Assessment of Quality and Determinant Factors of Post-Abortion Care in Governmental Hospitals of Tigray, Ethiopia, 2013

Abstract

Background: Unsafe abortion is one of the leading causes of maternal mortality and morbidity worldwide accounting for 13% of maternal deaths globally.Objective: To assess quality and determinant factors of post-abortion care in governmental Hospitals of Tigray, Ethiopia. Method:Institution based Cross-sectional study was conducted from January to May 2013. Four hundred twenty post apportion care clients were interviewed and 60 clients were observed to obtain qualitative data. Data was collected using pre prepared structured checklist and analyzed using SPSS version 16.00. The association between dependent and in dependent variables was assessed and presented using descriptive statistics, and logistic regression.Results: Majority (46.9%) of the study subjects fall in to the age category of 14-19 years. The study depicted that only 40.6% of the clients were satisfied. Client satisfaction was significantly associated with educational and occupational status, laboratory prescription and toilet access. Only 48 % of study subjects were informed about the available family planning methods and supplied with. The observational study revealed that 88.3% of the clients did not get the opportunity to pose questions or concerns. Only one of the health institutions has functional sink with adequate water supply in the abortion room. No more than 22.2 % of the care providers got refresher training on relevant areas. Conclusion:This study has identified main concerns that could have great input on the improvement of post abortion care. Hence, we can conclude that patient satisfaction is low and there is lack of refreshments trainings especially on counseling and supporting. Besides, there are shortage of materials and supplies. This all could have synergetic effect on compromising the quality of post abortion care. For this reason, it is recommended to skill up the providers with evidence based trainings to enhance quality of post abortion care.

A cross‐sectional analysis of Kenyan postabortion care services using a nationally representative sample

“…The use of invasive methods such as dilation and curettage (especially for first‐trimester evacuation procedures) raises concern over the adherence to guidelines, as well as the process through which service providers decide on treatment and the factors that inform the decision. The present finding differs from past studies, which showed that dilation and curettage equipment were available in healthcare facilities yet remained unused . Interestingly, almost all dilation and curettage cases recorded in the IMUA study occurred at level‐4–5 private facilities .…”

“…The present finding differs from past studies, which showed that dilation and curettage equipment were available in healthcare facilities yet remained unused. 19 Interestingly, almost all dilation and curettage cases recorded in the IMUA study occurred at level-4-5 private facilities. 16 Use of appropriate technology for PAC in the first and second trimesters can be seen against the backdrop of high cost of some of the highly invasive and inappropriate procedures such as dilation and curettage.…”

Client Satisfaction in the Quality of Post Abortion Care Among Women Attending in Public Health Facility of Gambella, Ethiopia

“…This is supported with findings done in Oromia and Amhara region in which 53.4% left the health facility by concealing about family planning and 44% received appropriate information and returned with different contraception methods [29]. This is also supported by a study in Guragea in which about 56.5% and in Tigray about 48% of participants were received accurate information and postabortion family planning [23,28].…”

“…The possible reason for the similarity could be due to the similarity in the study subjects and the similarity of socio-demographic and culture of the study subjects in both studies. But the finding is higher than the findings from Mexico 24%, Tanzania (20%), in Tigray (40.6%), in Oromia and Amhara region (79.6%), Jimma (76.3%), and Adis Ababa (60.5%) [25][26][27][28][29][30]. The possible reason for the discrepancy might be due to the variation in the sample size, study subjects, sampling methods, and sociocultural and demographic background of the study subjects.…”

Women’s Perceived Barriers to Accessing Post-Abortion Care Services in Selected Districts in KwaZulu Natal Province, South Africa: A Qualitative Study

“…This was confirmed by Perera et al and Yegon et al that stigma and poverty, nonetheless, also played a vital role in influencing the decision-making process [ 6 41 ]. Demtsu et al reported an association between the provision of PAC services, religious, cultural beliefs, morals, and values in terms of care of women seeking PAC services [ 42 ].…”