Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117286

Solomon Tesfaye, MD, MPH, Research and Evaluation, Ipas Ethiopia, 300 Market Street, Suite 200, Chapel Hill, NC 27516 and Tamara Fetters, MPH, Research and Evaluation Unit, Ipas, 300 Market St, Ste 200, Chapel Hill, NC 27516, 919-960-5629, fetterst@ipas.org.

In Ethiopia treating complications of abortion is commonplace in hospitals yet health centers (PHCs) have been slow to respond. A 2002 study examined abortion complications within hospitals and estimated 212,000 postabortion cases and 2,571 deaths result from abortion each year, researchers estimated treating these complications cost almost USD$7.5 million. Increased morbidity, mortality and costs are all associated with unnecessary delays to receiving appropriate postabortion care.

In 2000 and 2004, Ipas Ethiopia collaborated with the Ministry of Health on a pre-post evaluation of the availability and quality of postabortion clinical services. Twenty-seven hospitals and 93 PHCs were included and 42 intervention sites (31 of which were PHCs) were disaggregated for further analysis.

Access to emergency PAC services increased from 42 to 71% in PHCs primarily due to skill-building among midlevel providers (MLPs). In 2004, 21 MLPs reported they were the primary PAC providers and 55% of the PHCs reported using MVA, both of these figures were zero at baseline. Facilities with one or more provider capable of delivering PAC improved from 13% to 87% in the PHCs. The proportion of appropriate cases treated with MVA increased from 15% to 38% in these same sites. Providers reporting that they regularly distribute postabortion contraception increased from 15% to 77%. Additionally, reports of the length of patient stay decreased, usage of pain medication and client loads increased from 2000 to 2004.

Results of this assessment are being disseminated within Ethiopia and used to design and evaluate interventions for scaling up PAC services.

Learning Objectives:

• Describe the improvements to postabortion care access in Ethiopia created with a program focus on primary care and midlevel providers
• Develop a simple and low-cost program evaluation design to determine project impact
• Discuss the impact of abortion complications on the Ethiopian health system, men and women

Keywords: Post-Abortion Care, Evaluation

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF Ipas is an international NGO that promotes reproductive and sexual rights through support for training, service delivery, policy and research. Ipas also manufactures and distributes MVA instruments..

Recorded presentation