Post-abortion Care Services Research Articles

Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

BackgroundAfghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services.MethodsAccessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions.ResultsMost facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage.ConclusionsThis study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

The health system costs of post abortion care in Tanzania

BackgroundUnsafe abortion is common in Tanzania. Currently, postabortion care (PAC) is legally provided, but there is little information on the national cost. We estimated the health system costs of offering PAC in Tanzania in 2018, at existing levels of care and when hypothetically expanded to meet all need.MethodsWe employed a bottom-up costing methodology. Between October 2018 and February 2019, face-to-face interviews were conducted with facility administrators and PAC providers in a sample of 40 health facilities located across seven mainland regions and Zanzibar. We collected data on the direct and indirect cost of care, fees charged to patients, and costs incurred by patients for PAC supplies. Sensitivity analysis was used to explore the impact of uncertainty in the analysis.ResultsOverall, 3850 women received PAC at the study facilities in 2018. At the national level, 77,814 women received PAC, and the cost per patient was $58. The national health system cost for PAC provision at current levels totaled nearly $4.5 million. Meeting all need for PAC would increase costs to over $11 million. Public facilities bore the majority of PAC costs, and facilities recovered just 1% of costs through charges to patients. On average PAC patients incurred $7 in costs ($6.17 for fees plus $1.35 in supplies).ConclusionsResources for health care are limited. While working to scale up access to PAC services to meet women’s needs, Tanzanian policymakers should consider increasing access to contraception to prevent unintended pregnancies.

Utilization and its factors of post abortion modern contraceptive in Ethiopia: a systematic review and meta-analysis

BackgroundProviding post-abortion care service is a widely accepted to reduce maternal morbidity and mortality by promoting, preventing and treating maternal and neonatal health, identifying the utilization and its factor of post abortion contraceptive is crucial. Therefore we tried to review post abortion contraceptive utilization and its factors in Ethiopia.MethodsA review was performed by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic and a comprehensive literature searching mechanism were used without any restriction, through Google scholar, PubMed, EMBASE, Scopus, Web of Sciences, and Grey literature databases for reporting utilization of post abortion family planning. Pilo-tested were performed in random sample studies and a standardized data extraction form was used. All statistical analyses were done using STATA version 14 software for windows, and meta-analysis was used with a random-effects method. The results are presented using texts, tables and forest plots with measures of effect and 95% confidence interval.ResultsAmong 1221 records, 11 studies were taken in the meta-analysis with 4336 Participants that full fill the inclusion criteria. The pooled prevalence of post abortion contraceptive in Ethiopia was 74.56% (95% CI (73.31%, 75.81%)). Married women (OR 2.01 (95% CI (1.52, 2.66), I2: 0.0%)), women who were counseled (OR 5.36 (95% CI (3.10, 9.29), I2: 79.5%)), women whose educational level tertiary and above (OR 2.28 (95% CI (1.66, 3.17), I2: 0.0%)), women who had ever used contraceptive (OR 3.76 (95% CI (2.19, 6.47), I2: 67.8%)) and those women’s age 15–24 years old (OR 8.35 (95% CI (2.74, 14.74), I2: 87.4)) were statistically significant.ConclusionAccording to World Health Organization (WHO) guideline, "after a miscarriage or induced abortion, the recommended minimum interval to next pregnancy is at least 6 months in order to reduce risks of adverse maternal and perinatal outcomes".. According to this post abortion contraceptive utilization in Ethiopia is not optimal. Marital status, education, Counsel, previously exposed and age were significantly associated. Therefore, the Ministry of Health should work target fully to address those problems to maintain maternal and child health in Ethiopia.

Factors Facilitating the Uptake of Post-Abortion Care Services in Dar es Salaam, Tanzania

Unsafe abortion is associated with health complications which contribute to the global burden of maternal mortality. Post-abortion care is then promoted as a key strategy for addressing complications associated with unsafe, induced and spontaneous abortion. Prompt utilization of post abortion care (PAC) services has high chances of reducing the morbidity and mortality associated with abortion complications. This article employs data from a cross-sectional study in Temeke District in Dar es Salaam, Tanzania, involving 103 women who sought PAC services from health facilities. Qualitative and quantitative approaches were applied in the collection and analysis of data. Random sampling was used to select the facilities, while the respondents were recruited through criterion sampling. A semi-structured questionnaire was administered to women who utilized PAC services when they were about to exit health facilities. A descriptive thematic analysis approach was employed to analyse qualitative information, while descriptive statistics and univariate approaches were used to analyse quantitative data. The findings revealed that the availability of PAC services in the study facilities, sharing of information about one’s health status, ability to cater for transport and treatment costs, privacy and less waiting time, as well as availability and reliability of transport for emergency cases were the main factors that facilitated the uptake of PAC services. Also, the findings suggest that in areas where abortion is stigmatized and legally restricted, utilization of PAC services can be enhanced if such services are openly available and affordable. Moreover, privacy and less waiting time may further guarantee the uptake of PAC services. Likewise, there is a need to raise awareness about PAC and the availability of PAC services in Tanzania. Also, efforts should be made to ensure that privacy is maintained throughout the delivery of care to enhance the utilization of PAC services.

Postabortion care availability, facility readiness and accessibility in Nigeria and Côte d'Ivoire.

Postabortion care (PAC) is an essential component of emergency obstetric care (EmOC) and is necessary to prevent unsafe abortion-related maternal mortality, but we know little regarding the preparedness of facilities to provide PAC services, the distribution of these services and disparities in their accessibility in low-resource settings. To address this knowledge gap, this study aims to describe PAC service availability, evaluate PAC readiness and measure inequities in access to PAC services in seven states of Nigeria and nationally in Côte d’Ivoire. We used survey data from reproductive-age women and the health facilities that serve the areas where they live. We linked facility readiness information, including PAC-specific signal functions, to female data using geospatial information. Findings revealed less than half of facilities provide basic PAC services in Nigeria (48.4%) but greater PAC availability in Côte d’Ivoire (70.5%). Only 33.5% and 36.9% of facilities with the capacity to provide basic PAC and only 23.9% and 37.5% of facilities with the capacity to provide comprehensive PAC had all the corresponding signal functions in Nigeria and Côte d’Ivoire, respectively. With regard to access, while ∼8 out of 10 women of reproductive age in Nigeria (81.3%) and Côte d’Ivoire (79.9%) lived within 10 km of a facility providing any PAC services, significantly lower levels of the population lived <10 km from a facility with all basic or comprehensive PAC signal functions, and we observed significant inequities in access for poor, rural and less educated women. Addressing facilities’ service readiness will improve the quality of PAC provided and ensure postabortion complications can be treated in a timely and effective manner, while expanding the availability of services to additional primary-level facilities would increase access—both of which could help to reduce avoidable abortion-related maternal morbidity and mortality and associated inequities.

Constrains for seeking post-abortion care among adolescents and young women in Guangzhou, China: a cross-sectional study

BackgroundIn China, post-abortion care (PAC) services mainly focus on married couples, such that adolescents and unmarried young women have limited access to those services for contraception counseling. The provision of youth-friendly PAC services in public hospitals is a new concept in China. This study examined the magnitude of PAC services utilization as well as factors influencing its uptake among adolescents and young women in Guangzhou, China.MethodsA cross-sectional study was performed from 1st March 2020 to 30th September 2020 using an anonymous self-administered questionnaire among 688 women aged 15–24 years in Tianhe district, Guangzhou. The Multivariate logistic regression was used to determine factors that were significantly associated with the uptake of PAC services.ResultsThe magnitude of PAC services utilization was 35.9% among adolescents and young women in Guangzhou, China. Students were 69.0% significantly less likely to use PAC services compared to women who had no job. Immigrants were 59.0% significantly less likely to use PAC services than their native counterparts. Women who had a feeling of stigma were 70.0% significantly less likely to use PAC services compared to those who did not feel stigmatized.ConclusionsThe study highlights the need to strengthen youth-friendly PAC services provision, and emphasizes the importance of education about both family planning and abortion services among disadvantaged subgroups of women in the study setting.

The macroeconomics of abortion:A scoping review and analysis of the costs and outcomes.

Although abortion is a common gynecological procedure around the globe, we lack synthesis of the known macroeconomic costs and outcomes of abortion care and abortion policies. This scoping review synthesizes the literature on the impact of abortion-related care and abortion policies on economic outcomes at the macroeconomic level (that is, for societies and nation states). Searches were conducted in eight electronic databases. We conducted the searches and application of inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined one of the following macroeconomic outcomes: costs, impacts, benefits, and/or value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 189 data extractions with macroeconomic evidence, costs at the national level are the most frequently reported economic outcome (n = 97), followed by impacts (n = 66), and benefits/value (n = 26). Findings show that post-abortion care services can constitute a substantial portion of national expenditures on health. Public sector coverage of abortion costs is sparse, and individuals bear most of the costs. Evidence also indicates that liberalizing abortion laws can have positive spillover effects for women's educational attainment and labor supply, and that access to abortion services contributes to improvements in children's human capital. However, the political economy around abortion legislation remains complicated and controversial. Given the highly charged political nature of abortion around the global and the preponderance of rhetoric that can cloud reality in policy dialogues, it is imperative that social science researchers build the evidence base on the macroeconomic outcomes of abortion services and regulations.

Experiences of women seeking post-abortion care services in a Regional Hospital in Ghana.

IntroductionAbortions remain one of the highest contributors to maternal deaths in Ghana. In 2003, a policy on post-abortion care was introduced to help reduce abortion-related mortality and morbidity. However, depending on the method of pregnancy termination; women encounter varying experiences. This study examines the experiences of women seeking post-abortion care services in a Regional Hospital in Ghana.Materials and methodsIn-depth interview technique was used to collect data from 20 purposively selected post-abortion care clients at the Volta Regional Hospital. Data were analysed manually using a qualitative content analysis technique.ResultsThe study found that medical abortion was the main method of pregnancy termination used by women who participated in the study to induce abortion. Spontaneous abortion, however, was attributed mainly to engaging in activities that required the use of excessive energy and travelling on bad roads by pregnant women. The study also revealed that, women do not seek early post-abortion care services due to stigma and poverty.ConclusionsWe found that severity of pain from complications, stigma and financial constraints were factors that influenced women’s decision to seek post-abortion care services. Our findings also suggest that women who experienced spontaneous abortion mainly received financial and emotional support from partners and other family members. To encourage women to seek early post-abortion care services, the Ministry of Health and the Ghana Health Service should take pragmatic steps to educate women on the dangers associated with delay in seeking post-abortion care services and the factors that expose women to spontaneous abortions.

Effects of implementing a postabortion care strategy in Kinshasa referral hospitals, Democratic Republic of the Congo

ObjectivesTo evaluate the effects of the implementation of a postabortion care (PAC) strategy in Kinshasa referral hospitals, this study analyzed the quality of postabortion care services, including postabortion contraception, and the duration of hospitalization.MethodologyWe estimated the effects of the PAC strategy using a quasi-experimental study by evaluating the outcomes of 334 patients with the diagnosis of a complication of induced abortion admitted to 10 hospitals in which the PAC strategy was implemented compared to the same outcomes in 314 patients with the same diagnosis admitted to 10 control facilities from 01/01/2016 to 12/31/2018. In response to government policy, the PAC strategy included the treatment of abortion complications with recommended uterine evacuation technology, the family planning counseling and service provision, linkages with other reproductive health services, including STI evaluation and HIV counseling and/or referral for testing, and partnerships between providers and communities. The information was collected using a questionnaire and stored using open data kit software. We supplemented this information with data abstracted from patient records, facility registries of gynecological obstetrical emergencies, and family planning registries. We analyzed data and developed regression models using STATA15. Thus, we compared changes in use of specific treatments and duration of hospitalization using a "difference-in-differences" analysis.ResultsThe implementation of PAC strategy in Kinshasa referral hospitals has resulted in the utilization of WHO recommended uterine evacuation method MVA (29.3% more in the experimental structures, p = 0.025), a non-significant decline in sharp-curettage (19.3% less, p = 0.132), and a decline in the duration of hospitalization of patients admitted for PAC (1 day less, p = 0.020). We did not observe any change in the use of PAC services, mortality, and the provision of post abortion contraception.ConclusionDespite significant improvement in the management of PAC, the uptake in WHO approved technology—namely MVA, and the duration of hospitalization, these outcomes while a significant improvement for DRC, indicate that additional quality improvement strategies for management of PAC and risk-mitigating strategies to reduce barriers to care are required.

Strengthening healthcare providers\u2019 capacity for safe abortion and post-abortion care services in humanitarian settings: lessons learned from the clinical outreach refresher training model (S-CORT) in Uganda, Nigeria, and the Democratic Republic of Congo

BackgroundFragile and crisis-affected countries account for most maternal deaths worldwide, with unsafe abortion being one of its leading causes. This case study aims to describe the Clinical Outreach Refresher Training strategy for sexual and reproductive health (S-CORT) designed to update health providers’ competencies on uterine evacuation using both medications and manual vacuum aspiration. The paper also explores stakeholders’ experiences, recommendations for improvement, and lessons learned.MethodsUsing mixed methods, we evaluated three training workshops that piloted the uterine evacuation module in 2019 in humanitarian contexts of Uganda, Nigeria, and the Democratic Republic of Congo.ResultsResults from the workshops converged to suggest that the module contributed to increasing participants’ theoretical knowledge and possibly technical and counseling skills. Equally noteworthy were their confidence building and positive attitudinal changes promoting a rights-based, fearless, non-judgmental, and non-discriminatory approach toward clients. Participants valued the hands-on, humanistic, and competency-based training methodology, although most regretted the short training duration and lack of practice on real clients. Recommendations to improve the capacity development continuum of uterine evacuation included recruiting the appropriate health cadres for the training; sharing printed pre-reading materials to all participants; sustaining the availability of medication and supplies to offer services to clients after the training; and helping staff through supportive supervision visits to accelerate skills transfer from training to clinic settings.ConclusionsWhen the lack of skilled human resources is a barrier to lifesaving uterine evacuation services in humanitarian settings, the S-CORT strategy could offer a rapid hands-on refresher training opportunity for service providers needing an update in knowledge and skills. Such a capacity-building approach could be useful in humanitarian and fragile settings as well as in development settings with limited resources as part of an overall effort to strengthen other building blocks of the health system.

Out-of-clinic and self-managed abortion in Bangladesh: menstrual regulation provider perspectives

BackgroundIn Bangladesh, abortion is illegal except to save a woman’s life, though menstrual regulation (MR) is permitted. MR involves the use of manual uterine aspiration or Misoprostol (with or without Mifepristone) to induce menstruation up to 10–12 weeks from the last menstrual period. Despite the availability of safe and legal MR services, abortions still occur in informal setttings and are associated with high complication rates, causing women to then seek post abortion care (PAC). The objective of this study is to contextualize MR in Bangladesh and understand systemic barriers to seeking care in formal settings and faciltators to seeking care in informal settings via the perspective of MR providers in an effort to inform interventions to improve MR safety.MethodsQualitative individual semi-structured interviews were conducted with 25 trained MR providers (doctors and nurses) from urban tertiary care facilities in six different cities in Bangladesh from April to July, 2018. Interviews explored providers’ knowledge of MR and abortion in Bangladesh, knowledge/experience with informal MR providers, knowledge/experience with patients attempting self-managed abortion, personal attitudes and moral perspectives of MR/abortion in general, and barriers to formal MR. Team based coding and a directed content analysis approach was performed by three researchers.ResultsThere were three predominant yet overlapping themes: (i) logistics of obtaining MR/PAC/abortion, (ii) provider attitudes, and (iii) overcoming barriers to safe MR. With regards to logistics, lack of consensus among providers revealed challenges with defining MR/abortion gestational age cutoffs. Increasing PAC services may be due to patients purchasing Mifepristone/Misoprostol from pharmacists who do not provide adequate instruction about use, but are logistically easier to access. Patients may be directed to untrained providers by brokers, who intercept patients entering the hospitals/clinics and receive a commission from informal clinics for bringing patients. Provider attitudes and biases about MR can impact who receives care, creating barriers to formal MR for certain patients. Attitudes to MR in informal settings was overwhelmingly negative, which may contribute to delays in care-seeking and complications which endanger patients. Perceived barriers to accessing formal MR include distance, family influence, brokers, and lack of knowledge.ConclusionsLack of standardization among providers of MR gestational age cutoffs may affect patient care and MR access, causing some patients to be inappropriately turned away. Providers in urban tertiary care facilities in Bangladesh see primarily the complicated MR/PAC cases, which may impact their negative attitude, and the safety of out-of-clinic/self-managed abortion is unknown. MR safety may be improved by eliminating brokers. A harm reduction approach to improve counseling about MR/abortion care in pharmacies may improve safety and access. Policy makers should consider increasing training of frontline health workers, such as Family Welfare Visitors to provide evidence-based information about Mifepristone/Misoprostol.

Induced abortions in Pakistan: an afflicting challenge needing addressal

Unintended pregnancies due to low prevalence of contraceptive use in Pakistan leads to a huge burden of induced abortions. These abortions are a major cause of concern, as a majority of these abortions are performed in an unhygienic environment by untrained providers, leading to maternal morbidities and mortalities. Some of the contributing factors of unsafe abortions are lack of availability of quality services, financial barriers, stigma associated with abortion and lack of awareness about abortion law. Therefore, there is an urgent need to invest on family planning and post-abortion care services through health system strengthening approach. The proposed comprehensive strategy for actions at the individual, facility, community and policy levels can address the issue of unsafe abortion in the country.

Client Satisfaction in the Quality of Post Abortion Care Among Women Attending in Public Health Facility of Gambella, Ethiopia

Background: The quality of post-abortion care services is essential to improve the health of women who experience complications from abortion. Abortion and its complication is the most common cause of maternal death in Africa, particularly in Ethiopia. Despite this fact, little attention is given to the quality of post-abortion care. This study was aimed to assess client satisfaction in the quality of post-abortion care among women in the public health facility of Gambella, Ethiopia. Methods: A facility-based crossectional study was done among 194 participants. A consecutive sampling technique was used to select the study participants. A structured, pretested, and interviewer-administered questioner was used to collecting the data. Binary and multivariable logistic regression analysis was done to identify associated factors. An adjusted odds ratio with 95% CI was used to estimate the direction and strength of the association. Variable with a p-value <0.05 was considered as statistically significant. Results: About 169 (87.1%, 95% CI: (82, 91.8)) participants were satisfied in the quality of post abortion care (PAC) services. Unwanted pregnancy [AOR=1.8, 95% CI: (1.17, 10.9)], history of abortion [2.1, 95% CI: (1.6, 13.8)], assisted by physician [AOR=3.9 95% CI: (1.6, 8.6)], treated politely and respectfully [AOR=6.3, 95% CI: (1.82, 22.2)], the provider adress all questions raised by the client [AOR=5.1, 95% CI: (1.9, 14.5)] were significantly associated factors. Conclusion: The majority of the study participants were satisfied with the quality of post-abortion care services. Enhancing patient care in the facility, strengthening awareness of family planning services, and addressing the questions of the clients in a respected manner are important measures that increase client satisfaction.

Post-abortion care services at Red Sea State - Sudan.

Background:Although there are safe and effective methods of abortion, unsafe abortions still widely spread, mainly in underdeveloped countries.Objective:Study of post abortion care services at Red Sea State to address rate and utilization of post-abortion care package.Methods:This is a descriptive (observational hospital-based study), conducted at Port Sudan Maternity hospital (May 2018–May 2019). The sample included all patients with inevitable and incomplete miscarriage.Results:The total admissions to emergency in gynaecological department during the study period was 9525 cases, of them 1077 cases of abortion, hence the rate was 11.3%. Spontaneous onset occurred in 631 (58.6%) and induced in 446 (41.4%). Surprisingly very few surgical evacuations done in 2 (0.2%). 710 (66.1%) evacuated by Misoprostol and MVA done for 362 (33.7%). Patients who received family planning and counseling were 223 (20.7%).Conclusion:in conclusion the rate of abortion was 11.3%, high incidence of induced abortion and high non-surgical evacuation. Utilization of care package is reasonable.

KNOWLEDGE AND PRACTICE OF POST-ABORTION CARE BY MIDWIVES IN SELECTED PRIMARY HEALTH CARE FACILITIES IN ASHANTI REGION, GHANA

In Ghana, abortion-related mortality is considered a major public health issue that needs to be addressed. Midwives have been trained to safely and effectively provide post-abortion care in the country, yet the expected decline in maternal deaths from abortion complications especially in the rural settings is yet to be realized. Primary Healthcare (PHC) facility is the first point of contact for the rural populace, yet there is minimal evidence on the capacity of midwives serving there to provide post-abortion care. This study assessed the knowledge and practice of post abortion care among midwives in selected primary healthcare (PHC) facilities in Ashanti region of Ghana. A cross sectional descriptive survey design was utilized for the study, and a multi-staged sampling technique was used to select 16 PHCs comprising both government (11) and private (5) owned, from which 112 participants were recruited. A pre-tested structured, self-developed questionnaire was employed to obtain information from the study participants. Obtained data were analyzed using SPSS version 21. A total of 109 questionnaires were accurately completed out of 112 administered, giving a response rate of 97.3%. The midwives’ knowledge of post abortion care (PAC) was mainly in the areas of PAC as treatment for abortion complications 49(36%), while knowledge on the other PAC components was low. Only 63(58%) of the respondents had training on PAC, which was basically on the use of Manual Vacuum Aspiration (MVA) to complete incomplete abortion 52(41%). Among the 70(64%) respondents who indicated that their PHC facilities provide PAC services, only 72(66%) of them actually carried out post abortion care. Reasons advanced by the other 39(36%) who never carried out PAC were lack of; confidence 30(815), skills 27(73%), and knowledge 20(54%). The study recommended the training of midwives serving in PHCs in all components of post-abortion care as a feasible strategy for decentralizing PAC services and reaching out to the neglected rural populace. This aspect of reproductive health need to be re-emphasized in midwifery training curricula, buttress with regular mandatory continuing professional development in the area to improve skills.

Economic and social dimensions influencing safety of induced abortions amongst young women who sell sex in Zimbabwe

ABSTRACT Globally, women, experience inequities in access to safe abortion services and this is most acutely felt in country contexts where legal abortions are highly restricted. Data around abortion amongst young women who sell sex (YWSS) in sub-Saharan Africa are very limited. We conducted 30 focus group discussions and 42 in-depth interviews (IDIs) amongst YWSS (16–24 years) in urban and peri-urban areas of Zimbabwe, as well as IDIs amongst 16 peer educators, five health care providers and four key informants. Our findings indicate that abortions occur amongst YWSS in Zimbabwe but there remain questions over the extent of safety of abortions. The restrictive legal context around abortion and illegality of sex work in the country are key determinants underlying the clandestine nature of abortions. Socioeconomic concerns are key in decision-making around abortions. Youth, cost and lack of referral networks contribute towards unsafe abortions, even when safe abortion services are available. Many YWSS are not aware of the availability of post abortion care (PAC) services and resort to self-administered PAC. Being young and selling sex combine and interact on the economic and social levels to produce vulnerabilities greater than their sum to experiencing unsafe abortion.

Induced Abortion Among Reproductive Age Group Women in Health Facilities of Wolaita Sodo, South Ethiopia

There has been a significant reduction of abortion rates in high-income nations, while the rates remain unchanged in low-and middle-income countries. Post-abortion complications from induced abortion continued as the significant health burden of women in the reproductive age group in Ethiopia. This study aimed to assess factors associated with induced abortion among the reproductive age group in health facilities of Wolaita Sodo, 2020. A facility-based cross-sectional study among women who seek post-abortion care service was conducted from February-to-July, 2020. A systematic random sampling technique was used to select 362 women. Data were collected using a pre-tested structured interviewer-administered questionnaire. Epi data version 3.1 and SPSS version 23 were used for data entry and analysis. Descriptive statistics, followed by a multivariable logistic regression analysis were performed. In this study, 20.8% women experienced induced abortion. Being single {AOR: 5.8; 95% CI: (2.785, 11.898)}, having no formal education {AOR: 0.20; 95% CI: (0.050, 0.795)}, having current pregnancy order of ≥4 {AOR: 4.128; 95%CI: (1.597, 10.666)}, and unwanted pregnancies {AOR: 4.21; 95%CI:(1.432, 6.453)} were significantly associated with experiencing induced abortion. Being single, illiterate, having unwanted pregnancy and having four or more pregnancies were positively associated with induced abortion. Efforts to reduce induced abortion need to focus on increasing accessibility of contraception and fertility education by considering single, illiterate, and those who have four or more pregnancy history.

RETRACTED: Clinical monitoring and misoprostol for early embryo abortion based on embedded computer system

Abstract Abortion, under certain circumstances, is legal in India. It can be done for a variety of reasons for up to 20 weeks of gestation. In exceptional cases, the court, there is a possibility to end after 24 weeks. At the time of 2017, safety, there is a binary classification of unsafe Abortion. India has a law of liberal Abortion. The World Health Organization (WHO), in the death of 76,000 women with complications and treatment of unprocessed, mainly developing countries, has been estimated to be incomplete Abortion every year. Care of post-abortion, all reproductive health and international, and general terms used in the walk of life associated with implementing a particular service, all-natural and artificial Abortion, refer to the experienced woman. The maternal mortality rate must be the provision of health services to increase after Abortion. Misoprostol, women, must easily access women to carry out post-abortion health management is not access otherwise. Adequately trained, as long as safety is a nurse, supported, including the outpatient clinic, it can provide post-abortion care services in the first row. Tablets of contraception and safe abortion services misoprostol, to prevent unsafe Abortion, are connected to reduce the need for abortion aftercare. The health of the woman is the better treatment method to solve the complications.

RETRACTED: Intelligent medical diagnosis and misoprostol medical abortion nursing based on embedded system

Abstract Misoprostol tablets for miscarriage (abortion). It can be used to prevent heavy bleeding before and after delivery. The influence of drugs and increase their uterus contraction. Misoprostol should be available to those who can not get senior women post-abortion care services. Joint hospital care can be provided safely after pregnancy line care services, including outpatient care. Embedded Systems extends the real-time computer systems, and has a special function in the control of electromechanical systems. The proposed study used implantable linear parameters that used the dose threshold of misoprostol to change the implantable controller parameters. In this task, the value of the patient's health-related information from the sensor test is monitored. Depending on the patient's test details, the Misoprostol pills dosage has to be suggested. The gestational weeks compared with the patient last month period to fix the threshold value of dose. Finally, feedback should help with these comparisons obtained, then send cycle comparisons and database information after the controller like back. Built-in controller for updating an important factor of all information. Regarding the patient, it controls all the parameters of the board. Arduino is an open-source electronics prototyping platform. After reducing contraception abortion care, prevention of access to safe abortion services need Misoprostol pills unsafe abortions. The simulation results show that the implanted control method has much better accuracy misoprostol pills management potential.

Health system capacity for post-abortion care in Java, Indonesia: a signal functions analysis

BackgroundThe quality of obstetric care has been identified as a contributing factor in Indonesia’s persistently high level of maternal mortality, and the country’s restrictive abortion laws merit special attention to the quality of post-abortion care (PAC). Due to unique health policies and guidelines, in Indonesia, uterine evacuation for PAC is typically administered only by Ob/Gyns practicing in hospitals.MethodsUsing data from a survey of 657 hospitals and emergency obstetric-registered public health centers in Java, Indonesia’s most populous island, we applied a signal functions analysis to measure the health system’s capacity to offer PAC. We then used this framework to simulate the potential impact of the following hypothetical reforms on PAC capacity: allowing first-trimester uterine evacuation for PAC to take place at the primary care level, and allowing provision by clinicians other than Ob/Gyns. Finally, we calculated the proportion of PAC patients treated using four different uterine evacuation procedures.ResultsForty-six percent of hospitals in Java have the full set of services needed to provide PAC, and PAC capacity is concentrated at the highest-level referral hospitals: 86% of referral hospitals have the full set of services, staffing, and equipment compared to 53% of maternity hospitals and 34% of local hospitals. No health centers are adequately staffed or authorized to offer basic PAC services under Indonesia’s current guidelines. PAC capacity at all levels of the health system increases substantially in hypothetical scenarios under which authorization to perform first-trimester uterine evacuation for PAC is expanded to midwives and general physicians practicing in health centers. In 2018, 88% percent of PAC patients were treated using dilation and curettage (D&C).ConclusionsOffering first-trimester uterine evacuation for PAC in PONEDs and allowing clinicians other than Ob/Gyns to perform this procedure would greatly improve the capacity of Java’s health system to serve PAC patients. Increasing the use of vacuum aspiration and misoprostol for PAC-related uterine evacuation would lower the burden of treatment for patients and facilitate the task-shifting efforts needed to expand access to this life-saving service.