Improving safe post-abortion care practices: A study on interventions implemented by Ipas Pakistan

Area of Science:

• Public Health
• Maternal Health
• Family Planning

Background:

• Unsafe abortions cause significant maternal morbidity and mortality globally, particularly in developing countries.
• Pakistan faces challenges with unmet family planning needs, contributing to unwanted pregnancies and unsafe abortions.
• Post-abortion care (PAC) integrates maternal health and family planning to address these issues.

Purpose of the Study:

• To evaluate the effectiveness of an integrated PAC model in improving abortion-related practices across public health systems in Pakistan.
• To assess the impact of clinical training, community engagement, and counseling on safe post-abortion practices.

Main Methods:

• A descriptive study analyzed data from 27,616 post-abortion care clients across 104 public health facilities in Pakistan (March 2018-December 2021).
• Data collection involved service provider logbooks detailing client demographics, abortion characteristics, and care provided.
• The study examined the uptake of safe post-abortion care methods and contraceptive methods post-PAC.

Main Results:

• Most PAC clients were over 25 years old (82%) and in their first trimester (95%).
• 92% of women received safe PAC methods, including misoprostol (58%) and manual vacuum aspiration (32%).
• 72% of women adopted a contraceptive method, with condoms being the most frequent (34%). Key predictors for uptake included age (>25), early second trimester, and counseling.

Conclusions:

• The integrated PAC model is effective in improving abortion-related practices within Pakistan's public health system.
• Increased access to PAC and family planning services can reduce unsafe abortions, unintended pregnancies, and maternal mortality.
• The study demonstrates the successful implementation of an integrated PAC service delivery model across diverse public health settings.