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Kenya: Healthcare providers countrywide should receive comprehensive training on post-abortion care and adhere to set guidelines.
Reproductive health expert Wycliffe Kosgei, calls for continued post abortion care training of health workers adding that it has a rapid and direct effect on patient’s outcome by lowering the complication rate.
In preliminary findings of an on-going study, Dr Kosgei of Moi University, recommends that hospital administrations countrywide should be familiar to the need within their health facilities to update knowledge or refresh skills in response to changes in post abortion care practise globally.
Presenting a research paper titled, ‘Assessment of post-abortal care at Moi Teaching and Referral Hospital, Eldoret, Kenya,’ Dr Kosgei urges health professionals to adhere to Post Abortion Care protocols when treating women with complications from abortions within the hospital settings for better health outcomes.
“Three out of five health providers have been trained on Post Abortion Care (PAC) at the Moi Teaching and Referral Hospital women’s ward in Eldoret and while this is commendable, there is need to adhere to the required guidelines when treating patients with abortion complications,” says Dr Kosgei.
He says health workers need to receive training as part of formal education or on-job training which is relevant to their role in providing emergency abortion care.
Themed, ‘Africa Beyond 2015: Women’s health is women’s right,’ the conference jointly organised by Moi University and the Alexandria Regional Centre for Women’s Health and Development in Egypt featured 25 papers on sexual and reproductive health rights, safe motherhood , Female Genital Mutilation, evidence-based normal birth, contraceptive use and cancers of the female reproductive health system.
Emergency care
According to the study findings, post-abortion complications contribute up half of all admissions in the Moi Teaching and Referral Hospital, gynaecology ward, Faraja.
The study findings revealed that four out of every five patients studied, reported vaginal bleeding as the initial signs and symptoms to seek medical care while others experienced lower abdominal pain with the average time taken from admission to receiving definitive treatment at two and a half hours.
“Antibiotics and procedural pain management was given to the patients and counseling and testing for HIV provided alongside other services like information on STIs and cervical cancer,” says Dr Kosgei.
Most of the respondents sought PAC at or before 12 weeks gestation was at 76 per cent, while 24 per cent of women sought post abortion services after 12 weeks.
The study also found that four out of five women paid for treatment through out of pocket, whereas the rest had the bill settled by health insurance.
Post-abortion care concentrates on treating women with complications, providing family planning services to prevent future abortions, counseling and referring women for other needed services and engaging communities.
As per the International Conference on Population and Development (ICPD) Plan of Action, any measures or changes related to abortion within the health system can only be determined at the national or local level according to the national legislative process.
However, health experts globally, agree that prevention of unwanted pregnancies must always be given the highest priority and all attempts should be made to eliminate the need for abortion.
The ICPD meeting held in Cairo in 1994 underscored the need for high-quality treatment of complications of abortion, and post-abortion family planning counseling and services.
The World Health Organisation corroborates Dr Kosgei’s findings that emergency care must be provided even when there are legal restrictions on induced abortions, because any bleeding in pregnancy could cause complications that may lead to the woman’s death.
Maternal mortality
Dr Kosgei tells The Standard on Saturday that he was compelled to conduct the study because there is little literature on PAC service provision in health facilities in Africa, yet abortion related complications are a major contributor to maternal mortality.
“A study done in 2000 in Uganda reported that only 46 per cent of health units were able to handle complications of abortion,” says Dr Kosgei quoting the study titled Abortion in Uganda: Magnitude and Implications published in the African Journal of Reproductive Health.
The 316 women polled were aged between 15 and 49 years and if below18 years, parental consent was obtained. Also interviewed were health workers working in this ward during the study period working at the Moi Teaching and referral Hospital Faraja ward that handles gynecological conditions.
The researchers also noted that most of the respondents had achieved secondary level education at 45 per cent, 25 per cent had tertiary training, 28 per cent were traders while 20 per cent were unemployed.
Three out of five of the study participants were married while the rest were single with the mean age being 27 years with teenagers accounting for 8.4 per cent. Part of the treatment included psychosocial counseling, testing for HIV and information on Sexually Transmitted Infections and cervical cancer.
The conference participants were also taken through a one-day training of nurses, midwives and specialist doctors on cervical cancer screening and a module on natural childbirth.
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