Health Systems Factors Influencing Effective FP/LARC Integration Within PAC

Health systems factors
PAC health facilities (N)7632346738
No. of staff providing PAC servicesa11930231514193422276
Availability of trained personnelb
PAC (Total)12843543831334940416
 Group-based PAC course7022281911162718211
 On the job5821261920172222205
 Implants (Jadelle)231612159121617120
Supervision tools incorporate PAC inclusive of FP
Internal or external supervision or both7532346737
Equipment and supplies available
IEC materials6512345632
Contraceptives in MVA room
 Pills (POP/COC)5531245631
MVA equipment and supplies301000037
Infection prevention suppliesc4110303719
No. (%) of health facilities with any stock-outs of contraceptives1 (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 supplies3 (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 datad6 (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.