scholarly journals Burkina Faso: Upgrading postabortion care benefits patients and providers

2000 ◽  

At the request of the Family Health Directorate of the Ministry of Health in Burkina Faso, the Reproductive Health Research Network (CRESAR) conducted a study during 1996–98 to introduce emergency care for women with complications from miscarriage or unsafe abortion. With technical assistance from the Population Council and JHPIEGO, CRESAR trained staff at two large hospitals in Ouagadougou and Bobo-Dioulasso to provide postabortion care (PAC). Training for physicians, nurses, and midwives covered manual vacuum aspiration, family planning methods, infection prevention, and communication with patients. Staff also participated in the development of policies and standards for PAC services. To measure changes in knowledge and behavior, CRESAR interviewed 330 patients with abortion complications and 78 providers before the intervention, and 456 patients and 41 providers after the intervention. This brief states that training hospital staff to improve emergency medical care for women with miscarriage and unsafe abortion leads to better patient care, shorter hospital stays, lower costs, and increased contraceptive use, and that local anesthesia is essential for pain control.

2020 ◽  
Vol 3 ◽  
pp. 1499
Author(s):  
Dawn S. Chin-Quee ◽  
Kathleen Ridgeway ◽  
Yentéma Onadja ◽  
Georges Guiella ◽  
Guy Martial Bai ◽  
...  

Background: The Family Health Directorate of the Ministry of Health  and Marie Stopes Burkina Faso, with implementing partners, Association Burkinabè pour le Bien-être Familial  and Equilibres & Populations  collaboratively conducted a pilot project in Burkina Faso focused on “increasing access to family planning (FP) services through task-sharing short- and long-acting family planning methods to primary care cadres.” Four cadres of providers  provided intrauterine devices (IUDs) and implants, while community health workers (CHWs)  provided pills and subcutaneous injectables. FHI 360 and the Institut Supérieur des Sciences de la Population  evaluated the project’s impact on method uptake, client satisfaction, safety, acceptability and the feasibility of task sharing. Methods: The evaluation employed FP service statistics on new users and conducted 425 client exit interviews  and 27 in-depth interviews . New FP clients, community representatives, MoH officials, and pilot project-trained FP providers from Dandé and Tougan districts participated in these interviews. Results: Providers, community representatives and government officials all spoke favorably of the pilot project and considered it a boon to women and the communities in which they lived. FP clients were satisfied with their methods and the services they received from their respective providers, and they reported no safety concerns. However, service statistics did not show a clear and steady increase in method uptake for the four methods beyond spikes coinciding with pre-existing free contraceptive weeks. Conclusions:  A scale-up plan for 2020-2022 is in place and will purposefully implement sensitization and demand generation activities to improve FP uptake beyond free contraceptive weeks.


2019 ◽  
Vol 3 ◽  
pp. 1499 ◽  
Author(s):  
Dawn S. Chin-Quee ◽  
Kathleen Ridgeway ◽  
Yentéma Onadja ◽  
Georges Guiella ◽  
Guy Martial Bai ◽  
...  

Background: The Family Health Directorate of the Ministry of Health (MoH/FHD) and Marie Stopes Burkina Faso (MS BF), with implementing partners, Association Burkinabé pour le Bien-être Familial (ABBEF) and Equilibres & Populations (Equipop) collaborated to conduct a pilot project in Burkina Faso focused on “increasing access to family planning (FP) services through task-sharing short- and long-acting family planning methods to primary care cadres.” Four cadres of providers were trained to provide intrauterine devices (IUDs) and implants, while community health workers (CHWs) were trained to provide pills and subcutaneous injectables. FHI 360 and the Institut Supérieur des Sciences de la Population (ISSP) evaluated the project’s impact on method uptake, client satisfaction, safety, acceptability and the feasibility of task sharing. Methods: The evaluation employed service statistics, client exit interviews (quantitative) and in-depth interviews (qualitative). New FP clients, community representatives, MoH officials, and pilot project-trained FP providers from Dandé and Tougan districts participated in these interviews. Results: Providers, community representatives and government officials all spoke favorably of the pilot project and considered it a boon to women and the communities in which they lived. FP clients were satisfied with their methods and the services they received from their respective providers, and they reported no safety concerns. However, service statistics did not show a clear and steady increase in method uptake for the four methods beyond spikes coinciding with pre-existing free contraceptive weeks. Conclusions: Results of the evaluation were largely positive. These evaluation findings are being used to guide decisions about scale-up.


2000 ◽  
Author(s):  

Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, and counseling. To measure the impact of the training, CEFOREP interviewed 320 women receiving emergency treatment and 204 providers before the intervention, and 543 patients and 175 providers after. This brief states that improving postabortion care services can result in shorter hospital stays, decreased patient costs, better communication between providers and patients, increased acceptance of contraceptive use by women treated for abortion or miscarriage, and that local anesthesia is needed for pain control.


Author(s):  
Muluken Dessalegn Muluneh ◽  
Lyn Francis ◽  
Mhiret Ayele ◽  
Sintayehu Abebe ◽  
Misrak Makonnen ◽  
...  

This study examines the associations between women’s empowerment and family planning use in Jimma Zone, Western Ethiopia. A total of 746 randomly selected married women of reproductive age were interviewed. The data were employed by structural equation modelling (SEM) to investigate the complex and multidimensional pathways to show women’s empowerment domains in family planning utilisation. Results of the study revealed that 72% of married women had used family planning. Younger women, having access to information, having access to health facilities and being aware about family planning methods, living in a rural area, having an older partner and increased household decision-making power were associated with using family planning methods. Women’s empowerment is an important determinant of contraceptive use. Women’s empowerment dimensions included increased household decision-making power, socio-demographic variables and having access to information about family planning and accessible health facilities. These were found to be important determinants of contraceptive use. Future interventions should focus on integrating women’s empowerment into family planning programming, particularly in enhancing women’s autonomy in decision making. Further research is warranted on the socio-cultural context of women that influences women’s empowerment and family planning use to establish an in-depth understanding and equity of women in society.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  

Abstract Background Afghanistan 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. Methods Accessible 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. Results Most 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. Conclusions This 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.


2020 ◽  
pp. 101053952098314
Author(s):  
Shahina Begum ◽  
Himanshu Chaurasia ◽  
Kusum V. Moray ◽  
Beena Joshi

Data from National Family Health Survey (2015-2016) was analyzed to examine the contraceptive acceptance, discontinuation rates, and associated factors among reproductive age women in India over one year. Findings revealed that 11.7% accepted modern methods of which 68% were for spacing. Only 5% switched to other methods. Discontinuation rate was high among condom (56.8%) and oral contraceptive pill users (34.5%), among women aged less than 25 years, with parity less than 2, belonging to rural area, and having no education. Health concerns/side effects, husband’s disapproval, or method failure were most common reasons cited for discontinuation. The data show high discontinuation rates among some subgroups of women and for certain methods. Hence, women need to be provided options to switch methods to meet changing contraceptive needs and health priorities. Continuum of care with follow-up and counselling can facilitate sustained contraceptive use to avert unintended pregnancies.


2020 ◽  
Author(s):  
Sylvain Y. M. SOME ◽  
Christy Pu ◽  
Song-Lih Huang

Abstract Background In Burkina Faso, women still have difficulty satisfying their family planning demand because of the patriarchal and gender-unequal society. Despite evidence that women’s empowerment can help, few studies have measured its impact at both community and household levels. Taking into account these two parameters, we looked into the association between women’s empowerment and modern contraception use among Married Women of Reproductive Age (MWRA) with no desire for having children in Burkina Faso. Methods Using the 2010 Demographic and Health Survey (DHS), we analyzed data from 4714 MWRA with family planning needs from 573 communities. Indicators of gender equality at the community level were composed of aggregated variables for each primary sampling unit, and domains of women’s agency in households matters were derived with principal component analysis. A multilevel logistic regression model was used to gauge the effects of empowerment on modern contraceptives use adjusted for household socioeconomic status and demographics of women. Results Among MWRA, 30.8% satisfied their demand for family planning using modern methods. At the community level, higher women’s assets ownership (aOR 1.26, CI 1.04 - 1.54), secondary education (aOR 1.45, OR 1.08 - 1.64), and exposure to family planning messages (aOR 1.33, CI 1.08 - 1.64) were associated with more modern contraceptive use; higher ideal number of children was negatively associated (aOR 0.76, CI 0.61 - 0.95). Unexpectedly, higher community prevalence of female genital mutilation was positively associated with contraceptive use (aOR 1.25, CI 1.03-1.52). Women’s agency in household matters, including opposing domestic violence, involved with decisions and enjoying freedom in seeking healthcare were positively associated with use, but only the last domain remained significant in multilevel analysis (aOR 1.29, CI 1.08 - 1.54). Living in richer household, being older, and having secondary education level were also positively associated with modern contraceptive use. Conclusion Gender equality at the community level and women’s situation in the household constitute the context in which women’s demand for family planning is determined. Therefore, promoting gender equality and ensuring women’s entitlement to make life choices have the potential to increase modern contraceptive coverage along with improved life conditions.


Author(s):  
Rakesh Patel ◽  
Runoo Ghosh

Background: Lack of awareness, knowledge and education, religious beliefs and fear of side effects are the main causes why women do not use family planning methods. To study the knowledge, attitude and practice of contraception among clients undergoing to Medical termination of pregnancy (MTP) and sterilization.Methods: This prospective study was done among 400 indoor cases at Department of Obstetrics and Gynecology in B.J. Medical college, Ahmedabad during July 2002 to October 2003. All the clients undergoing MTP and sterilization were explained and counseled about contraception with GATHER approach of family planning. After taking detail history, a thorough clinical examination of the clients was carried out with preliminary investigations.Results: Almost 58% clients were willing to accept TL method as contraceptive option, 39.5% IUCD, 1.75% OC pill method of contraception. Regarding history of side effect of contraceptive use, 17.3% condom users, 68.5% OC pill users, 63% CuT users have felt side effect. Almost 42.5% clients were operated by MTP + Lap TL, 39.5% by MTP + CuT and 14.5% by plain Lap TL.Conclusions: Efforts should be made to promote information, education and communication regarding emergency contraception targeted to all women of reproductive age group. It is important that unwanted pregnancy be prevented through effective contraceptive practice rather than abortion.


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