Barriers to post-abortion care service provision: A cross-sectional analysis in Burkina Faso, Kenya and Nigeria.

Autor:	Muga W; African Population Health and Research Center, Nairobi, Kenya., Juma K; African Population Health and Research Center, Nairobi, Kenya., Athero S; African Population Health and Research Center, Nairobi, Kenya., Kimemia G; African Population Health and Research Center, Nairobi, Kenya., Bangha M; African Population Health and Research Center, Nairobi, Kenya., Ouedraogo R; African Population Health and Research Center, Nairobi, Kenya.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2024 Mar 07; Vol. 4 (3), pp. e0001862. Date of Electronic Publication: 2024 Mar 07 (Print Publication: 2024).
DOI:	10.1371/journal.pgph.0001862
Abstrakt:	Despite several political commitments to ensure the availability of and access to post-abortion care services, women in sub-Saharan Africa still struggle to access quality post-abortion care, and with devastating social and economic consequences. Expanding access to post-abortion care while eliminating barriers to utilization could significantly reduce abortions-related morbidity and mortality. We describe the barriers to providing and utilizing post-abortion care across health facilities in Burkina Faso, Kenya, and Nigeria. This paper draws on three data sources: health facility assessment data, patient-exit interview data, and qualitative interviews conducted with healthcare providers and policymakers. All data were based on a cross-sectional survey of a nationally representative sample of health facilities conducted between November 2018 and February 2019. Data on post-abortion care service indicators were collected, including staffing levels and staff training, availability of post-abortion care supplies, equipment and commodities. Patient-exit interviews focused on patients treated for post-abortion complications. In-depth interviews were conducted with healthcare providers within a sample of the study health facilities and national or local decision-makers in sexual and reproductive health. Few primary-level facilities in Burkina Faso (15%), Kenya (46%), and Nigeria (20%) had staff trained on post-abortion care. Only 16.6% of facilities in Kenya had functional operating theaters or MVA rooms, Burkina Faso (20.3%) and Nigeria (50.7%). Primary facilities refer post-abortion care cases to higher-level facilities despite needing to be more adequately equipped to facilitate these referrals. Several challenges that impede the provision of quality and comprehensive post-abortion care across the three countries. The absence of post-abortion care training, equipment, and inadequate referral capacity was among the critical reasons for the lack of services. There is a need to strengthen post-abortion care services across all levels of the health system, but especially at lower-level facilities where most patients seek care first. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2024 Muga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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