Michael M Mutua1,2, Thomas N O Achia2,3, Lenore Manderson2,4, Eustasius Musenge2. 1. African Population and Health Research Center (APHRC), Nairobi, Kenya. 2. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. 3. Centers for Disease Control and Prevention, Nairobi, Kenya. 4. Institute at Brown for Environment & Society (IBES), Brown University, Providence, Rhode Island, United States of America.
Abstract
INTRODUCTION: Information, counseling, availability of contraceptives, and their adoption by post-abortion care (PAC) patients are central to the quality of PAC in healthcare facilities. Effective contraceptive adoption by these patients reduces the risks of unintended pregnancy and repeat abortion. METHODS: This study uses data from the Incidence and Magnitude of Unsafe Abortion Study of 2012 to assess the level and determinants of highly effective contraception among patients treated with complications from an unsafe abortion in healthcare facilities in Kenya. Highly effective contraception was defined as any method adopted by a PAC patient that reduces pregnancy rate by over 99%. RESULTS: Generally, contraceptive counseling was high among all PAC patients (90%). However, only 54% of them received a modern family planning method-45% a short-acting method and 9% a long-acting and permanent method. Adoption of highly effective contraception was determined by patient's previous exposure to unintended pregnancies, induced abortion and modern family planning (FP). Facility level factors associated with the uptake of highly effective contraceptives included: facility ownership, availability of evacuation procedure room, whether the facility had a specialized obstetric-gynecologist, a facility that also had maternity services and the number of FP methods available for PAC patients. DISCUSSION AND CONCLUSION: For better adoption of highly effective FP, counseling of PAC patients requires an understanding of the patient's past experience with contraception and their future fertility intentions and desires in order to meet their reproductive needs more specifically. Family planning integration with PAC can increase contraceptive uptake and improve the reproductive health of post-abortion care patients.
INTRODUCTION: Information, counseling, availability of contraceptives, and their adoption by post-abortion care (PAC) patients are central to the quality of PAC in healthcare facilities. Effective contraceptive adoption by these patients reduces the risks of unintended pregnancy and repeat abortion. METHODS: This study uses data from the Incidence and Magnitude of Unsafe Abortion Study of 2012 to assess the level and determinants of highly effective contraception among patients treated with complications from an unsafe abortion in healthcare facilities in Kenya. Highly effective contraception was defined as any method adopted by a PACpatient that reduces pregnancy rate by over 99%. RESULTS: Generally, contraceptive counseling was high among all PACpatients (90%). However, only 54% of them received a modern family planning method-45% a short-acting method and 9% a long-acting and permanent method. Adoption of highly effective contraception was determined by patient's previous exposure to unintended pregnancies, induced abortion and modern family planning (FP). Facility level factors associated with the uptake of highly effective contraceptives included: facility ownership, availability of evacuation procedure room, whether the facility had a specialized obstetric-gynecologist, a facility that also had maternity services and the number of FP methods available for PACpatients. DISCUSSION AND CONCLUSION: For better adoption of highly effective FP, counseling of PACpatients requires an understanding of the patient's past experience with contraception and their future fertility intentions and desires in order to meet their reproductive needs more specifically. Family planning integration with PAC can increase contraceptive uptake and improve the reproductive health of post-abortion care patients.
Authors: Elizabeth H Bradley; Sarah A McGraw; Leslie Curry; Alison Buckser; Kinda L King; Stanislav V Kasl; Ronald Andersen Journal: Health Serv Res Date: 2002-10 Impact factor: 3.402
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