Exploring the utilization of postabortion care services and related factors among women at a tertiary health facility
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Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Womens Health
Abstract
Background: Abortion-related complications are the third leading cause of maternal mortality in Uganda, accounting
for approximately one-fourth of all maternal deaths. Most are preventable through adequate use of the full package of
postabortion care (PAC) services.
Objective: We aimed to assess the level of utilization of PAC services and the associated sociodemographic, obstetric,
gynecological, and system-related factors at a high-volume tertiary health facility in Northern Uganda.
Design: A cross-sectional survey was conducted among women receiving PAC at the Gulu Regional Referral Hospital
from March 2023 to June 2023. Participants were recruited consecutively and exit interviews were conducted using
structured questionnaires.
Methods: Utilization of PAC was defined as the use of four or more of the following: counseling, emergency treatment,
family planning services, linkage to other sexual and reproductive health services, and community health service provider
cooperation. Modified Poisson regression analysis was used to determine the independent predictors of PAC utilization.
Results: A total of 364 participants were enrolled in the study. Overall, 21.1% (n = 77) of the participants had used four
or more PAC services. Having a supportive partner (adjusted prevalence ratio (aPR): 1.9, 95% confidence interval (CI):
1.19–2.88, p = 0.006), knowledge on PAC services (aPR: 1.7, 95% CI: 1.19–2.48, p = 0.004), low parity (aPR: 2.2, 95% CI:
1.16–4.35, p = 0.016), nulliparity (aPR: 2.4 95% CI: 1.19–4.73, p = 0.014), and provision of privacy(physical privacy during
prescription, counseling, procedures) (aPR: 2.3 95% CI: 1.14–4.47, p = 0.02), were significantly associated with utilization
of PAC.
Overall, only one in five participants utilized four or more PAC services. Use of four or more PAC services was
significantly associated with women having a supportive partner, knowledge of PAC services, low parity, nulliparity, and
provision of privacy while receiving PAC services.
Conclusion: Approaches such as advocating male partner involvement, bridging the knowledge gap through health education, and promoting respectful care may improve the utilization of PAC services
Description
Acknowledgements: We appreciate the fraternity of the Gulu Regional Referral Hospital and Gulu University for their support during the study. We thank our data collectors and data analysis team. Pre- Publication Support Service (PREPSS) supported the development of this manuscript by providing author training, pre-publication peer review, and copy editing
Availability of data and materials:
The datasets and study materials are under the principal investigator’s custodianship. The data will not be publicly available for confidentiality reasons; however, they can be availed upon reasonable request from the corresponding author.
Keywords
abortion, postabortion care, utilization, Gulu city
Citation
Jackline A, Opee J, Bongomin F, Akello H, Atim SF, Pebolo PF. Exploring the utilization of postabortion care services and related factors among women at a tertiary health facility in Gulu, Northern Uganda. Women’s Health. 2024;20. doi:10.1177/17455057241295896