Integration of Family Planning Services within Post Abortion Care at Health Facilities in Dessie –North East Ethiopia

SummaryUnsafe abortion accounts for 35% of maternal mortality in Kenya. Post-abortion care (PAC) reduces maternal death and provides an opportunity to prevent unwanted pregnancies. Few studies have documented how the receipt of PAC services varies by client age. In this study, descriptive data were collected from clients, providers and eight health facilities in Kenya's Central and Nairobi provinces to examine receipt of PAC services by client age, client satisfaction and provider attitudes. Delivery of PAC treatment, pain management, HIV and STI services and violence screening did not vary by age. However, fewer youth between the ages of 15 and 24 received a contraceptive method compared with adult clients (35% versus 48%; p=0.02). Forty-nine per cent of youth reported not using a family planning method due to fears of infertility, side-effects or lack of knowledge compared with 22% of adults. Additional efforts are needed in Kenya to bolster the family planning services that young PAC clients receive and increase the uptake of contraception.

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Post-abortion fertility desires, contraceptive uptake and unmet need for family planning: voices of post-abortion care clients in Tanzania

Journal of Biosocial Science ◽

10.1017/s0021932020000607 ◽

2020 ◽

pp. 1-16

Author(s):

Colin Baynes ◽

Erick Yegon ◽

Grace Lusiola ◽

Japhet Achola ◽

Rehema Kahando

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Unmet Need ◽

Pregnancy Intentions ◽

Middle Income ◽

Fertility Desires ◽

Abortion Care ◽

Post Abortion Care ◽

Post Abortion ◽

Contraceptive Uptake

Abstract Post-abortion care (PAC) integrates elements of care that are vital for women’s survival after abortion complications with intervention components that aid women in controlling their fertility, and provides an optimal window of opportunity to help women meet their family planning goals. Yet, incorporating quality family planning services remains a shortcoming of PAC services, particularly in low- and middle-income countries. This paper presents evidence from a mixed method study conducted in Tanzania that aimed at explaining factors that contribute to this challenge. Analysis of data obtained through client exit interviews quantified the level of unmet need for contraception among PAC clients and isolated the factors associated with post-abortion contraceptive uptake. Qualitative data analysis of interviews with a subset of these women explored the multi-level context in which post-abortion pregnancy intentions and contraceptive behaviours are formed. Approximately 30% of women interviewed (N=412) could recall receiving counselling on post-abortion family planning. Nearly two-thirds reported a desire to either space or limit childbearing. Of those who desired to space or limited childbearing, approximately 20% received a contraceptive method before discharge from PAC. The factors significantly associated with post-abortion contraceptive acceptance were completion of primary school, prior use of contraception, receipt of PAC at lower level facilities and recall of post-abortion family planning counselling. Qualitative analysis revealed different layers of contextual influences that shaped women’s fertility desires and contraceptive decision-making during PAC: individual (PAC client), spousal/partner-related, health service-related and societal. While results lend support to the concept that there are opportunities for services to address unmet need for post-abortion family planning, they also attest to the synergistic influences of individual, spousal, organizational and societal factors that influence whether they can be realized during PAC. Several strategies to do so emerged saliently from this analysis. These emphasize customized counselling to enable client–provider communication about fertility preferences, structural intervention aimed at empowering women to assert those objectives in family and health care settings, availability of information and services on post-abortion fertility and contraceptive eligibility in PAC settings and interventions to facilitate constructive spousal communication on family planning and contraceptive use, after abortion and in general.

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

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2016.68061 ◽

2016 ◽

Vol 06 (08) ◽

pp. 457-462 ◽

Cited By ~ 2

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

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ANALYSIS OF SELECTION OF CONTRACEPTIVE METHOD AMONG WOMEN IN TANZANIA

International Medical Science Research Journal ◽

10.51594/imsrj.v1i2.63 ◽

2020 ◽

Vol 1 (2) ◽

pp. 45-49

Author(s):

Woo Lee ◽

Jasson John

Keyword(s):

Family Planning ◽

Contraceptive Method ◽

Menstrual Period ◽

Abortion Care ◽

Important Decision ◽

Post Abortion Care ◽

Living Children ◽

Post Abortion ◽

Permanent Method ◽

Selection Of

There are numerous methods of contraception selection and making selection among one of these method is an important decision. Commence of suitable contraception is important before starting first post-abortal menstrual period. Generally, it is required to provide individuals and couples about treatments, complications, counseling related to HIV/STI as part of post abortion care. The study is observational in nature and conducted in a hospital in Tanzanian capital. The sample included in the study was 60 patients. The results showed that among illiterate women along with those who have more than 1 living son or who have 4 or more living children prefer permanent method. We also found that contraception method is influenced by different demographic factors including living children gender, couple age, education, and income. Couples who feel that their families are completed mostly opt for permanent method of contraception. Family planning choices is also influenced by desire for a male child.

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DELIVERING POST-ABORTION CARE THROUGH A COMMUNITY-BASED REPRODUCTIVE HEALTH VOLUNTEER PROGRAMME IN PAKISTAN

Journal of Biosocial Science ◽

10.1017/s0021932012000296 ◽

2012 ◽

Vol 44 (6) ◽

pp. 719-731 ◽

Cited By ~ 4

Author(s):

SYED KHURRAM AZMAT ◽

BABAR T SHAIKH ◽

GHULAM MUSTAFA ◽

WAQAS HAMEED ◽

MOHSINA BILGRAMI

Keyword(s):

Reproductive Health ◽

Group Discussions ◽

Community Based ◽

Family Planning Services ◽

Abortion Care ◽

Care Services ◽

Post Abortion Care ◽

Post Abortion ◽

Depth Interviews

SummaryThis qualitative study was conducted in May–June 2010 with women using post-abortion care (PAC) services provided by the Marie Stopes Society in Pakistan during the six month period preceding the study, more than 70% of whom had been referred to the clinics by reproductive health volunteers (RHVs). The aim of the study was to establish the socio-demographic profile of clients, determine their preferred method of treatment, explore their perceptions of the barriers to accessing post-abortion services and to understand the challenges faced by RHVs. The sample women were selected from six randomly selected districts of Sindh and Punjab. Eight focus group discussions were conducted with PAC clients and fifteen in-depth interviews with RHVs. In addition, a quantitative exit interview questionnaire was administered to 76 clients. Medical, rather than surgical, treatment for incomplete and unsafe abortions was preferred because it was perceived to ‘cause less pain’, was ‘easy to employ’ and ‘having fewer complications’. Household economics influence women's decision-making on seeking post-abortion care. Other restraining factors include objection by husbands and in-laws, restrictions on female mobility, the views of religious clerics and a lack of transport. The involvement of all stakeholders could secure social approval and acceptance of the provision of safe post-abortion care services in Pakistan, and improve the quality of family planning services to the women who want to space their pregnancies.

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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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Contraceptive situation and Influencing Factors in Guangdong Province: A comparative questionnaire study

10.21203/rs.3.rs-220653/v1 ◽

2021 ◽

Author(s):

FAN JIANG ◽

Yanxia Qu ◽

Peixuan Lin ◽

Li Li ◽

Qingshan Xuan ◽

...

Keyword(s):

Family Planning ◽

Health Care Providers ◽

Contraceptive Use ◽

Induced Abortion ◽

Care Providers ◽

Monthly Income ◽

Abortion Care ◽

Post Abortion Care ◽

Contraceptive Services ◽

Post Abortion

Abstract BackgroundThe aim of our study is to describe the status of induced abortion and contraceptive use in reproductive women and make clear the correlated factors in Guangdong province.MethodA self-administered questionnaire survey was conducted separately in 1839 individuals aged 18–49 and 900 health care providers from Guangdong province. The content of questionnaire was based on status of induced abortion and contraceptive use for the former and problems concerning contraceptive services for the latter. Systematic random sampling was used and data were analyzed using SPSS 19.0. Descriptive statistics and binary logistic regression were used in this study.Results30.61% of participants experienced the induced abortion. The rate of repeated abortion was 19.96% and it was 20.45% in persons under 20 years old. 18.23% of 1839 individuals chose LARC as the main contraceptive method. The females with college degree(Odds ratio, OR = 1.867; 95% confidence intervals 95%CI: 1.175–2.969), technologists(OR = 2.291; 95%CI: 1.063–4.936) and the persons whose monthly income were of between 3000–5000¥(OR = 1.920; 95%CI: 1.204–3.065) were more likely to use LARC. The younger females less than 30 years old and never using PAC services had lower odds of using LARC. The rate of post abortion care performance was merely 12.23%. Age, monthly income, occupation, living conditions and obtaining free contraceptives in time were all strongerly influence factors for the use of post-abortion care(P < 0.01). The satisfaction rate of free contraceptive services was about 57.44%. Variety uniformity, obtaining inconveniently and worrying about the quality were the main reasons. 66.22% of hospitals set up the department of family planning in our study. Highly work intensity(54.67%) and less leadership (40.22%) influenced health care providers to provide family planning services.ConclusionThe abortion rate was high especially in young women. There were many problems affecting contraceptive services which damaged women’reproductive health. Increasing government investment for family planning services, strengthening the construction of the family planning department and performing post abortion care and long-acting reversible contraception by taking relevant steps would be useful measures for improving current contraceptive status.

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