Postabortion Care Services for Youth and Adult Clients in Kenya: A Comparison of Services, Client Satisfaction and Provider Attitudes

Unsafe abortion accounts for 35% of maternal mortality in Kenya. Postabortion care (PAC)—the treatment of obstetric complications from unsafe abortion and miscarriage—reduces maternal death and morbidity and provides an opportunity to prevent future unwanted pregnancies and address other sexual and reproductive concerns. The core components of PAC include: emergency treatment, family planning and other sexual and reproductive health services. Few studies have documented the services clients receive during PAC and how they vary by client age. This is important given the needs of youth seeking PAC have been found to be different from older women and very few PAC programs train providers to meet the needs of young women. Descriptive data were collected from 283 PAC clients, 20 providers and eight health facilities in Kenya's Central and Nairobi Provinces to examine receipt of services by client age, client satisfaction and provider attitudes. Delivery of PAC treatment, pain management, and HIV/STI services did not vary by age. No differences in client satisfaction were found between youth and older clients with the majority reporting high levels of satisfaction and positive attitudes towards providers. Providers also reported favorable attitudes towards clients. Fewer youth received a contraceptive method compared to adult clients (35% versus 44%). Forty-nine percent of youth reported not using a contraceptive method due to fears of infertility, side effects or lack of knowledge compared with 22% of adults. Efforts to strengthen FP services for young PAC clients could reduce unintended pregnancies and decrease the possibility of future unsafe abortions.