Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilities

ABSTRACT: Objectives: Unsafe abortion is a leading cause of global maternal mortality and morbidity. This study sought to estimate availability of essential postabortion care (PAC) services among publicly managed health facilities in Ethiopia. Study design: Data from public hospitals and health cen...

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Main Authors: Hayley V. McMahon, Celia Karp, Suzanne O. Bell, Solomon Shiferaw, Assefa Seme, Mahari Yihdego, Linnea A. Zimmerman
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:Contraception: X
Online Access:http://www.sciencedirect.com/science/article/pii/S2590151622000168
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author Hayley V. McMahon
Celia Karp
Suzanne O. Bell
Solomon Shiferaw
Assefa Seme
Mahari Yihdego
Linnea A. Zimmerman
author_facet Hayley V. McMahon
Celia Karp
Suzanne O. Bell
Solomon Shiferaw
Assefa Seme
Mahari Yihdego
Linnea A. Zimmerman
author_sort Hayley V. McMahon
collection DOAJ
description ABSTRACT: Objectives: Unsafe abortion is a leading cause of global maternal mortality and morbidity. This study sought to estimate availability of essential postabortion care (PAC) services among publicly managed health facilities in Ethiopia. Study design: Data from public hospitals and health centers in Ethiopia were collected in 2020. Among facilities offering labor and delivery, we assessed the proportion that: (1) offered PAC, (2) were equipped for each PAC signal function, and (3) were equipped for all PAC signal functions falling within their scope of care by facility type. Analysis: Our primary outcome was PAC service provision status. Descriptive statistics summarized the proportion of hospitals and health centers, respectively, categorized as each PAC status and with necessary equipment for individual signal functions. Per Federal Ministry of Health (FMOH) guidelines, hospitals are expected to provide comprehensive PAC, while health centers are expected to provide basic PAC. Results: Altogether, 69.1% (n = 94) of hospitals were equipped to provide comprehensive PAC, and 65.2% (n = 131) of health centers were equipped for basic PAC. Least available signal functions included obstetric surgery among hospitals (83.8%; n = 114) and uterine evacuation among health centers (84.6%; n = 170). Conclusion: Meaningful progress has been made toward achieving the Ethiopian FMOH's goal of universal PAC service availability at hospitals and health centers by 2020. Despite this, sizable gaps remain and may endanger maternal health in Ethiopia, underscoring a need for continued prioritization of PAC services. Implications: Ethiopia's commitment to PAC has fostered a service landscape that is stronger than many other low-resource settings; however, notable shortcomings are present. Further research is needed to understand the potential role of clinical training and supply-side interventions.
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spelling doaj.art-736442cbf0ea4fddbbc5cd772cfb74e52022-12-22T04:41:38ZengElsevierContraception: X2590-15162022-01-014100087Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilitiesHayley V. McMahon0Celia Karp1Suzanne O. Bell2Solomon Shiferaw3Assefa Seme4Mahari Yihdego5Linnea A. Zimmerman6Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Corresponding author. Hayley V. McMahonDepartment of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United StatesDepartment of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United StatesSchool of Public Health, Addis Ababa University, Addis Ababa, EthiopiaSchool of Public Health, Addis Ababa University, Addis Ababa, EthiopiaSchool of Public Health, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United StatesABSTRACT: Objectives: Unsafe abortion is a leading cause of global maternal mortality and morbidity. This study sought to estimate availability of essential postabortion care (PAC) services among publicly managed health facilities in Ethiopia. Study design: Data from public hospitals and health centers in Ethiopia were collected in 2020. Among facilities offering labor and delivery, we assessed the proportion that: (1) offered PAC, (2) were equipped for each PAC signal function, and (3) were equipped for all PAC signal functions falling within their scope of care by facility type. Analysis: Our primary outcome was PAC service provision status. Descriptive statistics summarized the proportion of hospitals and health centers, respectively, categorized as each PAC status and with necessary equipment for individual signal functions. Per Federal Ministry of Health (FMOH) guidelines, hospitals are expected to provide comprehensive PAC, while health centers are expected to provide basic PAC. Results: Altogether, 69.1% (n = 94) of hospitals were equipped to provide comprehensive PAC, and 65.2% (n = 131) of health centers were equipped for basic PAC. Least available signal functions included obstetric surgery among hospitals (83.8%; n = 114) and uterine evacuation among health centers (84.6%; n = 170). Conclusion: Meaningful progress has been made toward achieving the Ethiopian FMOH's goal of universal PAC service availability at hospitals and health centers by 2020. Despite this, sizable gaps remain and may endanger maternal health in Ethiopia, underscoring a need for continued prioritization of PAC services. Implications: Ethiopia's commitment to PAC has fostered a service landscape that is stronger than many other low-resource settings; however, notable shortcomings are present. Further research is needed to understand the potential role of clinical training and supply-side interventions.http://www.sciencedirect.com/science/article/pii/S2590151622000168
spellingShingle Hayley V. McMahon
Celia Karp
Suzanne O. Bell
Solomon Shiferaw
Assefa Seme
Mahari Yihdego
Linnea A. Zimmerman
Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilities
Contraception: X
title Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilities
title_full Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilities
title_fullStr Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilities
title_full_unstemmed Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilities
title_short Availability of postabortion care services in Ethiopia: Estimates from a 2020 national sample of public facilities
title_sort availability of postabortion care services in ethiopia estimates from a 2020 national sample of public facilities
url http://www.sciencedirect.com/science/article/pii/S2590151622000168
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