares de Britto e Alves ◽

Maria-da-Conceição C. Almeida ◽

...

Keyword(s):

Good Condition ◽

Northeastern Brazil ◽

Care Seeking ◽

Middle Income ◽

Risk Of Death ◽

Abortion Care ◽

Post Abortion Care ◽

Abortion Complications ◽

Post Abortion ◽

Almost All

Abstract: Around 18 million unsafe abortions occur in low and middle-income countries and are associated with numerous adverse consequences to women’s health. The time taken by women with complications to reach facilities where they can receive appropriate post-abortion care can influence the risk of death and the extent of further complications. All women aged 18+ admitted for abortion complications to public-sector hospitals in three capital cities in the Northeastern Brazil between August-December 2010 were interviewed; medical records were extracted (N = 2,804). Nearly all women (94%) went straight to a health facility, mainly to a hospital (76.6%); the rest had various care-seeking paths, with a quarter visiting 3+ hospitals. Women waited 10 hours on average before deciding to seek care. 29% reported difficulties in starting to seek care, including facing challenges in organizing childcare, a companion or transport (17%) and fear/stigma (11%); a few did not initially recognize they needed care (0.4%). The median time taken to arrive at the ultimate facility was 36 hours. Over a quarter of women reported experiencing difficulties being admitted to a hospital, including long waits (15%), only being attended after pregnant women (8.9%) and waiting for a bed (7.4%). Almost all women (90%) arrived in good condition, but those with longer delays were more likely to have (mild or severe) complications. In Brazil, where access to induced abortion is restricted, women face numerous difficulties receiving post-abortion care, which contribute to delay and influence the severity of post-abortion complications.

Download Full-text