More articles from ORIGINAL ARTICLE
- 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.
- “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.
- The Role of Digital Strategies in Financing Health Care for Universal Health Coverage in Low- and Middle-Income Countries
The development and adoption of effective digital health financing solutions that fit well in both coherent digital health information architectures and the universal health coverage agenda will require strong partnerships between entrepreneurs, developers, implementers, policy makers, and funders.
- Strengthening Delivery of Health Services Using Digital Devices
Delivery of high-quality efficient health services is a cornerstone of the global agenda to achieve universal health coverage. Digital health interventions for service delivery, such as digital health-enhanced referral coordination and mobile clinical decision support systems, demonstrate considerable potential to improve the quality and comprehensiveness of care received by patients but require greater standardization and engagement of health workers at different levels of the health system for effective scale up.
- The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps
Despite advances in digital technology to generate demand for health services, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. Future research should examine the long-term effects of, equity in access to, and cost-effectiveness and efficiency of digital demand generation interventions.