A cross-sectional analysis of Kenyan postabortion care services using a nationally representative sample

Area of Science:

• Reproductive Health
• Healthcare Quality Assessment
• Public Health Policy

Background:

• Postabortion care (PAC) is crucial for managing complications from unsafe abortions.
• Assessing the quality of PAC services is essential for improving maternal health outcomes.
• Kenyan healthcare facilities provide PAC, but the quality of care requires evaluation.

Purpose of the Study:

• To evaluate the quality of postabortion care (PAC) services in Kenyan healthcare facilities.
• To identify factors influencing the delivery of high-quality PAC.
• To compare PAC quality between public and private healthcare sectors.

Main Methods:

• A cross-sectional survey of 326 PAC-providing healthcare facilities in Kenya.
• Data collected from March to June 2012 as part of the Incidence and Magnitude of Unsafe Abortions study.
• Analysis included descriptive statistics, weighted proportions, and an ordered probit model.

Main Results:

• Appropriate technology use was higher for second-trimester (82.6%) than first-trimester (41.8%) PAC.
• Public facilities demonstrated superior use of appropriate technology compared to private facilities for both trimesters.
• Availability of trained providers, separate evacuation rooms, and a wider range of family planning methods correlated with better PAC delivery.

Conclusions:

• Effective monitoring of postabortion care services, especially in private facilities, is recommended to enhance overall quality.
• Improving infrastructure and provider training are key to elevating PAC quality.
• Standardized quality improvement initiatives are needed across all healthcare sectors offering PAC.