Figures & Tables
Figures
- FIGURE 1
Critical Steps Component and Overall Score of PAC MVA Cases Directly Observed
Abbreviation: MVA, manual vacuum aspiration.
Note: The categories of PAC critical steps were drawn from separate sources, hindering direct comparisons of provider performance between MVA and misoprostol treatment approaches in Figure 1 and 2.
- FIGURE 2
Critical Steps Component and Overall Score of PAC Misoprostol Cases Directly Observed
Note: The categories of PAC critical steps were drawn from separate sources, hindering direct comparisons of provider performance between MVA and misoprostol treatment approaches in Figure 1 and 2.
Tables
Domains of Structural Quality Measures Assessed Service availability Reported service availability of uterine evacuation and contraceptive methods; times of service availability; availability of contraceptives to PAC clients by treatment method and contraceptive method type Human resource capacity Number of staff by training status in all PAC treatment methods, LARCs; reported proportion of time trained staff are available at facility to perform PAC Service delivery environment Observed privacy and cleanliness of PAC provision environment, availability of running water, electricity, toilet, and information, education, and communication materials on PAC; presence of sink, operating furniture, and essential linens Supplies and contraceptives Availability of essential supplies, medications, and contraceptives in PAC provision setting (i.e., those required to implement the signal functions) Infection prevention and waste management System in place for solid infectious waste disposal, liquid infectious waste disposal, availability of protocols for collection and processing of waste, facility staff trained in waste management, and availability of infection prevention materials and supplies Health information system Availability and completeness of PAC register, documentation of gestational age, and treatment detail of clients in obstetrical register and maternal death register Abbreviations: LARCs, long-acting reversible contraceptives; PAC, postabortion care.
- TABLE 2.
Critical Components of PAC Service Delivery Assessed in Direct Observations of Client-Provider Interaction
Treatment Method Critical Components MVA Initial counseling and assessment; triage; initial history; family planning history; family planning counseling; medical evaluation; discussion of treatment options; initial infection prevention; MVA preparations; MVA procedure; post-MVA infection prevention; post-procedure care/other; and predischarge care (13 components) Misoprostol Initial counseling and assessment; initial and reproductive health history (including family planning); medical evaluation; establishes diagnosis/confirms eligibility for misoprostol; informs of treatment options; provides correct information on misoprostol; ensures client understands expected effects and side effects; ensures client understands signs of complications; counsels women on return to fertility and family planning; and follow-up (10 components) Abbreviations: MVA, manual vacuum aspiration; PAC, postabortion care.
- TABLE 3.
Utilization of PAC and Uptake of Contraception by Level of Care, September 2015 to March 2016
Health Center (n=13) Hospital (n=9) Regional Referral Hospital (n=3) Total (N=25) PAC volume, total number (min, max per facility) 520 (13, 70) 827 (61, 183) 828 (114, 503) 2,175 Family planning uptake, mean % (min, max) 62 (51, 92) 66 (99, 0) 39 (8, 81) 54 LARCs uptake, mean % (min, max) 4 (0, 30) 5 (0, 26) 2 (0.6, 7) 4 Abbreviations: LARCs, long-acting reversible contraceptives; PAC, postabortion care.
- TABLE 4.
Median Percentage of Structural Quality and Readiness Criteria Fulfilled by Key Subjects for Health Centers, Hospitals, and District Hospitals
Key Subject/Variable Health Center (n=13) Hospital (n=9) Regional Referral Hospital (n=3) Triage and service availability 42 44 62 Human resource capacity 58 58 73 Service delivery environment 60 60 73 Supplies and contraceptives 41 43 53 Infection prevention and waste management 55 67 66 Health information system 38 46 72 Overall 45 49 61
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