The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56845

Rasha Dabash, MPH¹, Abdoulaye Diagne, MD, Cheikh Tidiane Cissé, MD³, El-Hadji Ousseynou Faye, MD⁴, Isaiah Ndong, MD, and Erika Sinclair⁶. (1) Research and Evaluation, EngenderHealth, 440 Ninth Ave, New York, NY 10001, (2) OB/GYN, CHU Le Dantec Hospital, C/O EngenderHealth Villa N 8527 Sacre Coeur 1, BP 16235, Dakar, Senegal, (3) Ministry of Health, Senegal, C/O Engenderhealth Villa N8527 Sacre Coeur 1, BP 16235, Dakar, Senegal, (4) Maternity and Postabortion Care Program, EngenderHealth, 440 Ninth Avenue, 3rd Floor, New York, NY 10001, 212-561-8000, esinclair@engenderhealth.org

Senegal’s low modern contraceptive prevalence and large unmet need for family planning contribute to the country’s high incidence of unintended pregnancy. Negative outcomes of unintended pregnancy, including abortion related complications, are leading causes of high maternal morbidity and mortality. Social and health indicators reflect a need for expanding current postabortion care (PAC) service to a more integrated model, which includes family planning and other reproductive health counseling and services. Expanded efforts are particularly needed in rural settings, where, in the absence of accessible tertiary care facilities, lower level health facilities provide care to the majority of clients presenting with abortion complications. To inform the development of national PAC protocols, EngenderHealth, in collaboration with the MOH, conducted an operations research project to examine the feasibility of introducing an integrated PAC model at lower level facilities in two predominantly rural regions of Senegal. The intervention resulted in increased client access to quality PAC services, including improved management of abortion complications and access to reproductive health counseling, services, and linkages. Post-intervention clients benefited from safer less painful treatment, reduced out of pocket costs, and shorter facility stays. Clients also reported greater overall satisfaction with services. The intervention also strengthened client-provider interactions resulting in improved counseling, facilitated linkages, and greater access to contraceptive methods. Findings suggest the feasibility and benefits of offering integrated PAC services in rural areas, and that similar efforts could greatly contribute to a reduction in maternal morbidity and mortality.

Learning Objectives:

• At the conclusion of the session, the participant will be able to:
• 1. Describe the essential components of an integrated postabortion care model.
• 2. Identify strategies to improve postabortion care services in rural settings
• 3. Apply the lessons learned to replicate or evaluate similar postabortion care efforts

Keywords: Post-Abortion Care, International Reproductive Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.