Quality of post abortion care services in Public Health facilities in Kampala – Uganda

Abstract

Introduction Complications occurring after unsafe abortion contribute to maternal mortality and morbidity in low income countries and are recognized by the international community as an important public health problem. In Uganda, morbidity due to unsafe abortion is still prevalent and is actually higher compared to neighboring countries like Rwanda. Comprehensive and high-quality Post Abortion Care (PAC) services avert repeat unplanned pregnancies and the cycle of repeat abortions; by providing counseling , a broad range of contraceptive services and reproductive health services at the time and location of emergency treatment of abortion complications, and before the patient is discharged from the health facility. Objective: The main objective of the study was to assess the quality of post abortion care services in public health facilities in Kampala. Methods: A facility based, Cross-sectional study design employing quantitative technique for data collection was used. The study used the adopted model of quality of care inspired by the works of Donabedian with three factors: structure, process, and outcome. A total of 280 PAC client exit interviews were conducted, six direct service observations and inventory of the equipment and supplies were utilized to capture the different aspects of quality of care. Results: The age of post-abortion care clients ranged from 15 to 35 years and above with a mean age of 26 years (SD ± 6.39). Using a cut off of 70%, over all, the quality of PAC services was found to be “poor” as only 32.5% of the respondents received “good” quality PAC services. Results revealed post abortion- family planning and linking PAC clients to reproductive health services as some of the procedures largely not done at the health facilities. Conclusion: Greater emphasis should be placed on incorporating post abortion family planning counselling, provision of modern contraceptives and other reproductive health services into this care. Keywords: Quality, Post abortion Care, Abortion, Health facility