FACTORS INFLUENCING REFERRAL RATE AMONG WOMEN ATTENDING POST ABORTION CARE AT ST. MARY’S HOSPITAL-LACOR AND GULU REGIONAL REFERRAL HOSPITAL, NORTHERN UGANDA
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Date
2025-01
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Gulu University
Abstract
Background: Abortion-related deaths account for over 75% of all maternal deaths in sub-Saharan Africa. Most abortion-related deaths and complications are preventable by appropriate post-abortion care (PAC) services. Referral is a critical aspect in the chain of management of women experiencing abortion. Objective: To assess the factors influencing referral rate among women attending post-abortion care at St. Mary’s Hospital-Lacor and Gulu Regional Referral Hospital, Gulu, Uganda.
Methods: An embedded mixed-methods study was conducted at St. Mary’s Hospital-Lacor and Gulu Regional Referral Hospital from July to December 2023. Quantitative and qualitative data were collected concurrently using structured questionnaires, and one-on-one interviews were conducted with purposefully selected participants, respectively. Factors influencing referral were assessed quantitatively using logistic regression and qualitatively using thematic analysis and reported using the Capability, Opportunity, and Motivation to Behavior (COM-B) framework.
Results: Quantitatively, 152 participants with a median age of 26 (interquartile range: 21-32) years were enrolled. Overall, 46 (30.3%) participants were referral cases. The proportion of referred cases were about 15.5-fold higher among women from rural residences compared to those from urban areas (adjusted odds ratio (aOR): 15.5; 95% confidence interval (CI): 4.44—53.83, p<0.001), compared to women between 20 and 34 years, those younger than 20 years old (aOR: 2.8, 95% CI: 1.02—7.56, p=0.046). Qualitatively, four themes emerged as drivers to referral: 1) lack of expertise of healthcare professionals, 2) low capacity at low-level healthcare facilities, 3) financial constraints, and 4) transport challenges.
Conclusions: Approximately one-third of women attending post-abortion care were referred, with significantly higher rates among those from rural areas. There is a pressing need to enhance post-abortion care services at low-level healthcare facilities, especially in rural settings and among women under 20 years.
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Keywords
Referal, Post Abortion Care
Citation
OPee, Jimmy (2025) FACTORS INFLUENCING REFERRAL RATE AMONG WOMEN ATTENDING POST ABORTION CARE AT ST. MARY’S HOSPITAL-LACOR AND GULU REGIONAL REFERRAL HOSPITAL, NORTHERN UGANDA