The status of provision of post abortion care services for women and girls in Eastern and Southern Africa: a systematic review

Aantjes, Carolien; Gilmoor, Andrew R.; Syurina, Elena V.; Crankshaw, Tamaryn L.

doi:10.1016/j.contraception.2018.03.014

Cited by 24 publications

(21 citation statements)

References 77 publications

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“… 8 9 11 30 31 Our results underline the importance of using standardised definitions including the application of WHO’s near-miss criteria 29 to ensure comparability when quantifying the burden of abortion-related complications as well as measuring the progress globally and in the context of Africa. 12 13 …”

Section: Discussionmentioning

confidence: 99%

“…6 40 The less frequent use of misoprostol may be due to lack of availability, familiarity, training and guidelines as well as providers’ perceptions on misoprostol being a less effective and safe method of postabortion care. 12 40 The inequities in the provision of good quality care highlight the need to strengthen the adoption and implementation of evidence-based recommendations for the provision of postabortion care. 4 41…”

Section: Discussionmentioning

confidence: 99%

“… 44 Furthermore, provider perceptions on abortion care and workload can negatively impact provider-patient interaction, timeliness and quality of care. 12 Globally, there is growing interest in measuring person-centred reproductive healthcare including abortion care, contraception and maternity care. 38 45–47 While the evidence around measuring women’s experiences seeking abortion-related care, in particular, is limited, research efforts are increasing to support the development of measurement tools.…”

Section: Discussionmentioning

confidence: 99%

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Understanding abortion-related complications in health facilities: results from WHO multicountry survey on abortion (MCS-A) across 11 sub-Saharan African countries

et al. 2021

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IntroductionComplications due to unsafe abortions are an important cause of morbidity and mortality in many sub-Saharan African countries. We aimed to characterise abortion-related complication severity, describe their management, and to report women’s experience of abortion care in Africa.MethodsA cross-sectional study was implemented in 210 health facilities across 11 sub-Saharan African countries. Data were collected on women’s characteristics, clinical information and women’s experience of abortion care (using the audio computer-assisted self-interviewing (ACASI) system). Severity of abortion complications were organised in five hierarchical mutually exclusive categories based on indicators present at assessment. Descriptive bivariate analysis was performed for women’s characteristics, management of complications and reported experiences of abortion care by severity. Generalised linear estimation models were used to assess the association between women’s characteristics and severity of complications.ResultsThere were 13 657 women who had an abortion-related complication: 323 (2.4%) women were classified with severe maternal outcomes, 957 (7.0%) had potentially life-threatening complications, 7953 (58.2%) had moderate complications and 4424 (32.4%) women had mild complications. Women who were single, multiparous, presenting ≥13 weeks of gestational age and where expulsion of products of conception occurred prior to arrival to facility were more likely to experience severe complications. For management, the commonly used mechanical methods of uterine evacuation were manual vacuum aspiration (76.9%), followed by dilation and curettage (D&C) (20.1%). Most frequently used uterotonics were oxytocin (50∙9%) and misoprostol (22.7%). Via ACASI, 602 (19.5%) women reported having an induced abortion. Of those, misoprostol was the most commonly reported method (54.3%).ConclusionThere is a critical need to increase access to and quality of evidence-based safe abortion, postabortion care and to improve understanding around women’s experiences of abortion care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Understanding abortion-related complications in health facilities: results from WHO multicountry survey on abortion (MCS-A) across 11 sub-Saharan African countries

et al. 2021

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“…The total score was calculated and converted into an index score by dividing the total calculated score by the full attainable score. An index score of 0.59 and below was considered unsatisfactory, between 0.60 and 0.79 was considered satisfactory, and 0.80 and over was considered very good [ 56 , 57 ]. The index scores assigned by both independent reviewers (SSR and AIP) were compared.…”

Section: Methodsmentioning

confidence: 99%

Non-Communicable Diseases-Related Stigma: A Mixed-Methods Systematic Review

Sing

Syurina

Peters

et al. 2020

IJERPH

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This systematic review examines and consolidates existing evidence on stigma associated with the top four non-communicable diseases (NCDs)—cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes—and its impact on the lives of people affected. We conducted a systematic literature search in PubMed, PsycINFO, JSTOR, Science Direct, and Web of Science for original research in English that explored health-related stigma among people living with either of the four NCDs. A three-step integrative synthesis of data was conducted. Twenty-six articles (qualitative = 15; quantitative = 11) were selected, with most (n = 15) related to cancers, followed by diabetes (n = 7), chronic respiratory diseases (n = 3), and cardiovascular diseases (n = 1). Blame, shame, and fear were the main causes of stigma, the origin and nature of which differed according to the disease-specific features. The manifestations (enacted and felt stigma) and consequences (social, behavioral, psychological, and medical) of stigma across NCDs were similar. Inconsistencies existed in the conceptualization of stigma processes. To fill this gap, we developed an NCD-related stigma framework. People living with NCDs can experience stigma, which can negatively impact their health, management of their disease, and quality of life. The new framework can help in improving the understanding of the processes and experiences of stigma related to NCDs.

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“…Nevertheless, a recent systematic review of the status of PAC in Eastern and Southern Africa concluded that social stigma constitutes a major barrier to the advances of these services throughout the regions. 39 …”

Section: Literature Reviewmentioning

confidence: 99%

Abortion-related care and the role of the midwife: a global perspective

Fullerton¹,

Butler²,

Aman³

et al. 2018

IJWH

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IntroductionThe International Confederation of Midwives (ICM) represents 132 midwifery associations in 113 countries. The ICM disseminates the Essential Competencies for Basic Midwifery Practice (EC) that describes the global scope of midwifery practice. The basic (core) and expanded (additional or optional) role of midwives in providing abortion-related care services was first described in 2010. A literature review about three items that are particularly critical to access to abortion services was conducted. Findings that emerged in the recent 2016–2017 update study about these three items are presented.MethodsA modified Delphi study was administered via the Internet in a series of three rounds. Thirty-seven statements of abortion-related knowledge and skill were presented.ResultsA total of 895 individuals participated. The total of respondents across all three rounds represented 90 of the 105 member countries at the time of the study. The role of midwives in providing comprehensive abortion care, including referral for abortion and provision of postabortion family planning, achieved the necessary 85% agreement to be designated as essential (basic) knowledge or skill for the global scope of midwifery practice. The provision of medication abortion and performance of manual vacuum aspiration abortion were designated as optional for midwives who wished to provide these services. Endorsement of these latter practices was highest in both Francophone and Anglophone regions of Africa, Asian Pacific countries, and countries at a lower state of economic development.ConclusionThe role of midwives in provision of abortion-related care services was reaffirmed in the recent Delphi study to inform the update to the EC. The role of midwives as direct providers of medical and vacuum aspiration abortions was reaffirmed for those individual midwives who wish to obtain the requisite competency to provide those services, in jurisdictions where these services are legally authorized.

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The status of provision of post abortion care services for women and girls in Eastern and Southern Africa: a systematic review

Cited by 24 publications

References 77 publications

Understanding abortion-related complications in health facilities: results from WHO multicountry survey on abortion (MCS-A) across 11 sub-Saharan African countries

Understanding abortion-related complications in health facilities: results from WHO multicountry survey on abortion (MCS-A) across 11 sub-Saharan African countries

Non-Communicable Diseases-Related Stigma: A Mixed-Methods Systematic Review

Abortion-related care and the role of the midwife: a global perspective

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