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Health systems' capacity to provide post-abortion care: a multicountry analysis using signal functions
Onikepe O Owolabi1, Ann Biddlecom1, Hannah S Whitehead1
1Guttmacher Institute, New York, NY, USA.
The Lancet. Global Health
|December 4, 2018
Summary
Post-abortion care capacity is critically low in most health facilities globally. This study reveals significant gaps in essential services, hindering efforts to reduce maternal mortality from unsafe abortions.
Area of Science:
- Global Health
- Reproductive Health
- Health Systems Research
Background:
- Abortion-related mortality is a major contributor to global maternal deaths.
- While safe abortion is often restricted, post-abortion care (PAC) is a universal commitment for managing complications.
- Evidence on national health system capacity for PAC is limited.
Purpose of the Study:
- To assess the capacity of national health systems to provide post-abortion care (PAC).
- To identify gaps in essential PAC services at primary and referral-level facilities.
Main Methods:
- Multicountry analysis of Service Provision Assessment (SPA) survey data (2007-2017) from ten countries.
- Facilities offering delivery services were classified as primary or referral level.
- Assessed PAC capacity using signal functions (equipment and service availability) for basic and comprehensive PAC.
Main Results:
- Critical gaps exist in PAC provision across all analyzed facilities.
- In 70% of countries, less than 10% of primary facilities offered basic PAC.
- In 80% of countries, less than 40% of referral facilities offered comprehensive PAC.
Conclusions:
- Health facility capacity for providing PAC is notably low at both primary and referral levels.
- A significant disparity exists between political commitments and health system capabilities for PAC.
- Enhancing high-quality PAC is crucial for reducing abortion-related morbidity and mortality.