Assessment of Post-abortion Care Services in Public Health Facilities in Bauchi State
Assessment of Post-abortion Care Services in Public Health Facilities in Bauchi State
ABSTRACT
Worldwide, an estimated five million women are hospitalized each year for treatment of abortion-related complications, such as hemorrhage and sepsis.
Almost all abortion related deaths occur in developing countries.2 These deaths are highest in Africa, where there were an estimated 650 deaths per 100,000 unsafe abortions in 2003, compared with 10 per 100,000 in developed regions.
African women suffer the world’s highest abortion related deaths estimated at 680 deaths per 100,000 abortions, compared to 330 deaths per 100,000 abortions in the rest of the developing world.
Complications of abortion are one of the major causes of maternal mortality in Nigeria, causing the death of women in thousands annually.
Comprehensive Post-abortion care (PAC) services are obtainable only at tertiary health care centers and to some extent, at secondary care level in most States in Northern Nigeria.
However, recently several Non-governmental organizations (NGOs), both local and international are involved in the provision of PAC services in rural and urban communities more especially in health facilities in such areas.
The availability, accessibility and affordability of such services in such facilities especially in the rural areas is unclear to many concerned individuals and groups some of whom are calling for the expansion of PAC services especially in the primary and secondary levels of care.
For about a decade now the Bauchi state government, several NGOs both international and local are involved in provision of post-abortion care services in Bauchi state but the maternal mortality (presently at 1549 deaths/100,000 livebirths and morbidity in the state remain high.
TABLE OF CONTENTS
Title Page – – – – – – – – – i
Declaration – – – – – – – – – ii
Certification – – – – – – – – – iii
Dedication – – – – – – – – – iv
Acknowledgement – – – – – – – – v
Summary – – – – – – – – – vi
Table of Contents – – – – – – – – viii
List of Tables – – – – – – – – – x
List of Figures – – – – – – – – xi
List of Appendices – – – – – – – – xii
List of Acronyms – – – – – – – – xiii
Chapter One – Introduction
1.1 Problem statement- – – – – – – – 3
1.2 Justification – – – – – – – – 4
1.3 Aims and objectives of study – – – – – – 5
Chapter Two – Literature review
2.1 Definition of unsafe abortion – – – – – – 6
2.2 Scope of the problem – – – – – – – 8
2.3 Health consequences – – – – – – – 10
2.4 Relationship between unsafe abortion and abortion law – – – 10
2.5 Lack of contraception access and use – – – – – 11
2.6 Origins of post-abortion care – – – – – – 13
2.7 Essential elements of PAC Model – – – – – 17
2.8 Availability of post-abortion care in hospitals – – – – 19
2.9 Equipment and supplies needed – – – – – – 24
Chapter Three – Methodology
3.1 Background of study – – – – – – – 38
3.2 Study design – – – – – – – – 39
3.3 Study population – – – – – – – – 39
3.4 Sample size – – – – – – – – 39
3.5 Sampling technique – – – – – – – 40
3.6 Methods of data collection – – – – – – 41
3.7 Quality assurance of data – – – – – – 41
3.8 Method of data analysis – – – – – – – 41
3.9 Limitations of study – – – – – – – 41
3.9.1 Ethical considerations – – – – – – – 42
3.9.2 Duration of study – – – – – – – 42
Chapter Four – Results – – – – – – – 43
Chapter Five – Discussion
5.1 Availability of Post-Abortion Care in Hospitals – – – – 66
5.2 Availability of basic equipment for PAC in Hospital – – – 68
5.3 Equipment and Supplies Needed – – – – – – 70
Chapter six – Conclusion and Recommendations
6.1 Conclusion – – – – – – – – 78
6.2 Recommendations – – – – – – – 79
References – – – – – – – – – 80
Appendices – – – – – – – – – 86
INTRODUCTION
The term “abortion” refers to the termination of pregnancy from whatever cause before the fetus is capable of extra-uterine life.
“Spontaneous abortion” refers to those terminated pregnancies that occur without deliberate measures, whereas “induced abortion” refers to termination of pregnancy through a deliberate intervention intended to end the pregnancy.1
Estimates are that at least 15% of all pregnancies end in spontaneous abortion and, according to World Health Organization estimates, up to 15% of pregnancy related mortality worldwide is due to abortion.
A woman’s fertility can return quickly following an abortion from as early as two weeks. This may leave a lot of women with unmet need for family planning and the risk of another unintended pregnancy and in some cases subsequent repeated abortion.2
Moreover, in many settings, women who have an abortion rarely leave the health facility “armed with the knowledge and the means to avoid repeating the process of unprotected intercourse and unwanted pregnancy”.
REFERENCES
Carolyn C. Meeting Health Care Needs of Women Experiencing Complications of
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Melkamu Y, Enquselassie F, Ali A, Gebresilassie H, Yusuf L. Fertility awareness and
post-abortion pregnancy intention in Addis Ababa, Ethiopia. Ethiopian J. Health Dev.
2003; 17(3): 167-174.
Ebele I. Good Health: Nigerian Women need better post Abortion Care Services. The
Vanguard [News paper online].2004 September 7 [cited 2012 May 8]. Available
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Okonufua, F.E. Unwanted Pregnancy, Unsafe Abortion and Laws in Nigeria.
Tropical Journal of Obstetrics and Gynecology 2002; 19(1): 15-17.
World Health Organization (WHO), Unsafe Abortion: Global and Regional Estimates
of Incidence of unsafe abortion and Mortality [ebook]. 6th ed. Geneva: WHO, 2008
[cited 2012 March 12]. Available from: http://www.who.int/publications/en/
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Guidelines for Prevention and Treatment [document online]. Geneva: WHO, 1994
[cited 2012 March 14].
