Experiences of women seeking care for abortion complications in health facilities: Secondary analysis of the WHO Multi-Country Survey on Abortion in 11 African countries

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Experiences of women seeking care for abortion complications in health facilities: Secondary analysis of the WHO Multi-Country Survey on Abortion in 11 African countries


JournalJournal of Gynecology & Obstetrics
Article typeJournal research article – Clinical research
Publication date – Dec – 2021
Authors – Philip Govule, Sasha Baumann, Jean-Paul Dossou, Clara Calvert, Sourou Goufodji, Hedieh Mehrtash, Özge Tuncalp, Kwame Adu-Bonsaffoh, Rachidatou Compaore, Véronique Filippi
Keywordshealth system, Survey, WHO Multi-Country, women seeking care
Open access – Yes
SpecialityHealth policy, Obstetrics and Gynaecology
World region Central Africa, Eastern Africa, Southern Africa, Western Africa
Country: Benin, Burkina Faso, Chad, Democratic Republic of the Congo, Ghana, Kenya, Malawi, Mozambique, Niger, Nigeria, Uganda
Language – English
Submitted to the One Surgery Index on December 14, 2021 at 6:52 am
Abstract:

Objective
Despite evidence of acute and long-term consequences of suboptimal experiences of care, standardized measurements across countries remain limited, particularly for postabortion care. We aimed to determine the proportion of women reporting negative experiences of care for abortion complications, identify risk factors, and assess the potential association with complication severity.

Methods
Data were sourced from the WHO Multi-Country Survey on Abortion for women who received facility-based care for abortion complications in 11 African countries. We measured women’s experiences of care with eight questions from an audio computer-assisted self-interview related to respect, communication, and support. Multivariable generalized estimating equations were used for analysis.

Results
There were 2918 women in the study sample and 1821 (62%) reported at least one negative experience of postabortion care. Participants who were aged under 30 years, single, of low socioeconomic status, and economically dependent had higher odds of negative experiences. Living in West or Central Africa, rather than East Africa, was also associated with reportedly worse care. The influence of complication severity on experience of care appeared significant, such that women with moderate and severe complications had 12% and 40% higher odds of reporting negative experiences, respectively.

Conclusion
There were widespread reports of negative experiences of care among women receiving treatment for abortion complications in health facilities. Our findings contribute to the scant understanding of the risk factors for negative experiences of postabortion care and highlight the need to address harmful provider biases and behaviors, alleviate health system constraints, and empower women in demanding better care.

OSI Number – 21392

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