More articles from ORIGINAL ARTICLE
- Three Waves of Data Use Among Health Workers: The Experience of the Better Immunization Data Initiative in Tanzania and Zambia
Data quality and use rollout in Tanzania's and Zambia's immunization programs progressed along 3 phases—from strengthening data collection, to improving data quality, to increasing data use for programmatic decision making cultivating a culture of data use.
- Unintended Consequences of mHealth Interactive Voice Messages Promoting Contraceptive Use After Menstrual Regulation in Bangladesh: Intimate Partner Violence Results From a Randomized Controlled Trial
Automated interactive voice messages about post-menstrual regulation contraception delivered to women in Bangladesh via mobile phone were associated with increased reports of intimate partner violence. This finding highlights the importance of taking steps to minimize risk when delivering phone messages on sensitive topics and the need for assessing violence in such situations.
- Evidence-Based Process for Prioritizing Positive Behaviors for Promotion: Zika Prevention in Latin America and the Caribbean and Applicability to Future Health Emergency Responses
To maximize the impact of Zika prevention programming efforts, a prioritization process for social and behavior change programming was developed based on a combination of research evidence and programmatic experience. Prioritized behaviors were: application of mosquito repellent, use of condoms, removing unintentional standing water, covering and scrubbing walls of water storage containers, seeking prenatal care, and seeking counseling on family planning if not planning to get pregnant.
- “They Love Their Patients”: Client Perceptions of Quality of Postabortion Care in North and South Kivu, the Democratic Republic of the Congo
Women who sought postabortion care (PAC) at supported health facilities reported positive experiences, particularly regarding client-provider interactions, demonstrating the feasibility of implementing good-quality, respectful PAC in a humanitarian setting.
- The Quality of Postabortion Care in Tanzania: Service Provider Perspectives and Results From a Service Readiness Assessment
Of the approximately 2,000 postabortion care (PAC) clients treated over 6 months in 2016, 55% chose a contraceptive method before discharge. Gaps in PAC availability and quality spanned multiple domains including human resource capacity and availability of supplies and contraceptives. While PAC providers generally expressed commitment to providing high-quality care, several facility and systems factors constrained their efforts, including limited training and facility space, lack of time, and supply chain challenges.
- Reducing Barriers to Postabortion Contraception: The Role of Expanding Coverage of Postabortion Care in Dar es Salaam, Tanzania
Expanding postabortion care (PAC) coverage to 64 public facilities over 30 months in Dar es Salaam, Tanzania, contributed to >6,000 women voluntarily adopting a contraceptive method, for an overall acceptance rate of about 81% and 78% adopting a long-acting method. Key interventions included clinical training and follow-up mentorship; PAC service reorganization, equipment provision, and an expanded method mix offering; standardized PAC documentation tools; and community linkages and referrals.
- Voluntary Contraceptive Uptake Among Postabortion Care Clients Treated With Misoprostol in Rwanda
Voluntary contraceptive uptake among postabortion care clients treated with misoprostol in Rwanda was high and unhindered by the extended bleeding that sometimes occurs with misoprostol use. However, provider knowledge regarding return to fertility and contraceptive methods appropriate for postabortion care clients should be strengthened.
- Women’s Satisfaction With and Perceptions of the Quality of Postabortion Care at Public-Sector Facilities in Mainland Tanzania and in Zanzibar
Tanzanian women expressed greater satisfaction with postabortion care received at district hospitals and health centers, where they experienced shorter waiting times, more family planning counseling, and threefold greater voluntary uptake of family planning, than at regional hospitals. Continued decentralization to district hospitals would likely enhance client satisfaction with postabortion care.
- Findings and Lessons Learned From Strengthening the Provision of Voluntary Long-Acting Reversible Contraceptives With Postabortion Care in Guinea
Integrating voluntary long-acting reversible contraceptive (LARC) methods within postabortion care (PAC) in Guinea has increased LARC uptake among PAC clients, compared with non-PAC clients. With aid from government champions and leveraging of resources, Guinea has incorporated PAC into national policies and guidelines and trained providers on PAC and LARCs to expand service provision.
- The Unit and Scale-Up Cost of Postabortion Care in Tanzania
Given the high burden and cost of postabortion care (PAC) in Tanzania, health policy should strengthen voluntary family planning programs and the availability of a variety of contraceptive methods to PAC clients. A particular focus should be placed on decentralizing PAC to lower-level facilities, including health centers and dispensaries, which can provide safe, accessible, and appropriate PAC at the lowest cost including surgical or medical options.