Factors Influencing Utilization of Post Abortion Care in Selected Governmental Health Institutions, Addis Ababa, Ethiopia

Abstract

IntroductionWorldwide, each year more than 500,000 women, 99% of them in developing countries, die from pregnancy and childbirth-related complications and an additional 15 to 20 million women suffer from debilitating consequences of pregnancy [1]. The major causes of maternal deaths are hemorrhage, infection, obstructed labor, hypertensive disorders in pregnancy, and complications of unsafe abortion [2].Maternal deaths due to unsafe abortion in developing countries fall within a narrow range from 9% to 17% of all maternal deaths [3]. Both the lowest and the highest figures are found in Africa (9% in Southern Africa and 17% in Eastern Africa), reflecting the combined impact of the legal abortion and health systems, with more liberal access to abortion and post abortion care in the health systems [3].Ethiopia is one of the counties with highest maternal mortality ratio which is currently estimated at 676/100,000 live births [4]. Main contributing factors for this high death includes unsafe abortion, among others [5]. Several studies in Ethiopia indicated that unsafe abortion may account for up to 25-35% of the maternal deaths [6][7][8]. A recent nationwide study on abortion related complications has shown that an estimated number of 17 patients are seen in hospitals for post abortion complications in a month and complications due to abortion were also reported from low-level facilities, which do not provide post abortion care services [9]. From a community based large-scale survey in Addis Ababa, Ethiopia, maternal mortality in the city was estimated to be 566 per 100,000 live births and abortion was major contributor to the deaths [4,8,10]. In addition, safe abortion service is a recent trend and a formal post abortion care (PAC) service in the country is not yet well expanded [3,11,12]. Thus this study assessed the influencing factors of PAC utilization in selected health institutions in Addis Ababa, Ethiopia. Methods Study design, area and periodAn institution-based cross sectional study was conducted among reproductive age women (15-49 years) who were attending maternal and child health (MCH) services using structured interviews. A total of 153 respondents were recruited from six MCH clinics in Addis Ababa, Ethiopia. Data were collected between February and April, 2012. There were 620 clients attending MCH services that obtained from monthly registration report of MCH clinics in these six MCH clinics. Respondents were recruited proportionally to the client flow from each MCH clinics. For the purpose of this study, we defined users of post abortion care as women of childbearing age who had received all components of post abortion care services, and non users of post abortion care as women of childbearing age who had not received all of the components. We used the inclusion criteria as all reproductive age women with at least one abortion history in the last one year, and exclusion criteria as all reproductive age women who had no any abortion history, women with hearing problem, and mentally incompetent women d...

Prevalence and determinants of post--abortion family planning utilization in a tertiary Hospital of Northwest Ethiopia: a cross sectional study

“…Women whose monthly income was 5000 ETB and above were less likely to use PAFP than those women whose monthly income was less than 5000 ETB. This is contrary to another Ethiopian study from Addis Ababa, which found no significant association between use of post-abortion contraception and monthly income of the client [23].…”

“…Several factors are associated with women's decisions regarding starting post-abortion family planning. Studies done in Ethiopia indicate that urban residence, higher maternal education level, occupation, undergoing spontaneous abortion, receiving post abortion family planning counseling, good knowledge of family planning, and availability of family planning are significantly associated with uptake of family planning in the postabortion period [16,[20][21][22][23][24].…”

Factors Associated with Management Outcome of Incomplete Abortion in Yirgalem General Hospital, Sidama Zone, Southern Ethiopia

“…Incomplete abortion occurring in gestational age beyond 12 weeks had 3.4 times more risk developing unfavorable management outcome. This finding is in line with several studies' findings conducted in Ethiopia [ 9 , 10 , 14 ]. This is because as the fetus in the uterus grows older, the size of conceptus and blood supply is increased very much which in turn results in extensive bleeding and uterine manipulation, which harms the mother and make outcome of abortion management unfavorable.…”

“…The sample size for the second objective is calculated by taking estimated proportions of the most common risk factors determining management outcome of incomplete abortion (duration of vaginal bleeding <3 days = 80% and OR = 7.5) according to a study conducted in Adigrat Zonal Hospital, Tigray Region, Northern Ethiopia [ 14 ].…”

Role-players in abortion decision-making in the Accra Metropolis, Ghana

“…A key strength of this study is that both survey-administered interviews and IDIs were conducted in communities, and the research staff and individual respondents determined the place of interview together. This is in contrast to most post-abortion studies in which data collection occurs in health facilities [ 3 , 26 – 29 ] and carries a high risk of bias introduced by the health facility environment. Another strength of this study is the concurrent qualitative and quantitative methods, which ensured both breadth and depth and which is rarely the case in abortion research, to the best of our knowledge.…”