Safe Abortion Care, Utilization of Post Abortion Contraception and associated Factors, Jimma Ethiopia

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.

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

10.21203/rs.3.rs-34406/v2 ◽

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.

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Knowledge of Safe Abortion Care Services and Associated Factors Among Women of Reproductive Age Working at Non-Health Sector Public Institutions in Addis Ababa, Ethiopia

10.20944/preprints202102.0287.v1 ◽

2021 ◽

Author(s):

endalew Sendo ◽

Fekadu Bulti ◽

Debela Gela ◽

jembere deressa ◽

Negalign Dinagde

Keyword(s):

Associated Factors ◽

Addis Ababa ◽

Care Service ◽

T Test ◽

Reproductive Age ◽

P Value ◽

Women Of Reproductive Age ◽

Safe Abortion ◽

Abortion Care ◽

Care Services

Background: Health-related knowledge is among the essential factors to enable women to be aware of their rights to seek health services. However, little is known about knowledge of safe abortion care services among women of reproductive age in Ethiopia. The main purpose of the study was to assess knowledge of safe abortion care services and associated factors among women of reproductive age in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from April-June 2019 among 432 respondents. Bivariate statistics including correlation coefficients, student t-test, one-way analysis of variance, and linear regressions, and multiple linear regression analyses were used. A significant statistical test was determined at a 95% confidence interval and p-value <0.05. Results: About 65.5% had heard about safe abortion care services; media being the main source of information for 79.5%. The finding from an independent-sample t-test shows that the place where the respondents grew up (p< 0.006), history of past miscarriage, and previous information of abortion care service were significantly associated with the knowledge about safe abortion care services (p< 0.001). Conclusions: Women without prior health experiences and those with rural origin could be targeted for reproductive health information interventions including safe abortion care provision.

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

BMC Health Services Research ◽

10.1186/s12913-021-07141-5 ◽

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.

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Factors associated with seeking post-abortion care among women in Guangzhou, China

10.21203/rs.2.16957/v1 ◽

2019 ◽

Author(s):

Hui Wang ◽

Yan Liu ◽

Ribo Xiong

Keyword(s):

Logistic Regression ◽

Associated Factors ◽

Health Care Facilities ◽

Multivariate Logistic Regression Model ◽

Utilization Rate ◽

Multivariate Logistic Regression ◽

Cross Sectional ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion

Abstract Background: Post-abortion care(PAC) service in China relies on integrating post-abortion family planning (PAFP) services into existing abortion services in hospital settings where the vast majority of induced abortion is performed. This study aims to assess post-abortion care (PAC) utilization and identify factors affecting PAC uptake among clients on the day of abortion in Guangzhou, China. Methods: A cross-sectional study was conducted involving a total of 423 abortion clients in the selected hospitals of Guangzhou From June to September, 2018. The anonymous, self-reported questionnaires regarding associated factors were administered to all participants. Multivariate logistic regression model was used to determine associated factors of PAC utilization. Results: The magnitude of PAC counseling before they leave the health care facilities was 42.1%. Multivariate logistic regression showed that unmarried women, women with local household registration, knowing fertility could return sooner after abortion and women themselves as the main decider on PAC use were significantly associated with PAC utilization. Conclusions: The utilization rate of PAC was low in Guangzhou, China. There’s an urgent need to improve the awareness of regular use of PAC and provide better access for migrants. Partners should be involved during counseling after obtaining women’s consent. Women empowerment through enhancing health education on own decision making in PAC utilization should also be strengthened.

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Health worker roles in safe abortion care and post-abortion contraception

The Lancet Global Health ◽

10.1016/s2214-109x(15)00145-x ◽

2015 ◽

Vol 3 (9) ◽

pp. e512-e513 ◽

Cited By ~ 6

Author(s):

Bela Ganatra

Keyword(s):

Health Worker ◽

Safe Abortion ◽

Abortion Care ◽

Post Abortion

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MEN'S ATTITUDES ABOUT ABORTION IN UGANDA

Journal of Biosocial Science ◽

10.1017/s0021932010000507 ◽

2010 ◽

Vol 43 (1) ◽

pp. 31-45 ◽

Cited By ~ 23

Author(s):

ANN M. MOORE ◽

GABRIEL JAGWE-WADDA ◽

AKINRINOLA BANKOLE

Keyword(s):

Care Seeking ◽

Dominant Culture ◽

Safe Abortion ◽

Abortion Care ◽

Post Abortion Care ◽

Abortion Complications ◽

Appropriate Treatment ◽

Induced Abortions ◽

Post Abortion ◽

Depth Interviews

SummaryAbortion is illegal in Uganda except to save the life of the woman. Nevertheless, the practice is quite common: about 300,000 induced abortions occur annually among Ugandan women aged 15–49 (Singh et al., 2005) and a large proportion of these women require treatment for post-abortion complications. In the male-dominant culture of Uganda, where men control most of the financial resources, men play a critical part in determining whether women receive a safe abortion, or appropriate treatment if they experience abortion complications. This study examines men's roles in determining women's access to a safer abortion and post-abortion care. It draws on in-depth interviews carried out in 2003 with 61 women aged 18–60 and 21 men aged 20–50 from Kampala and Mbarara, Uganda. Respondents' descriptions of men's involvement in women's abortion care agreed that men's stated attitudes about abortion often prevented women from involving them in either the abortion or post-abortion care. Most men believe that if a woman is having an abortion, it must be because she is pregnant with another man's child, although this does not correspond with women's reasons for having an abortion – a critical disjuncture revealed by the data between men's perceptions of, and women's realities regarding, reasons for seeking an abortion. If the woman does experience post-abortion complications, the prevailing attitude among men in the sample was that they cannot support a woman in such a situation seeking care because if it had been his child, she would not have had a covert abortion. Since money is critical to accessing appropriate care, without men's support, women seeking an abortion may not be able to access safer abortion options and if they experience complications, they may delay care-seeking or may not obtain care at all. Barriers to involving men in abortion decision-making endanger women's health and possibly their lives.

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Abortion Service Provision in South Asia: A Comparative Study of Four Countries

10.21203/rs.2.13901/v1 ◽

2019 ◽

Author(s):

Susheela Singh ◽

Aparna Sundaram ◽

Altaf Hossain ◽

Mahesh Puri ◽

Zeba Sathar ◽

...

Keyword(s):

Public Sector ◽

Rural Women ◽

Rural Areas ◽

Urban Areas ◽

Safe Abortion ◽

Number Of Children ◽

Abortion Care ◽

Vacuum Aspiration ◽

Post Abortion Care ◽

Post Abortion

Abstract Background Safe abortion services are essential if women are to fulfill their right to have the number of children they want, when they want them. This paper examines the provision of abortion and menstrual regulation (MR) services in four South Asian countries that have many commonalities in sexual and reproductive outcomes and in barriers to accessing needed services, despite variation in their abortion laws —Nepal, India (six states), Bangladesh, and Pakistan. Methods Using representative health facility surveys, we assess availability of legal abortion/MR services —relevant in three of the countries—and post-abortion care, relevant for all four countries. We examine the role of the public sector in providing these services and the proportion of facilities located in rural areas, as indicators of service accessibility for poor and rural women. We assess quality of abortion care through selected indicators: provision of WHO-recommended methods, vacuum aspiration (VA) and medication abortion (MA); use of outdated, invasive methods such as dilatation and curettage (D&C); and the proportion of facilities turning away women seeking services. Results Results show that in India and Nepal the majority of public sector facilities do not provide induced abortion services, and in India and Pakistan, the majority of facilities providing any abortion services are private sector. Further, although all four countries are mostly rural, the majority of facilities providing abortion services are located in urban areas. While facilities that provide abortion services already commonly provide MA in Nepal and India and increasingly offer MRM (MR with medication) in Bangladesh, D&C is over-used in all four countries for PAC and in India for induced abortions as well. Conclusion There is an urgent need to expand and improve provision of abortion and post-abortion care to reduce abortion-related morbidity and mortality and to fulfill the rights of all women to quality sexual and reproductive health care.

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