scholarly journals Effects of implementing a postabortion care strategy in Kinshasa referral hospitals, Democratic Republic of the Congo

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Daniel Katuashi Ishoso ◽  
Antoinette Tshefu ◽  
Thérèse Delvaux ◽  
Michèle Dramaix ◽  
Guy Mukumpuri ◽  
...  
Keyword(s):  
Family Planning ◽  
Open Data ◽  
Reproductive Health Services ◽  
Abortion Complications ◽  
Postabortion Care ◽  
Referral Hospitals ◽  
Duration Of Hospitalization ◽  
Quasi Experimental ◽  
Republic Of The Congo ◽  
Post Abortion

Abstract Objectives To evaluate the effects of the implementation of a postabortion care (PAC) strategy in Kinshasa referral hospitals, this study analyzed the quality of postabortion care services, including postabortion contraception, and the duration of hospitalization. Methodology We estimated the effects of the PAC strategy using a quasi-experimental study by evaluating the outcomes of 334 patients with the diagnosis of a complication of induced abortion admitted to 10 hospitals in which the PAC strategy was implemented compared to the same outcomes in 314 patients with the same diagnosis admitted to 10 control facilities from 01/01/2016 to 12/31/2018. In response to government policy, the PAC strategy included the treatment of abortion complications with recommended uterine evacuation technology, the family planning counseling and service provision, linkages with other reproductive health services, including STI evaluation and HIV counseling and/or referral for testing, and partnerships between providers and communities. The information was collected using a questionnaire and stored using open data kit software. We supplemented this information with data abstracted from patient records, facility registries of gynecological obstetrical emergencies, and family planning registries. We analyzed data and developed regression models using STATA15. Thus, we compared changes in use of specific treatments and duration of hospitalization using a "difference-in-differences" analysis. Results The implementation of PAC strategy in Kinshasa referral hospitals has resulted in the utilization of WHO recommended uterine evacuation method MVA (29.3% more in the experimental structures, p = 0.025), a significant decline in sharp-curettage (19.3% less, p = 0.132), and a decline in the duration of hospitalization of patients admitted for PAC (1 day less, p = 0.020). We did not observe any change in the use of PAC services, mortality, and the provision of post abortion contraception. Conclusion Despite significant improvement in the management of PAC, the uptake in WHO approved technology—namely MVA, and the duration of hospitalization, these outcomes while a significant improvement for DRC, indicate that additional quality improvement strategies for management of PAC and risk-mitigating strategies to reduce barriers to care are required.

scholarly journals Effectiveness of Health Education Family Planning Guidelines on Health Beliefs and Behaviours Regarding Family Planning Methods Among Married Men in Myanmar

Jurnal NERS ◽  
2017 ◽  
Vol 12 (2) ◽  
pp. 278
Author(s):  
Zay Yar Tun ◽  
Tintin Sukartini
Keyword(s):  
Family Planning ◽  
Health Education ◽  
Health Beliefs ◽  
Health Belief ◽  
Control Group ◽  
Reproductive Health Services ◽  
Married Men ◽  
Quasi Experimental ◽  
Planning Methods ◽  
Family Planning Methods

Introduction: Males are the most important members and care-takers of the family, but they are considered to be uncooperative when it comes to the usage of family planning methods. Traditionally, family planning programs have focused primarily on women, and most of the methods are designed for women considering that it is the women who become pregnant and it is easy to deliver reproductive health services as part of maternal and child health programs. The main objective of this study was to study the effectiveness of Health Education (HE) Family Planning Guidelines on Health Belief and Behaviours regarding family planning methods among married men Methods: A quasi-experimental study design was used to compare the results of the effectiveness of health education on the health beliefs and behaviours regarding family planning methods among married men. Mann-Whitney test and Manova test were used to analyse the data. Results:  It was found that there was a difference of health belief with p= 0.038, knowledge with p= 0.000 and attitude with p= 0.000 between the treatment and control group. Conclusions: There was an impact on the improvement of health belief and behaviours regarding family planning methods in the study group which was significantly improved after intervention. As the predetermined hypothesis, a difference was found between the knowledge, attitude and health beliefs of the married men who received health education and those who did not receive health education.

scholarly journals Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

2021 ◽  
Author(s):  
George Ochieng Otieno ◽  
Leopold Ouedraogo ◽  
Triphonie Nkurunziza ◽  
Chilanga Asmani ◽  
Hayfa Elamin ◽  
...  
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Reproductive Health Services ◽  
Abortion Care ◽  
Sexual Reproductive Health ◽  
Post Abortion Care ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background: The COVID-19 pandemic has had a major impact on the capacity of health systems to continue the delivery of essential health services. While health systems around the world are being challenged by increasing demand for care of COVID-19 patients, it is critical to all other services including sexual reproductive health services. Countries are expected to ensure optimal balance between fighting the COVID-19 pandemic and maintenance of essential health services like sexual reproductive health. The purpose of this report was to assess and document continuity of sexual and reproductive health services with a focus on safe abortion, post abortion care and family planning services during the COVID -19 pandemic in selected countries of the World Health Organization Africa Region.Methods: A descriptive survey using a simplified and user-friendly virtual web based rapid needs assessment through a questionnaire was filled in by key informants drawn from the ministries of health from 30 countries in July 2020. The questionnaires were filled in by the World Health Organization staff in charge of sexual reproductive health services in collaboration with their counterparts in the ministries of health and uploaded in excel data sheets and categorized in to thematic areas for analysis.Results: Responses were received from 17 countries out of the 30 countries that received the questionnaires. Of the 17 countries, only 2 (12%) countries reported that sexual and reproductive health services are not integrated in the essential health services package. All the sexual reproductive health elements-family planning/contraception and comprehensive abortion care, including post abortion care are integrated in the essential health services package in 12 (80%) of the 15 countries that have sexual reproductive health integrated. Also,14(82%) countries reporting having ongoing awareness raising campaigns/communication messages about family planning, comprehensive abortion care and post abortion care during the COVID pandemic. 9(59%) of the countries reported reduction in the use of family planning services, 6(35%) indicated no changes in the use of family planning services with only 2(12%) countries providing no response. Conclusion: The survey provides information on the weak health systems of the participating member states of the WHO Africa Region and the magnitude of disruptions of sexual reproductive health services in selected countries. Further, strategies adopted by countries to ensure continuity of sexual reproductive health services amidst COVID -19 like communications, Countries finally identified key areas that need to be supported in family planning/contraception, comprehensive abortion care and post abortion care during the COVID-19 pandemic.

scholarly journals Correction to: Effects of implementing a postabortion care strategy in Kinshasa referral hospitals, Democratic Republic of the Congo

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Daniel Katuashi Ishoso ◽  
Antoinette Tshefu ◽  
Thérèse Delvaux ◽  
Michèle Dramaix ◽  
Guy Mukumpuri ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Postabortion Care ◽  
Referral Hospitals ◽  
Republic Of The Congo

scholarly journals Bolivia and Mexico: System-wide planning is needed for decentralized postabortion care

2005 ◽  
Author(s):  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Essential Elements ◽  
Clinical Treatment ◽  
Appropriate Technology ◽  
Public Hospitals ◽  
Outpatient Basis ◽  
Reproductive Health Services ◽  
Postabortion Care ◽  
Clinical Records

Governments in developing countries recognize the need for appropriate technology for the treatment of emergencies from incomplete abortion or miscarriage. Numerous studies have investigated the appropriateness of an integrated model of postabortion care (PAC) that includes three essential elements: emergency treatment for spontaneous or induced abortion; counseling and family planning services; and links to other reproductive health services. Many integrated PAC services include replacement of the conventional clinical treatment, sharp curettage (SC), with manual vacuum aspiration (MVA). In 1997 and 1999 the Population Council supported intervention studies in Mexico and Bolivia, respectively, to assess PAC programs in terms of safety, effectiveness, quality of care, cost, and subsequent contraceptive use by clients. Both interventions introduced integrated PAC services and compared the outcomes of MVA and SC use in large public hospitals. To assess changes in service quality and costs, researchers analyzed clinical records and interviewed clients and providers before and after the interventions. As noted in this summary, SC and MVA are equally safe and effective and can be provided on an outpatient basis. Integrating clinical treatment with family planning counseling and services increased clients’ knowledge and contraceptive use.

scholarly journals Postabortion family planning benefits clients and providers

2005 ◽  
Author(s):  
James R. Foreit
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Unmet Need ◽  
Community Support ◽  
Reproductive Health Services ◽  
Hiv Counseling ◽  
Sexually Transmitted ◽  
Incomplete Abortion ◽  
Postabortion Care ◽  
Contraceptive Services

A woman’s fertility can return quickly following an abortion or miscarriage, yet recent data show high levels of unmet need for family planning (FP) among women who have been treated for incomplete abortion. This leaves many women at risk of another unintended pregnancy and in some cases subsequent repeated abortions and abortion-related complications. It is thus vital for programs to provide a comprehensive package of postabortion care (PAC) services that includes medical treatment, FP counseling and services, and other reproductive health services such as evaluation and treatment for sexually transmitted infections, HIV counseling and/or testing, and community support and mobilization. Providing FP services within PAC benefits clients and programs. Facilities that can effectively treat women with incomplete abortions can also provide contraceptive services, including counseling and appropriate methods. As stated in this brief, any provider who can treat incomplete abortion can also provide selected FP methods. Clients, providers, and programs benefit when FP methods are provided to postabortion clients at the time of treatment.

Conclusion

2018 ◽  
Author(s):  
Yana van der Meulen Rodgers
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Health Outcomes ◽  
Cost Effective ◽  
Reproductive Health Services ◽  
Cost Effective Approach ◽  
Restrictive Legislation

Chapter 7 concludes by highlighting the three biggest messages from the analysis presented in this book: (1) the global gag rule has failed to achieve its goal of reducing abortions; (2) restrictive legislation is associated with more unsafe abortions; and (3) the expanded global gag rule is likely to have negative repercussions across a range of health outcomes for women, children, and men. They are simple but powerful messages that should be heard by policymakers over the voices calling for an ideologically based policy that fails to achieve its desired outcome. The chapter closes with a more constructive and cost-effective approach for US family-planning assistance that targets integrated reproductive health services.

scholarly journals Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
High Volume ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Products Of Conception ◽  
Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

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

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Asmamaw Demis Bizuneh ◽  
Getnet Gedefaw Azeze
Keyword(s):  
Family Planning ◽  
Marital Status ◽  
Meta Analysis ◽  
Grey Literature ◽  
Eastern Africa ◽  
Determinant Factors ◽  
Unintended Pregnancies ◽  
Pooled Prevalence ◽  
History Of ◽  
Post Abortion

Abstract Background Utilization of post-abortion family planning is very critical to reduce high levels of unintended pregnancy, which is the root cause of induced abortion. In Eastern Africa, it is estimated that as many as 95% of unintended pregnancies occurred among women who do not practice contraception at all. Therefore, this meta-analysis aimed to assess post-abortion family planning utilization and its determinant factors in Eastern Africa. Methods Published papers from Scopus, HINARI, PubMed, Google Scholar, and Web of Science electronic databases and grey literature repository were searched from database inception to January 30, 2020, with no restriction by design and date of publishing. We screened records, extracted data, and assessed risk of bias in duplicate. Cochrane I2 statistics were used to check the heterogeneity of the studies. Publication bias was assessed by Egger and Biggs test with a funnel plot. A random-effects model was calculated to estimate the pooled prevalence of post-abortion family planning utilization. Results A total of twenty-nine cross-sectional studies with 70,037 study participants were included. The overall pooled prevalence of post-abortion family planning utilization was 67.86% (95% CI 63.59–72.12). The most widely utilized post-abortion family methods were injectable 33.23% (95% CI 22.12–44.34), followed by implants 24.71% (95% CI 13.53–35.89) and oral contraceptive pills 23.42% (95% CI 19.95–26.89). Married marital status (AOR=3.20; 95% CI 2.02–5.05), multiparity (AOR=3.84; 95% CI 1.43–10.33), having a history of abortion (AOR=2.33; 95% CI 1.44–3.75), getting counselling on post-abortion family planning (AOR=4.63; 95% CI 3.27–6.56), and ever use of contraceptives (AOR=4.63; 95% CI 2.27–5.21) were factors associated with post-abortion family planning utilization in Eastern Africa. Conclusions This study revealed that the marital status of the women, multiparity, having a history of abortion, getting counselling on post-abortion family planning, and ever used contraceptives were found to be significantly associated with post-abortion family planning utilization.

scholarly journals Promoting Scale-Up Across a Global Project Platform: Lessons from the Evidence to Action Project

2021 ◽  
Author(s):  
Laura Ghiron ◽  
Eric Ramirez-Ferrero ◽  
Rita Badiani ◽  
Regina Benevides ◽  
Alexis Ntabona ◽  
...  
Keyword(s):  
Family Planning ◽  
Scale Up ◽  
Scaling Up ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Country Level ◽  
Look Ahead ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Multi Stakeholder

AbstractThe USAID-funded flagship family planning service delivery project named Evidence to Action (E2A) worked from 2011 to 2021 to improve family planning and reproductive health for women and girls across seventeen nations in sub-Saharan Africa using a “scaling-up mindset.” The paper discusses three key lessons emerging from the project’s experience with applying ExpandNet’s systematic approach to scale up. The methodology uses ExpandNet/WHO’s scaling-up framework and guidance tools to design and implement pilot or demonstration projects in ways that look ahead to their future scale-up; develop a scaling-up strategy with local stakeholders; and then strategically manage the scaling-up process. The paper describes how a scaling-up mindset was engendered, first within the project’s technical team in Washington and then how they subsequently sought to build capacity at the country level to support scale-up work throughout E2A’s portfolio of activities. The project worked with local multi-stakeholder resource teams, often led by government officials, to equip them to lead the scale-up of family planning and health system strengthening interventions. Examples from project experience in the Democratic Republic of the Congo, Kenya, Nigeria, and Uganda illustrating key concepts are discussed. E2A also established a community of practice on systematic approaches to scale up as a platform for sharing learning across a variety of technical agencies engaged in scale-up work and to create learning opportunities for interacting with thought leaders around critical scale-up issues.

Sign in / Sign up

Export Citation Format

Share Document