scholarly journals The infrastructural capacity of Ghanaian health facilities to provide safe abortion and post-abortion care: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Onikepe Owolabi ◽  
Taylor Riley ◽  
Easmon Otupiri ◽  
Chelsea B. Polis ◽  
Roderick Larsen-Reindorf
Keyword(s):  
Scale Up ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Safe Abortion ◽  
Signal Functions ◽  
Rural Location ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background Ghana is one of few countries in sub-Saharan Africa with relatively liberal abortion laws, but little is known about the availability and quality of abortion services nationally. The aim of this study was to describe the availability and capacity of health facilities to deliver essential PAC and SAC services in Ghana. Methods We utilized data from a nationally representative survey of Ghanaian health facilities capable of providing post-abortion care (PAC) and/or safe abortion care (SAC) (n = 539). We included 326 facilities that reported providing PAC (57%) or SAC (19%) in the preceding year. We utilized a signal functions approach to evaluate the infrastructural capacity of facilities to provide high quality basic and comprehensive care. We conducted descriptive analysis to estimate the proportion of primary and referral facilities with capacity to provide SAC and PAC and the proportion of SAC and PAC that took place in facilities with greater capacity, and fractional regression to explore factors associated with higher structural capacity for provision. Results Less than 20% of PAC and/or SAC providing facilities met all signal function criteria for basic or comprehensive PAC or for comprehensive SAC. Higher PAC caseloads and staff trained in vacuum aspiration was associated with higher capacity to provide PAC in primary and referral facilities, and private/faith-based ownership and rural location was associated with higher capacity to provide PAC in referral facilities. Primary facilities with a rural location were associated with lower basic SAC capacity. Discussion Overall very few public facilities have the infrastructural capacity to deliver all the signal functions for comprehensive abortion care in Ghana. There is potential to scale-up the delivery of safe abortion care by facilitating service provision all health facilities currently providing postabortion care. Conclusions SAC provision is much lower than PAC provision overall, yet there are persistent gaps in capacity to deliver basic PAC at primary facilities. These results highlight a need for the Ghana Ministry of Health to improve the infrastructural capability of health facilities to provide comprehensive abortion care.

scholarly journals Health Systems’ Preparedness to Provide Post-abortion Care: Assessment of Health Facilities in Burkina Faso, Kenya and Nigeria

2021 ◽  
Author(s):  
Kenneth Okoth Juma ◽  
Ramatou Ouedraogo ◽  
Joshua-Amo Adjei ◽  
Ali Sie ◽  
Mamadou Ouattara ◽  
...  
Keyword(s):  
Public Health ◽  
Burkina Faso ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Unsafe Abortion ◽  
Public Health Facilities ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Care Assessment ◽  
Post Abortion

Abstract Background: In many parts of sub-Saharan Africa (SSA), access to abortion is legally restricted, which partly contributes to high incidence of unsafe abortion. This may result in unsafe abortion-related complications that demand long hospital stays, treatment and attendance by skilled health providers. There is however, limited evidence on the capacity of public health facilities to deliver post-abortion care (PAC) in these settings. We describe and discuss the preparedness and capacity of public health facilities to deliver complete and quality PAC services in Burkina Faso, Kenya and Nigeria. Methods: A cross-sectional survey of primary, secondary and tertiary-level public health facilities was conducted between November 2018 and February 2019 in the three countries. Data on signal functions for measuring the ability of health facilities to provide post-abortion services were collected and analyzed. These data included information on essential PAC equipment and supplies, PAC staffing and training among others. Results: Across the three countries, fewer primary health facilities (ranging from 4.3%–12.2% in Kenya and Burkina Faso) had the capacity to deliver on all components of basic PAC services. Only one in three (30–33%) of referral facilities across Burkina Faso, Kenya and Nigeria could provide comprehensive PAC services. Lack of trained staff, absence of necessary equipment and lack of PAC commodities and supplies were a main reason for inability to deliver specific PAC services (such as surgical procedures for abortion complications, blood transfusion and post-PAC contraceptive counselling). Further, the lack of capacity to refer acute PAC cases to higher-level facilities was identified as a key weakness in provision of post-abortion care services. Conclusions: Our findings reveal considerable gaps and weaknesses in the delivery of basic and comprehensive PAC within the three countries. There is need for increased investments by governments to strengthen capacity of primary, secondary and tertiary public health facilities to deliver quality PAC services.

scholarly journals Safe abortion service and post abortion care: Understanding complications

1970 ◽  
Vol 2 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Sudha Thapa ◽  
Indira Satyal ◽  
Kasturi Malla
Keyword(s):  
Induced Abortion ◽  
Abortion Rate ◽  
Uterine Perforation ◽  
Safe Abortion ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Manual Vacuum Aspiration ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Aim: To see if unsafe abortions are getting lesser after the establishment of comprehensive abortion care (CAC) Unit since March 2004. Methods: Retrospective study of women admitted with complication of abortions [induced (medically/criminal) or spontaneous] during the entire ten years period after the inception of post abortion care (PAC) Unit 2095 May -2007 April; the last 3 years overlapping the service years of CAC Unit establishment. Result: CAC and PAC units both are using manual vacuum aspiration (MVA) to procure uterine evacuation. CAC clients in the last 3 years have reached to a little less than 10,000. This is close to MVA services provided in the PAC Unit in the last 10 years amounting to 11,519. But the number (n=3958) of service provided by the PAC Unit for a complete period of three years 2058-2060 (April 2001 - April 2004) showed a slight increase to (n=4323) as the CAC Unit became functional during the 2061-2063 (15th April 2004- 2007). The complications observed in PAC unit while providing MVA are much more than CAC unit (5.75%: 2%). But the nature of complication is much more serious in CAC Unit, 10 of them needing laparotomy for 20(0.02%) cases of uterine perforation. The induced abortion rate within the hospital, three years before and during CAC services is almost similar (4.07%: 4.34%). Seriousness of the problem has definitely reduced during recent 3 year's period (Baisakh 2061-2063 Chaitra) i.e. 52: 34 except for an unfortunate rise in uterine perforation from 8 to 29 cases, 10 being from the CAC Unit. Conclusion: Though the number of complicated cases of induced abortion seeking hospitalization has not changed much after inception of CAC services in the recent three years, there is definitely a decline in the admission of more serious complicated cases of induced abortion in the recent years with unfortunate rise in number of cases of uterine perforation.   doi:10.3126/njog.v2i1.1476 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 44 - 49 May -June 2007

scholarly journals Cost of abortions in Zambia: A comparison of safe abortion and post abortion care

2015 ◽  
Vol 12 (2) ◽  
pp. 236-249 ◽  
Author(s):  
Divya Parmar ◽  
Tiziana Leone ◽  
Ernestina Coast ◽  
Susan Fairley Murray ◽  
Eleanor Hukin ◽  
...  
Keyword(s):  
Safe Abortion ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Post Abortion

scholarly journals Integration of Post Abortion Care Package in the Activity of 56 Health Facilities by the Burkina Faso Society of Obstetricians and Gynecologists (SOGOB)

2016 ◽  
Vol 06 (08) ◽  
pp. 457-462 ◽  
Author(s):  
Sibraogo Kiemtoré ◽  
Hyacinthe Zamané ◽  
Yobi Alexis Sawadogo ◽  
Charlemagne Marie Ouédraogo ◽  
Dantola Paul Kaïn ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Health Facilities ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Care Package ◽  
Post Abortion

scholarly journals Post Abortion Contraception Model: A Comprehensive Package for Improving Safe Abortion Care in Developing Countries

2018 ◽  
Vol 1 (1) ◽  
pp. 12-21
Author(s):  
Fred Yao Gbagbo
Keyword(s):  
Developing Countries ◽  
Induced Abortion ◽  
Health Facilities ◽  
Capital City ◽  
Safe Abortion ◽  
Governmental Organization ◽  
Abortion Care ◽  
Care Services ◽  
Wide Availability ◽  
Post Abortion

Background: Despite liberal abortion laws and wide availability of contraceptives in Ghana, declining Post Abortion Contraception remains a public health challenge due to early unplanned pregnancies and recurrent abortions. The development of this model was therefore to address challenges of low contraception following induced abortion in health facilities within the capital city of Ghana. Method: The development of this model was an outcome of a nested study title: ‘decision making for induced abortion in Accra metropolis, Ghana’ in 2014. This model was piloted for four years using Marie Stopes, Ipas and Ghana Health Service trained abortion providers with family planning skills in one hundred purposively selected health facilities comprising 90 private and 10 Non-Governmental Organization mandated by law to provide safe abortion care services in the capital city of Ghana. The model mainly focused on contraceptive products, pricing, placement, promotion and people. Results: There was an increase (90% average) in Post Abortion Contraception across the selected facilities following the intervention using the model. Conclusion: The study concludes that an integration of products, pricing, placement, promotion and people with options counselling prior to an induced abortion are key considerations for an improved post abortion contraception uptake in developing countries.

scholarly journals Family planning practices of women working in the Cambodian garment industry: a qualitative study

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Elisa Oreglia ◽  
Ly Sokhey ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Medical Abortion ◽  
Garment Industry ◽  
Safe Abortion ◽  
Modern Contraception ◽  
Abortion Care ◽  
Garment Factories ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background: Women working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods: We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results: We interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children. Conclusion: This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work to address this gap could involve the development of appropriate interventions and informative tools for women in the Cambodian garment industry such as through existing client contact-centres or social media, including creation of videos or posts on topics that come from clients questions.

Sign in / Sign up

Export Citation Format

Share Document