Quality of post-abortion care in public health facilities in Ethiopia

Abstract

Abstract

Background: Comprehensive quality Post Abortion Care (PAC) is one of the important strategies to save lives where access to safe abortion is restricted by Law and services are inaccessible.

Objective: The objective of the study was to assess the status of quality of PAC in health facilities of Amhara and Oromiya regional states.

Methods: The study was cross-sectional by design and was conducted from November 2002 to March 2003. Patient interview, provider interview and direct service delivery observation were utilized to capture different aspects of care. Eleven health facilities (five in Oromiya and six in Amhara Regions), 103 post-abortion patients and 87 health service providers were included in the study.

Results: although facilities were found to be prepared to manage abortion complications, some patients were delayed from receiving services because of requirement to pay before getting services, and to buy drugs and supplies from other sources. Patient-provider interaction was generally satisfactory as viewed by the respondents. Majority (88.3%) of patients felt that PAC services maintained confidentiality. Patients were not informed about the steps of each procedure. Nearly two-third of service providers informed the patients about the cause of their problem, but only 50.5% of them told the outcome of treatment. Information provision regarding important precautions and warning signs was uniformly very low in all study facilities. Only 53.4% of patients left the facilities counseled about family planning and 44.7% with contraceptives. But, 84.5% of women do not plan pregnancy within three months following the abortion. Great majority of the patients responded that they were satisfied with services they have obtained. Dissatisfaction included maltreatment by service providers, and inconvenient setup of service delivery. Patient assessment was principally based on last menstrual period and bimanual pelvic examination in most of the facilities. Service providers do not usually stick to infection prevention and universal precautions.

Conclusion: the study has shown areas of improvement for better services to respond to various needs of the postabortion patients. [Ethiop.J.Health Dev. 2008;22 (1):26-33]