Effects of an intervention initiated by a national society to improve postabortion care in rural facilities in Burkina Faso

Kiemtoré, Sibraogo; Zamané, Hyacinthe; Kaïn, Danlotoma P.; Sawadogo, Yobi Alexis; Ouédraogo, Issa; Ouédraogo, Ali; Lankoandé, J.

doi:10.1002/ijgo.12031

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…Medical treatment with Misoprostol is increasingly being used to treat incomplete abortions and is a cheap and safe way to induce contractions of the uterus and an evacuation in a natural way [ 20 , 24 , 25 ]. However, the QECH was the only hospital that used medical treatment, in just 3.2% (95 CI, 2.6–4.5) of the cases in 2015; medical treatment was mostly used to prepare patients for surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi

Odland

Membe‐Gadama

Kafulafula

et al. 2018

IJERPH

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Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to be treated to avoid further harm. Although manual vacuum aspiration (MVA) is a safe and cheap method of evacuating the uterus, the most commonly used method in Malawi is curettage. Medical treatment is used sparingly in the country, and the Ministry of Health has been trying to increase the use of MVA. The aim of this study was to investigate the treatment of incomplete abortions in three public hospitals in Southern Malawi during a three-year period. All medical files from the female/gynecological wards from 2013 to 2015 were reviewed. In total, information on obstetric history, demographics, and treatment were collected from 7270 women who had been treated for incomplete abortions. The overall use of MVA at the three hospitals during the study period was 11.4% (95% CI, 10.7–12.1). However, there was a major increase in MVA application at one District Hospital. Why there was only one successful hospital in this study is unclear, but may be due to more training and dedicated leadership at this particular hospital. Either way, the use of MVA in the treatment of incomplete abortions continues to be low in Malawi, despite recommendations from the World Health Organization (WHO) and the Malawi Ministry of Health.

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Section: Discussionmentioning

confidence: 99%

The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi

Odland

Membe‐Gadama

Kafulafula

et al. 2018

IJERPH

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“…It is an effective, safe, acceptable and affordable method of miscarriage management; however, arrangements for appropriate clinical follow-up are necessary as there is a risk of incomplete expulsion of pregnancy tissue with this method. 74,75 Manual vacuum aspiration (MVA) is effective and safe for early pregnancies and is recommended by the World Health Organization to replace dilatation and curettage where these are still practiced. 76 However, a strategic assessment of unsafe abortion in Malawi found MVA is used infrequently, with dilatation and curettage being used in preference.…”

Section: Global Perspectivesmentioning

confidence: 99%

Sporadic miscarriage: evidence to provide effective care

et al. 2021

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“…Nine decentralization studies (33%) showed improvement in one or more outcome measures including mortality, complication rate, or patient satisfaction. 26,32,33,35,37,40,48,50,51 All studies showing improved outcomes included workforce training and investment in infrastructure, equipment, or supplies as major components of their interventions. Five out of these nine studies (55.5%) included 4 or more intervention categories.…”

Section: Resultsmentioning

confidence: 99%

Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

Iverson

Svensson

Sonderman

et al. 2019

Int J Health Policy Manag

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Background: While recommendations for the optimal distribution of surgical services in high-income countries (HICs) exist, it is unclear how these translate to resource-limited settings. Given the significant shortage and maldistribution of surgical workforce and infrastructure in many low- and middle-income countries (LMICs), the optimal role of decentralization versus regionalization (centralization) of surgical care is unknown. The aim of this study is to review evidence around interventions aimed at redistributing surgical services in LMICs, to guide recommendations for the ideal organization of surgical services. Methods: A narrative-based literature review was conducted to answer this question. Studies published in English between 1997 and 2017 in PubMed, describing interventions to decentralize or regionalize a surgical procedure in a LMIC, were included. Procedures were selected using the Disease Control Priorities’ (DCP3) Essential Surgery Package list. Intervention themes and outcomes were analyzed using a narrative, thematic synthesis approach. Primary outcomes included mortality, complications, and patient satisfaction. Secondary outcomes included input measures: workforce and infrastructure, and process measures: facility-based care, surgical volume, and referral rates. Results: Thirty-five studies were included. Nine (33%) of the 27 studies describing decentralization showed an improvement in primary outcomes. The procedures associated with improved outcomes after decentralization included most obstetric, gynecological, and family planning services as well as some minor general surgery procedures. Out of 8 studies on regionalization (centralization), improved outcomes were shown for trauma care in one study and cataract extraction in one study. Conclusion: Interventions aimed at decentralizing obstetric care to the district hospital and health center levels have resulted in mortality benefits in several countries. However, more evidence is needed to link service distribution to patient outcomes in order to provide recommendations for the optimal organization of other surgical procedures in LMICs. Considerations for the optimal distribution of surgical procedures should include the acuity of the condition for which the procedure is indicated, anticipated case volume, and required level of technical skills, resources, and infrastructure. These attributes should be considered within the context of each country.

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Effects of an intervention initiated by a national society to improve postabortion care in rural facilities in Burkina Faso

Abstract: SOGOB's intervention has improved the quality of PAC in rural health facilities in Burkina Faso.

Cited by 8 publications

References 12 publications

The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi

The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi

Sporadic miscarriage: evidence to provide effective care

Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

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