Abstract
To assess satisfaction with care for abortion-related complications experienced among adolescents compared to older women. A secondary analysis of the WHO Multi-Country Survey on Abortion-related Morbidity and Mortality-a cross-sectional study conducted in health facilities in 11 Sub-Saharan African countries. Women with abortion-related complications who participated in an audio computer-assisted self-interview were included. Two composite measures of overall satisfaction were created based on five questions: (1) study participants who were either satisfied or very satisfied across all five questions; and (2) study participants who reported being very satisfied only across all five questions. Multivariable general estimating equation analyses were conducted to assess whether there was any evidence that age (adolescents 12-19years and older women 20+) was associated with each composite measure of satisfaction, controlling for key confounders. The study sample consisted of 2817 women (15% adolescents). Over 75% of participants reported being satisfied or very satisfied for four out of five questions. Overall, 52.9% of study participants reported being satisfied/very satisfied across all five questions and 22.4% reported being consistently very satisfied. Multivariable analyses showed no evidence of an association between age group and being either satisfied or very satisfied (OR 1.07; 95% CI, 0.82-1.41, P=0.60), but showed strong evidence that adolescents were 50% more likely to be consistently very satisfied with their overall care than older women (OR 1.49; 95% CI, 1.13-1.96, P=0.005). Both adolescents and older women reported high levels of satisfaction with care when looking at different components of care individually, but the results of the composite measure for satisfaction showed that many study participants reported being less than satisfied with at least one element of their care. Further studies to explore the expectations, needs, and values of women's satisfaction with care for abortion-related complications are needed.
Highlights
In 2012, approximately seven million women in low-and middle- income countries received treatment for abortion-related complications as a result of unsafe abortion.[1]
Recent data from the World Health Organization (WHO) Multi-Country Survey on Abortion (MCS-A) across Sub-Saharan Africa found no evidence that the severity of complications in adolescents attending facilities with abortion-related complications was more severe when compared with older women; differences in experience of care and, satisfaction with care between adolescents and older women were not reported.[8]
Adolescents made up 15.4% of the sample (n = 435), while older women made up 84.6% of the sample (n = 2382)
Summary
In 2012, approximately seven million women in low-and middle- income countries received treatment for abortion-related complications as a result of unsafe abortion.[1]. Many providers reported risk of being stigmatized by colleagues if caught treating adolescent PAC patients politely.[5] In Ghana, Tagoe-Darko et al.[6] conducted a qualitative study among women who had been treated for postabortion complications in a large referral hospital to assess how stigma influenced the quality of PAC. Adolescent- friendly PAC services have been found to be rare in Sub-Saharan Africa.[4,6,7] Recent data from the World Health Organization (WHO) Multi-Country Survey on Abortion (MCS-A) across Sub-Saharan Africa found no evidence that the severity of complications in adolescents attending facilities with abortion-related complications was more severe when compared with older women (aged ≥30 years); differences in experience of care and, satisfaction with care between adolescents and older women were not reported.[8]
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