Health Systems Factors Influencing Effective FP/LARC Integration Within PAC
| Region | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Conakry | Kindia | Boke | Mamou | Labe | Faranah | Kankan | Nzérékoré | Total | |
| Health systems factors | |||||||||
| PAC health facilities (N) | 7 | 6 | 3 | 2 | 3 | 4 | 6 | 7 | 38 |
| No. of staff providing PAC servicesa | 119 | 30 | 23 | 15 | 14 | 19 | 34 | 22 | 276 |
| Median | 8 | 5.5 | 9 | 7.5 | 6 | 5 | 5.5 | 3 | 5 |
| Range | 1–39 | 1–8 | 5–9 | 3–12 | 1–7 | 4–5 | 2–10 | 0–5 | 1–39 |
| Availability of trained personnelb | |||||||||
| PAC (Total) | 128 | 43 | 54 | 38 | 31 | 33 | 49 | 40 | 416 |
| Group-based PAC course | 70 | 22 | 28 | 19 | 11 | 16 | 27 | 18 | 211 |
| On the job | 58 | 21 | 26 | 19 | 20 | 17 | 22 | 22 | 205 |
| FP/LARCs | |||||||||
| IUD | 54 | 18 | 13 | 15 | 9 | 17 | 24 | 26 | 176 |
| Implants (Jadelle) | 23 | 16 | 12 | 15 | 9 | 12 | 16 | 17 | 120 |
| Supervision tools incorporate PAC inclusive of FP | |||||||||
| Internal or external supervision or both | 7 | 5 | 3 | 2 | 3 | 4 | 6 | 7 | 37 |
| Equipment and supplies available | |||||||||
| IEC materials | 6 | 5 | 1 | 2 | 3 | 4 | 5 | 6 | 32 |
| Contraceptives in MVA room | |||||||||
| Condoms | 5 | 5 | 2 | 0 | 2 | 3 | 2 | 3 | 22 |
| Pills (POP/COC) | 5 | 5 | 3 | 1 | 2 | 4 | 5 | 6 | 31 |
| DMPA | 5 | 4 | 2 | 0 | 1 | 2 | 4 | 6 | 24 |
| IUD | 6 | 4 | 3 | 2 | 3 | 4 | 4 | 5 | 32 |
| Implants | 6 | 6 | 3 | 2 | 3 | 3 | 5 | 5 | 32 |
| MVA equipment and supplies | 3 | 0 | 1 | 0 | 0 | 0 | 0 | 3 | 7 |
| Infection prevention suppliesc | 4 | 1 | 1 | 0 | 3 | 0 | 3 | 7 | 19 |
| No. (%) of health facilities with any stock-outs of contraceptives | 1 (14) | 2 (33) | 2 (67) | 0 (0) | 2 (67) | 2 (50) | 4 (67) | 4 (57) | 17 (45) |
| No. (%) of health facilities with a complete set of minimum equipment and supplies | 3 (43) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (29) | 5 (13) |
| HMIS functioning | |||||||||
| No. (%) of health facilities that report PAC datad | 6 (86) | 5 (83) | 3 (100) | 2 (100) | 3 (100) | 3 (75) | 6 (100) | 7 (100) | 35 (92) |
Abbreviations: COC, combined oral contraceptive; DMPA, depo-medroxyprogesterone acetate; FP, family planning; HMIS, health management information system; IEC, information, education, and communication; IUD, intrauterine device; LARC, long-acting reversible contraceptive; MVA, manual vacuum aspiration; PAC, postabortion care; POP, progestin-only pill.
Data sources include maternity in-charge responses and the facility assessments.
↵a The investigators could not confirm the number of PAC providers in one health facility in N’zérékoré; thus providers are included from only 6 health facilities in that region.
↵b We assume that maternity in-charges did not list the same providers as both trained through group-based and on-the-job PAC training.
↵c Exhaustive list of 28 items that included access to water source, cleaning supplies, personal protective equipment, means to sterilize or high-level disinfect MVA equipment and instruments, containers, antiseptics, and disinfectants.
↵d Two health facility maternity in-charges, one in Conakry and one in Kindia, did not report the PAC data they collected. One health facility in Faranah did not collect PAC data at all.