Health Topics
- Postabortion Family Planning Progress: The Role of Donors and Health Professional Associations
Global leadership from donors and international professional associations has enabled postabortion family planning services to be scaled up worldwide through preservice education, clinical service delivery, and global health programming.
- Postabortion Care in Humanitarian Emergencies: Improving Treatment and Reducing Recurrence
Despite the challenging environment of humanitarian emergencies, with focused programmatic attention, demand for quality postabortion care can be created and services delivered while voluntary contraceptive uptake for PAC clients can simultaneously increase substantially, even in settings where the use of contraception after abortion is often stigmatized. Greater representation of long-acting methods, as a proportion of the methods PAC clients chose, occurred in all 3 countries’ method mix, but at different rates.
- 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.
- 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.
- 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.
- “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.
- 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.
- 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.
- 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.
- Exploring Barriers: How to Overcome Roadblocks Impeding the Provision of Postabortion Care to Young People in Togo
Before providers were trained in offering youth-friendly postabortion care (PAC), including provision of voluntary contraceptive methods, no youth PAC client chose a modern method before leaving the facility. After training, over a 6-month period 41% of youth PAC clients chose a modern method, most commonly oral contraceptive pills followed by implants and injectables.