In Ethiopia maternal deaths associated with complications of pregnancy and delivery are among the highest world-wide. Several studies indicate that complications of unsafe abortion account for 25-50% of these deaths. Ipas/Ethiopia collaborated with three Regional Health Bureaus to conduct an assessment of postabortion care (PAC) services. In the three regions, 27 hospitals and 93 health centers (62% coverage) were assessed for the availability and quality of postabortion clinical services, staff competence, provision of postabortion family planning and counselling, infection prevention and completeness of record keeping. Only half of the facilities provided uterine evacuation services (treatment for incomplete abortions); most were in hospitals. Only 12% of facilities offered manual vacuum aspiration (MVA), a simple, safe and low cost procedure for uterine evacuation. Almost three-quarters of these facilities provided nothing for managing pain of uterine evacuations. Women receiving treatment for incomplete abortions are often discharged without the means to prevent another unwanted pregnancy. While many women may receive family planning “counselling”, the quality and consistency of these messages is overlooked. More than 80% of facilities do not provide contraceptive methods at the site of PAC services. Most women who are treated for an incomplete abortion leave without a family planning method. The results of this assessment are being used to design service delivery interventions for scaling up PAC services and to provide a message to stakeholders about the magnitude of the problem.
Learning Objectives: 1. Discuss the key aspects of postabortion care service delivery in Ethiopia. 2. Recognize the need for PAC service delivery improvements for the prevention of maternal mortality in Ethiopia.
Keywords: Abortion, Access and Services
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The authors are employees of Ipas, a non-profit international reproductive health organization. Ipas provides technical assistance in training, service delivery, research, and policy, and produces and distributes manual vacuum aspiration instruments.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.