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

Author(s):  
Kenneth Okoth Juma ◽  
Ramatou Ouedraogo ◽  
Joshua-Amo Adjei ◽  
Ali Sie ◽  
Mamadou Ouattara ◽  
...  

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.

2016 ◽  
Vol 06 (08) ◽  
pp. 457-462 ◽  
Author(s):  
Sibraogo Kiemtoré ◽  
Hyacinthe Zamané ◽  
Yobi Alexis Sawadogo ◽  
Charlemagne Marie Ouédraogo ◽  
Dantola Paul Kaïn ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Onikepe Owolabi ◽  
Taylor Riley ◽  
Easmon Otupiri ◽  
Chelsea B. Polis ◽  
Roderick Larsen-Reindorf

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.


2010 ◽  
Vol 4 (3) ◽  
pp. 170-174 ◽  
Author(s):  
Akinola Oluwarotimi Ireti ◽  
Fabamwo Adetokunbo Olusegun ◽  
Tayo Adetokunbo Olufela ◽  
Alokha Mercy ◽  
Oshodi Yussuf Abisowo ◽  
...  

2007 ◽  
Vol 64 (11) ◽  
pp. 2210-2222 ◽  
Author(s):  
Deborah L. Billings ◽  
Barbara B. Crane ◽  
Janie Benson ◽  
Julie Solo ◽  
Tamara Fetters

2021 ◽  
Author(s):  
Aynalem Yetwale ◽  
Teklemariam Gultie ◽  
Dessalegn Ajema ◽  
Semahegn Tilahun ◽  
Bezawit Afework

Abstract Background Antenatal depression is the most common psychiatric disorder during pregnancy and it’s associated with psychosocial and obstetric factors. Antenatal depression has serious consequences for the mother and fetus, such as recurrent spontaneous abortions, pregnancy induced hypertension, pre-eclampsia, postpartum bleeding, pre-term delivery, postnatal depressive disorders and low birth weight. However it doesn’t get appropriate attention.Methods Institutional based cross-sectional study design was conducted on 446 pregnant women coming for antenatal care service at Jinka public health facilities, from June 01 to June 30, 2018. Data was collected through semi-structured and pretested questionnaire by face to face interview technique and Beck Depression Inventory was used to assess women’s depression condition. Collected data was entered in to Epi data version 3.3.1 after checking their completeness and exported to statistical package for social science version 20.0 for analysis. Logistic regression was used to find out association between explanatory and response variables. Explanatory variables which fulfill the assumption of logistic regression and had P-value less than 0.25 from bi-variable logistic regression were considered for the multivariable logistic regression model. Strength of association was evaluated using odds ratio at 95% confidence interval and P-value < 0.05 was considered to declare significant associations.Result The magnitude of antenatal depression in this study was 24.4%(20.2-28.5 at 95% CI) and it had statistically significant association with unmarried marital status AOR =13.39 [(95%CI); (3.11-57.7)], chronic medical illness AOR=3.97 [(95%CI); (1.07-14.7)], unplanned pregnancy AOR =6.76 [ (95%CI); (2.13-21.4)], history of abortion AOR =2.8 [(95%CI); (1.14-7.02)], history of previous pregnancy complication AOR =4.8 [(95%CI); (2.12-17.35)] and fear of pregnancy related complications AOR=5.4 [(95%CI); (2.32-12.4)].Conclusion and recommendation The magnitude of antenatal depression was high. So integrating mental health service in antenatal care assessment, provide comprehensive family planning service and improve obstetric service are recommended.


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