Recorded presentation

Rosemarie Muganda¹, Muadi Mukenge, MA², Jacob Ochieng³, Kitche Magak, MA⁴, Christine Ombaka, MA⁴, Monica Oguttu³, Solomon Orero, MD⁴, Khama Rogo, MD, PhD⁴, and Innocentia Riker, MA². (1) Center for the Study of Adolescence, PO Box 19329, Nairobi, Kenya, 254 2 4445951, csa@africaonline.co.ke, (2) Africa Program, Pacific Institute for Women's Health, 3450 Wilshire Blvd., Suite 1000, Los Angeles, CA 90010, (3) KMET, Kenya Medical and Educational Trust, PO Box 6805, Kisumu, Kenya, (4) Centre for the Study of Adolescence, PO Box 19329, Nairobi, Kenya

The presentation shares findings from the final evaluation of an intervention project entitled Community-Based Abortion Care (COBAC), designed to prevent unsafe abortion in rural Western Kenya. The COBAC strategy, which mainstreams community involvement in the prevention of unsafe abortion, supplements the traditional medical approach to post-abortion care (PAC).

In Kenya, 35% - 50% of maternal deaths are due to complications from unsafe abortion.

The COBAC interventions include:

· Community sensitisation and mobilisation, including peer education and the use of film, to increase awareness of reproductive health services; · Facilitating herbalists and other community-based health workers as referral points for women needing PAC; · Building the capacity of professional healthcare providers to provide efficient reproductive health services, especially PAC services; · Creating linkages between informal, mid-level and upper-level healthcare providers

The final evaluation assesses quality of care at participating facilities, change in demand for family planning and PAC, community involvement in the COBAC program, and attitude change towards unintended pregnancy and abortion services.

Mid-term evaluation results already revealed that maternal deaths from unsafe abortion have decreased from 14 in 2001 to 1 in 2002 and none in 2003. Since COBAC activities began, facilities offering PAC services have increased from 1 to 17. There is a significant increase in use of family planning with 63% of the community obtaining non-prescriptive contraceptives from community-based health workers.

The findings validate linkages between the community and trained formal providers as a strategy to increase access to high quality PAC services and decrease maternal mortality.

Learning Objectives: