DOCSLIB.ORG

Expanding Access to Postabortion Care in Zimbabwe Through the Integration Of

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

September 2013 Expanding Access to Postabortion Care in Zimbabwe through the Integration of Misoprostol FINAL REPORT Zimbabwe Ministry of Health and Child Care Through the combined efforts of the government, organizations, communities and individuals, the Government of Zimbabwe aims to provide the highest possible level of health and quality of life for all its citizens, and to support their full participation in the socio-economic development of the country. This vision requires that every Zimbabwean have access to comprehensive and effective health services. The mission of the Zimbabwe Ministry of Health and Child Care (ZMoHCC) is to provide, administer, coordinate, promote and advocate for the provision of quality health services and care to Zimbabweans while maximizing the use of available resources. Venture Strategies Innovations (VSI) VSI is a US-based nonprofit organization committed to improving women and girls' health in developing countries by creating access to effective and affordable technologies on a large scale. VSI connects women with life-saving medicines and services by engaging governments and partners to achieve regulatory approval of quality products and integrating them into national policies and practices. Zimbabwe Ministry of Health and Child Care The Permanent Secretary Kaguvi Building, 4th Floor Central Avenue (Between 4th and 5th Street) Harare, Zimbabwe Telephone: +263-4-798537-60 Website: http://www.mohcw.gov.zw Venture Strategies Innovations 19200 Von Karman Avenue, Suite 400 Irvine, California 92612 USA Telephone: +1 949-622-5515 Website: www.vsinnovations.org ii Acknowledgements Zimbabwe Ministry of Health and Child Care: Dr. Bernard Madzima, Director, Maternal and Child Health Ms. Margaret Nyandoro, Deputy Director, Director of Reproductive Health Principal Investigators : Dr. Tsungai Chipato, University of Zimbabwe Dr. Partson Zvandasara, University of Zimbabwe Dr. Velda Mushangwe, University of Zimbabwe VSI program team: Ndola Prata, Medical Director Nuriye Nalan Sahin Hodoglugil, Associate Medical Director Katharine Rivett, Program Manager Engeline Mawere, Program Officer Molly Moran, Monitoring and Evaluation Specialist Alice Mpete, Nurse Administrator Allison Boiles, Communications Specialist This project could not have been completed without the contributions of the expert staff and colleagues at the Zimbabwe Ministry of Health and Child Care (ZMoHCC) and Venture Strategies Innovations (VSI), whose dedication to this operations research and invaluable contributions to its development led to its successful implementation. The operations research program benefited from the participation of the district officials, who contributed to supportive supervision and monitoring of operations research activities. The operations research also benefitted from the participation of community leaders and other community members who led and participated in community awareness activities. Tarra McNally, former VSI Country Representative, initiated the preliminary work on this operations research, and oversaw the activities until August 2013 and Melody Liu provided data management support until August 2013. Debbie Koh provided programmatic support until January 2013. Most importantly, VSI would like to thank all of the women who consented to participate in this operations research. iii Executive Summary The Zimbabwe Ministry of Health and Child Care (ZMoHCC) is committed to preventing maternal mortality and morbidity due to unsafe abortion and miscarriage by ensuring access to high quality postabortion care (PAC). The estimated maternal mortality ratio (MMR) of 960 maternal deaths per 100,000 live births ranks Zimbabwe among the 40 countries globally with the highest MMR. Abortion-related complications are among the primary obstetric causes of maternal death in Zimbabwe. Misoprostol and manual vacuum aspiration (MVA) are two treatment methods recommended by the World Health Organization (WHO) for the treatment of incomplete abortion and miscarriage (TIAM). Misoprostol is a safe, effective, heat-stable and inexpensive treatment method for incomplete abortion and miscarriage. Misoprostol has been shown to be as effective as MVA for TIAM and can be administered by primary care providers in facilities that lack capacity to provide MVA or other surgical methods. In 2011, after successful advocacy by the ZMoHCC, misoprostol was added to the Essential Drugs List of Zimbabwe (EDLIZ). To advance the government objective of ensuring timely access to quality PAC services, the ZMoHCC and Venture Strategies Innovations (VSI), a US-based non-profit organization, conducted operations research (OR) to provide evidence on the feasibility and acceptability of introducing misoprostol in the PAC service package to be delivered at all levels of the health system, from hospitals to rural health centers. The ZMoHCC’s and VSI’s joint OR was conducted in 68 health facilities in four districts of Zimbabwe. The OR sites included a) provincial hospitals b) district hospitals c) rural and mission hospitals and d) rural health centers. A training of trainers was conducted for 40 senior doctors and nurses, followed by cascade trainings for 135 primary care nurses (PCNs), nurses and midwives from all sites. Facility services from September 2011 to February 2012 were reviewed to provide a baseline facility assessment. Operations research (OR) was conducted from January 2013 to June 2013, during which misoprostol was available for women at these facilities. Also during this time, health providers and Village Health Workers (VHWs) disseminated key messages on the dangers of unsafe abortion, the availability of misoprostol for TIAM and family planning services at OR sites, and the importance of preventing unwanted pregnancies. According to the facility assessment, prior to the OR, there was limited availability of PAC services at the OR sites. In addition to the provincial hospital, only one of three district hospitals and six of thirteen rural and mission hospitals reported offering TIAM. Dilatation and curettage (D&C) was the TIAM treatment method available at the largest number of facilities (n=5) with only two facilities offering MVA. Rural health centers (RHCs) and rural and mission hospitals readily introduced PAC services that included TIAM with misoprostol. At RHC’s, 89% of women who enrolled in the OR were treated with misoprostol. At rural and mission hospitals, 95% of those enrolled were treated with misoprostol. Primary care nurses, the highest level of trained staff at most RHCs, treated over 40% of the women who were administered misoprostol for TIAM. The number receiving misoprostol for PAC at RHCs increased fourfold in just four months. iv The introduction of misoprostol for PAC dramatically reduced the proportion of women at RHCs and rural and mission hospitals that had to be referred for treatment. Only 10% of enrolled women who sought PAC services at RHCs were referred to a higher level facility, compared with 98% at baseline. At rural and mission hospitals, the percentage of women referred for PAC treatment declined by nearly 95%, from 48% to 3%. Health providers at the OR facilities and VHWs in the catchment areas increased community awareness of the availability of misoprostol for PAC, the dangers of unsafe abortion, and the importance of family planning during facility-based health education sessions and community meetings. Overall, 13,845 community members were reached with messages about misoprostol for PAC during the course of the OR. Among the women who returned for follow-up for whom data were recorded (n=120), 96% were successfully treated. Only one woman at an RHC had to be referred for further treatment; at rural and mission hospitals only two women received additional treatment. These outcomes are consistent with the 91-98% efficacy rate of misoprostol for PAC observed in randomized controlled studies. The provision of family planning counseling and services at the time and location that women access services for spontaneous or induced abortion is regarded as a proven high-impact practice to maximize investments in a comprehensive family planning strategy, especially when scaled up and institutionalized,. Over 80% of women in the OR accepted a modern contraceptive method as part of PAC services. Rates of contraceptive uptake were highest at the provincial hospital (92%) and RHCs (87%). Women treated with misoprostol were advised to return after 7-14 days for follow-up. Women treated at RHCs were most likely to return for follow-up (75%), compared with those treated at rural and mission hospitals (39%) and the provincial hospitals (12%). Ten percent of the women who returned for follow-up received a contraceptive at follow-up and not at the initial visit. Women treated with misoprostol experienced minimal side effects. Among the 124 women treated with misoprostol who returned for follow-up, 29 women reported having some side effect after taking the tablets. The most commonly reported side effect was abdominal pain reported by 16 women, followed by chills and/or fever (n=8), nausea and vomiting (n=5) and diarrhea (n=5). The following recommendations on opportunities to strengthen PAC services in Zimbabwe are based on the results of the OR and lessons learned by the ZMoHCC and providers during project implementation. Consequently, a number of the recommendations encompass issues related to scaling up PAC services in Zimbabwe that are not specifically tied to data from the OR. 1. Introduce TIAM with misoprostol
Recommended publications
  • Women's Experiences with Abortion Complications in the Post War Context of South Sudan

    Women's Experiences with Abortion Complications in the Post War Context of South Sudan

    Women's Experiences with Abortion Complications in the Post War Context of South Sudan Author: Monica Adhiambo Onyango Persistent link: http://hdl.handle.net/2345/1836 This work is posted on eScholarship@BC, Boston College University Libraries. Boston College Electronic Thesis or Dissertation, 2010 Copyright is held by the author, with all rights reserved, unless otherwise noted. Boston College William F. Connell School of Nursing WOMEN’S EXPERIENCES WITH ABORTION COMPLICATIONS IN THE POST WAR CONTEXT OF SOUTH SUDAN A dissertation by MONICA ADHIAMBO ONYANGO Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy May 2010 © Copyright by MONICA ADHIAMBO ONYANGO 2010 ii Women’s experiences with abortion complications in the post war context of South Sudan Monica Adhiambo Onyango Dissertation Chair: Rosanna Demarco, PhD, PHCNS-BC, ACRN, FAAN Committee Members: Sandra Mott, PhD, RNC and Pamela Grace, PhD, APRN Abstract For 21 years (1983-2004), the civil war in Sudan concentrated in the South resulting in massive population displacements and human suffering. Following the comprehensive peace agreement in 2005, the government of South Sudan is rebuilding the country’s infrastructure. However, the post war South Sudan has some of the worst health indicators, lack of basic services, poor health infrastructure and severe shortage of skilled labor. The maternal mortality ratio for example is 2,054/100,000 live births, currently the highest in the world. Abortion complication leads among causes of admission at the gynecology units. This research contributes nursing knowledge on reproductive health among populations affected by war. The purpose was to explore the experiences of women with abortion complications in the post war South Sudan.
  • The Global Gag Rule and Access to Abortion

    The Global Gag Rule and Access to Abortion

    THE GLOBAL GAG RULE AND ACCESS TO ABORTION: Impact on law reform in Zimbabwe, Zambia, Mozambique, Eswatini and Malawi Southern Africa Litigation Centre Second Floor, President Place, 1 Hood Avenue, Rosebank, Johannesburg, South Africa, 2196 e-mail: [email protected], tel: +27 (0) 10 596 8538 www.southernafricalitigationcentre.org twitter: @Follow_SALC Electronic copies of this report can be found at: www.southernafricalitigationcentre.org. © Southern Africa Litigation Centre, 2020 SALC POLICY BRIEF The Global Gag Rule and Access to Abortion: Impact on law reform in Zimbabwe, Zambia, Mozambique, Eswatini and Malawi About the Southern Africa Litigation Centre The Southern Africa Litigation Centre (SALC), established in 2005, aims to provide support to human rights and public interest advocacy and litigation undertaken by domestic lawyers and human rights organisations in Southern Africa. SALC works in Angola, Botswana, Democratic Republic of Congo, Eswatini, Lesotho, Malawi, Mozambique, Namibia, Tanzania, Zambia and Zimbabwe. Authorship and acknowledgments This report was adapted from an initial draft commissioned by amfAR in 2017. The report was researched and written by Tambudzai Gonese-Manjonjo, Equality Programme Lawyer at SALC. Additional research was provided by Christina Hunguana (Mozambique), Walker Syachalinga (SALC intern) and Nick Bugeja (SALC intern). The document was edited by Anneke Meerkotter (SALC Litigation Director), Nick Bugeja (SALC intern) and Zoe Tsumbane (SALC intern). The research was made possible through the generous support of the Open Society Initiative for Eastern Africa(OSIEA) and amfAR, the Foundation for AIDS Research. CONTENTS 04. INTRODUCTION 05. The right to safe abortion and international obligations 07. THE PROTECTING LIFE IN GLOBAL HEALTH ASSISTANCE POLICY (GLOBAL GAG RULE) 07.
  • Induced Abortion and Postabortion Care in Zimbabwe

    Induced Abortion and Postabortion Care in Zimbabwe

    FACT SHEET Induced Abortion and Postabortion Care in Zimbabwe Revised July 16, 2019 ■■ Zimbabwe has one of the highest Zimbabwe, the regional abortion rate is maternal mortality ratios in the world, nearly double, at 34 per 1,000 women estimated at 651 maternal deaths per aged 15–44. 100,000 live births. In contrast to a worldwide trend of declines, maternal ■■ Abortion rates in Zimbabwe vary mortality has increased in Zimbabwe greatly across the country. The highest Delays and gaps in service over the past 25 years. rates are in the Mashonaland provinces provision and Harare (21 per 1,000 women aged ■■ Many women experiencing complica- ■■ Abortion is legally permitted in the 15–49) and lowest in the Manicaland tions from unsafe abortion or miscar- country only under limited circum- and Masvingo provinces (12 per 1,000 riage in 2016 faced delays in obtaining stances, including if the pregnant wom- women). postabortion care. On average, nearly an’s life is in danger or in cases of rape, two full days elapsed between expe- incest or fetal impairment. In practice, Provision of postabortion care riencing complications and receiving it is extremely difficult to obtain a legal ■■ Of the estimated 25,200 women completed treatment. Common rea- abortion; as a result, most abortions receiving facility-based postabortion sons for treatment delays included lack are clandestine and potentially unsafe. care in 2016, about half were treated of money, lack of transportation and for complications related to abortions distance to a health facility. ■■ The Zimbabwe Ministry of Health and (many of which were unsafe), and half Child Care has made efforts to increase were treated for complications related ■■ Postabortion care is not offered at the access to and improve postabortion care to late miscarriage.
  • Availability, Accessibility and Utilization of Post-Abortion Care in Sub-Saharan Africa: a Systematic Review

    Availability, Accessibility and Utilization of Post-Abortion Care in Sub-Saharan Africa: a Systematic Review

    HEALTH CARE FOR WOMEN INTERNATIONAL https://doi.org/10.1080/07399332.2019.1703991 REVIEW ARTICLE Availability, accessibility and utilization of post-abortion care in Sub-Saharan Africa: A systematic review Chimaraoke Izugbaraa, Frederick Murunga Wekesahb , Meroji Sebanya, Elizabeth Echokac, Joshua Amo-Adjeid, and Winstoun Mugab aInternational Center for Research on Women, Washington, D.C, USA; bAfrican Population & Health Research Center, Nairobi, Kenya; cCentre for Public Health Research, Kenya Medical Research Institute - KEMRI, Nairobi, Kenya; dDepartment of Population and Health, University of Cape Coast, Cape Coast, Ghana ABSTRACT ARTICLE HISTORY At the 1994 ICPD, sub-Saharan African (SSA) states pledged, Received 28 June 2019 inter alia, to guarantee quality post-abortion care (PAC) serv- Accepted 9 December 2019 ices. We synthesized existing research on PAC services provi- sion, utilization and access in SSA since the 1994 ICPD. Generally, evidence on PAC is only available in a few countries in the sub-region. The available evidence however suggests that PAC constitutes a significant financial burden on public health systems in SSA; that accessibility, utilization and avail- ability of PAC services have expanded during the period; and that worrying inequities characterize PAC services. Manual and electrical vacuum aspiration and medication abortion drugs are increasingly common PAC methods in SSA, but poor-qual- ity treatment methods persist in many contexts. Complex socio-economic, infrastructural, cultural and political factors mediate the availability, accessibility and utilization of PAC services in SSA. Interventions that have been implemented to improve different aspects of PAC in the sub-region have had variable levels of success. Underexplored themes in the exist- ing literature include the individual and household level costs of PAC; the quality of PAC services; the provision of non-abor- tion reproductive health services in the context of PAC; and health care provider-community partnerships.
  • Justifying the Decision to Terminate Pregnancies: Comparisons of Women’S Narratives from South Africa and Zimbabwe

    Justifying the Decision to Terminate Pregnancies: Comparisons of Women’S Narratives from South Africa and Zimbabwe

    Justifying the decision to terminate pregnancies: Comparisons of women’s narratives from South Africa and Zimbabwe. Malvern Chiweshe, Jabulile Mavuso, Catriona Macleod Critical Studies in Sexualities and Reproduction, Psychology Department, Rhodes University, South Africa Introduction The decision-making process regarding how to resolve a pregnancy refers to the time spanning from the moment the woman realises she is pregnant until a decision has been made as to whether to carry the pregnancy to term or terminate the pregnancy (Kjelsvik & Gjengedal, 2011). Relatively little research has been done on the decision-making process itself (Lie, Robson & May, 2008). Recently, Coast, Norris, Moore and Freeman (2014) have tried to document the abortion decision-making process by using data from different countries and coming up with a framework that tries to cover the different aspects of abortion decision-making. While research by Coast et al (2014), and similar research, will help towards greater understanding of what abortion decision-making entails, the approach used within this kind of work is not without limitations. Research on abortion decision-making (including Coast et al.’s 2014 study) has tended to employ a health determinants approach where factors or influences that are seen to affect abortion decision-making are explored (Harvey-Knowles, 2012; Mdleleni-Bookholane, 2007, Schuster, 2005). For example, among a sample of women who attended Umtata General Hospital in the Eastern Cape, South Africa, to terminate a pregnancy, Mdleleni-Bookholane (2007) identified the following as factors that led to the abortion decision: the extent to which the pregnancy was intended, willingness or ability on the part of the woman to make the adjustments necessary to include a child in her future life, and awareness of the availability of abortion.
  • Estimating Abortion Incidence: Assessment of a Widely Used Indirect Method

    Estimating Abortion Incidence: Assessment of a Widely Used Indirect Method

    Population Research and Policy Review https://doi.org/10.1007/s11113-019-09517-2 Estimating Abortion Incidence: Assessment of a Widely Used Indirect Method Susheela Singh1 · Fatima Juarez1,2 · Elena Prada3 · Akinrinola Bankole1 Received: 17 May 2018 / Accepted: 13 February 2019 © The Author(s) 2019 Abstract Induced abortion is a reproductive behavior that remains difcult to measure in countries where the procedure is highly restricted by law. Additionally, in some countries where abortion is broadly legal, a high proportion of abortions are car- ried out by illegal and untrained providers. In these contexts, ofcial statistics are non-existent or highly incomplete. Measurement of the incidence of induced abor- tion is essential to inform sexual and reproductive health policies and programs. Researchers have developed diverse methodologies over the years. Direct methods, such as population-based surveys that ask women about their abortion experience, generally are subject to high levels of underreporting. A range of indirect methods have been developed to obtain more accurate estimates. Created in the early 1990s, the Abortion Incidence Complications Method (AICM) is a widely applied indirect method that has produced robust estimates of abortion incidence in a range of con- texts. This paper presents the original AICM methodology used in countries where abortion is highly restricted. It also highlights modifcations made for two situations, one of which is newly emerging. First, the methodology has been adapted recently for countries where, despite the restrictive abortion laws, a new, relatively safe method—medication abortion (mainly misoprostol alone)—is increasingly used. Second, it has been adapted for countries where abortion is broadly legal but unsafe abortion remains common.
  • Unsafe Abortion in Nigeria in Certain Circumstances Nurses Could Participate

    Unsafe Abortion in Nigeria in Certain Circumstances Nurses Could Participate

    LETTERS TO THE EDITOR J Fam Plann Reprod Health Care: first published as 10.1783/147118907781005038 on 1 July 2007. Downloaded from Nurses and abortion there were plenty of expressions available which Vincent Argent, FRCOG, LLB Vincent Argent and Lin Pavey have concluded, in would have had that effect. Surgical termination Consultant Obstetrician and Gynaecologist an analysis of the House of Lords case Royal using modern methods was not amongst the (Lead in Sexual Health), Addenbrooke’s College of Nursing v DHSS [1981] 1 AC 800 procedures envisaged, and it was certainly not Cambridge University Teaching Hospital, (“the RCN case”), that without any change in the foreseen or foreseeable that it might be Cambridge, UK. E-mail: [email protected] law, nurses can legally perform surgical induced suggested that nurses might be significant abortion.1 Their article contains some dangerous operators in such procedures. Lin Pavey, RGN legal misconceptions. The dissenting views cannot merely be Member of RCN Nurses Working in Termination The RCN case concerned the participation of discounted. They emphasised, very powerfully, of Pregnancy Network nurses in prostaglandin-induced abortions. The the need for great caution in the construction of House of Lords decided by a majority (3:2) that the statute, and in particular the need for judges to Unsafe abortion in Nigeria in certain circumstances nurses could participate. be careful not to usurp the function of Parliament Each minute of every day, nearly 40 women The RCN case decided that for the procedure and engage in judicial legislation. The danger of undergo dangerous, unsafe abortions.1 These that the court was considering: such judicial legislation is particularly acute since unsafe abortions are often performed by unskilled (a) Medical abortion is a process.
  • Woman-Centered, Comprehensive Abortion Care Reference Manual

    Woman-Centered, Comprehensive Abortion Care Reference Manual

    Second Edition Woman-Centered, Comprehensive Abortion Care Reference Manual Disclaimer: The regularly updated Clinical Updates in Reproductive Health (www.ipas.org/clinicalupdates) provides Ipas’s most up-to-date clinical guidance, which supersedes any guidance that may differ in Ipas curricula or other materials. ISBN: 1-882220-87-0 © 2005, 2013 Ipas. Produced in the United States of America. Ipas. (2013). Woman-centered, comprehensive abortion care: Reference manual (second ed.) K. L. Turner & A. Huber (Eds.), Chapel Hill, NC: Ipas. Ipas is a nonprofit organization that works around the world to increase women’s ability to exercise their sexual and reproductive rights, especially the right to safe abortion. We seek to eliminate unsafe abortion and the resulting deaths and injuries and to expand women’s access to comprehensive abortion care, including contraception and related reproductive health information and care. We strive to foster a legal, policy and social environment supportive of women’s rights to make their own sexual and reproductive health decisions freely and safely. Ipas is a registered 501(c)(3) nonprofit organization. All contributions to Ipas are tax deductible to the full extent allowed by law. Cover photo credits: © Richard Lord Illustrations: Stephen C. Edgerton The illustrations and photographs used in this publication are for illustrative purposes only. No similarity to any actual person, living or dead, is intended. For more information or to donate to Ipas: Ipas P.O. Box 9990 Chapel Hill, NC 27515 USA 1-919-967-7052 [email protected] www.ipas.org Printed on recycled paper. Ipas Woman-Centered, Comprehensive Abortion Care: Reference Manual Acknowledgments - Second edition This second edition of Ipas’s Woman-Centered, Comprehensive Abortion Care: Reference Manual was revised by the following Ipas staff and consultants: Katherine L.
  • Noetic Propaedeutic Pedagogy As a Panacea to the Problem of Abortion Peter B

    Noetic Propaedeutic Pedagogy As a Panacea to the Problem of Abortion Peter B

    Online Journal of Health Ethics Volume 12 | Issue 1 Article 4 Noetic Propaedeutic Pedagogy as a Panacea to the Problem of Abortion Peter B. Bisong [email protected] Follow this and additional works at: http://aquila.usm.edu/ojhe Part of the Ethics and Political Philosophy Commons Recommended Citation Bisong, P. B. (2016). Noetic Propaedeutic Pedagogy as a Panacea to the Problem of Abortion. Online Journal of Health Ethics, 12(1). http://dx.doi.org/10.18785/ojhe.1201.04 This Article is brought to you for free and open access by The Aquila Digital Community. It has been accepted for inclusion in Online Journal of Health Ethics by an authorized administrator of The Aquila Digital Community. For more information, please contact [email protected]. Noetic Propaedeutic Pedagogy as a Panacea to the Problem of Abortion Introduction Abortion has over the years posed ethical, medical, political and legal problems in the world and in Nigeria in particular. These problems (such as, danger to health, psychological trauma, unnecessary economic cost, population depletion etc) have been and have continued to be fuelled by the pro-abortionists supportive arguments. The pro-abortionists argue that abortion is good because it brings financial benefits to medical practitioners; it preserves the life of the mother when in danger; it controls population and enables the couple to live a more comfortable and meaningful life amongst other reasons. Unfortunately these arguments seem to have taken root in the heart of Nigerians, for only this will explain why Nigerians still perform abortion en masse in spite of the current illegality status of it.
  • Pattern of Complicated Unsafe Abortions in Niger Delta University Teaching Hospital Okolobiri, Nigeria: a 4 Year Review

    Pattern of Complicated Unsafe Abortions in Niger Delta University Teaching Hospital Okolobiri, Nigeria: a 4 Year Review

    Pattern of Complicated Unsafe Abortions in Niger Delta University Teaching Hospital Okolobiri, Nigeria: A 4 Year Review. Type of Article: Original Isa Ayuba Ibrahim, Israel Jeremiah, Isaac J Abasi, Abednego O Addah Department of Obstetrics and Gynaecology, Niger Delta University Teaching Hospital, Okolobiri, Nigeria. INTRODUCTION ABSTRACT Unsafe abortion is a persistent, but preventable pandemic with grave implications on the life of women and their reproductive Background: Abortions performed by persons lacking career1,2. It is defined by the World Health Organization the requisite skills or in environments lacking minimal (W.H.O) as a procedure for terminating an unwanted medical standards or both are considered unsafe. It is pregnancy, either by a person lacking the necessary skill or in an estimated that over 20 million unsafe abortions are environment lacking the minimum standard or both2. It is one performed annually and about 70,000 women die of the five leading causes of maternal mortality world wide. globally as a result, with majority occurring in the Out of the over half a million maternal deaths that occur each developing world. This study aims to determine the year globally2,3, it is estimated that one quarter to one third may pattern of complicated unsafe abortions in Niger delta be a consequence of complications arising from unsafe University Teaching Hospital (NDUTH) Okolobiri. abortion.1,4,5 Methods: The study is a four-year retrospective analysis It is estimated that about 210 million pregnancies occur each of cases of complicated unsafe abortion managed at the year, nearly half of these pregnancies are unplanned and a 2,3,6 Niger Delta University Teaching Hospital Okolobiri, greater definitely unwanted .
  • Woman-Centered Post-Abortion Care in Public Hospitals in Tucumán, Argentina: Assessing Quality of Care and Its Link to Human Rights Rodolfo Gómez Ponce De León

    Woman-Centered Post-Abortion Care in Public Hospitals in Tucumán, Argentina: Assessing Quality of Care and Its Link to Human Rights Rodolfo Gómez Ponce De León

    University of South Carolina Scholar Commons Faculty Publications Health Promotion, Education, and Behavior 2006 Woman-Centered Post-Abortion Care in Public Hospitals in Tucumán, Argentina: Assessing Quality of Care and Its Link to Human Rights Rodolfo Gómez Ponce de León Deborah Lynn Billings University of South Carolina - Columbia, [email protected] Karina Barrionuevo Follow this and additional works at: https://scholarcommons.sc.edu/ sph_health_promotion_education_behavior_facpub Part of the Public Health Commons Publication Info Published in Health and Human Rights, ed. Sofia Gruskin, Volume 9, Issue 1, 2006, pages 174-201. Gómez Ponce de León, R., Billings, D. L., & Barrionuevo, K. (2006). Woman-centered post-abortion care in public hospitals in Tucumán, Argentina: Accessing quality of care and its link to human rights. Health and Human Rights, 9(1), 174-201. © Health and Human Rights, 2006, Harvard School of Public Health This Article is brought to you by the Health Promotion, Education, and Behavior at Scholar Commons. It has been accepted for inclusion in Faculty Publications by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Ab,stract Unsafe abortion is a major public health and human rights problem in Argentina. Implementation of a woman-centered post-abortion care (PAC)model is one strategy to improve the situation. The quality of PAC services was measured in three public hospitals in Tucumin, a province with high levels of poverty and maternal mortality due to unsafe abor- tion. Overall, the quality of PAC services was found to be poor. Women do not receive services in a manner that respects their human rights, in particular their rights to health and health care, information, and to the benefits of scientific progress.
  • 1 the Incidence of Induced Abortion in Zimbabwe Elizabeth A

    1 the Incidence of Induced Abortion in Zimbabwe Elizabeth A

    The Incidence of Induced Abortion in Zimbabwe Elizabeth A. Sully 1, Mugove Gerald Madziyire 2, Tsungai Chipato 2, Ann M. Moore 1, Marjorie Crowell 1, Taylor Riley 1, Margaret Tambudzai Nyandoro 3 and Bernard Madzima 3, (1) Guttmacher Institute, USA (2) UZ-UCSF Collaborative Research Programme, Zimbabwe (3)Zimbabwe Ministry of Health and Child Care, Zimbabwe Short Abstract With Zimbabwe’s high maternal mortality, there is a pressing need to better understand unsafe abortion. The prolonged economic crisis is affecting the health care system and thereby the availability and potentially quality of post-abortion care (PAC) in the country. Using the Abortion Incidence Complications Methodology (AICM) and the Prospective Morbidity Methodology (PMM), this paper estimates the national incidence of induced abortion, the proportion of unintended pregnancies, and the quality of post-abortion care. Our analysis draws on three national surveys conducted in 2016: a retrospective census of 245 health facilities with the capacity to provide PAC, a prospective survey of women seeking abortion-related care in a nationally representative sample of those facilities, and a purposive sample of 118 experts on abortion. This is the first national estimate of the abortion rate in Zimbabwe, strengthening the evidence base of the sexual and reproductive health needs in this context of declining economic stability. Extended Abstract: Background An estimated 22 million unsafe abortions take place globally every year, resulting in approximately 47,000 deaths and disability in an additional 5 million women (World Health Organization, 2011). Ninety-five percent of these deaths and complications related to unsafe abortion occur in the developing world (World Health Organization, 2011).