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Private-sector postabortion care services offered by nurse-midwives in Kenya: How sustainable are they?

Stephen Musau1, Maureen Corbett, MIA2, Christine Ayuyo2, Tom Omurwa2, and Elizabeth Fischer, MCRP1. (1) Abt Associates, Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301-913-0500, dnelson@intrahealth.org, (2) IntraHealth International, 1700 Airport Rd., Suite 300, CB 8100, Chapel Hill, NC 27599-8100

Private-sector health care providers have become an important source of quality postabortion care (PAC) services in Kenya. From 1998 to 2002, in partnership with the National Nursing Association of Kenya and the Nursing Council of Kenya, the PRIME I and PRIME II projects trained and equipped more than 200 primary-level private nurse-midwives in Nairobi, Rift Valley and Central provinces to deliver PAC services, including family planning and STI/HIV services. Private providers found that PAC services may not be profitable, however, resulting in some providers offering only partial PAC services, discontinuing PAC services entirely, or providing services at a financial loss. This finding challenged a key assumption about working with the private sector: that the fee-for-service structure would increase the potential for sustainable PAC services. Before further investment in scaling-up PAC among private-sector providers in Kenya, it is imperative to identify and document the key determinants of long-term sustainability of PAC services. To understand the full range of issues that affect sustainability in the Kenyan context, PRIME is conducting a study to document the factors that facilitate or hinder PAC service sustainability. The study asks: "What needs to be done with the existing comprehensive PAC services offered by private-sector nurse-midwives in Kenya to increase the sustainability of these services for ongoing PAC providers and for PAC providers included in future scale-up?" Study results and recommendations should be of interest to implementers of programs in other countries that seek to establish or scale-up sustainable private-sector PAC services in low-resource settings.

Learning Objectives:

Keywords: Post-Abortion Care, Sustainability

Presenting author's disclosure statement:
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.

Post Abortion Care: Programming for Success

The 132nd Annual Meeting (November 6-10, 2004) of APHA