Quality of post abortion care services in Bungoma District hospital, Kenya

Abstract

Background: Abortion is the commonest complication of early pregnancy occurring in 10% - 15% of pregnancies. The demand for Post Abortion Care remains high in hospitals in Kenya. The public health rationale to address abortions and its complications was due to the fact that morbidity and mortality associated with abortions is preventable. Objective: The study objective was to ascertain the quality of PAC offered in Bungoma District Hospital by finding out whether the first four elements of post abortion care were applied to patients seeking these services. It aimed at ! determining its weaknesses and eventually giving recommendations on improvement of care to our patients Study design/methodology: The study was a hospital based cross sectional survey covering a period of four months - December 2008 to March 2009. After obtaining approval from the KNH/UON Ethics & Research Committee, a total of 250 patients who had been diagnosed to have incomplete abortion and 30 caregivers were recruited. Findings: All patients in this hospital were being evacuated by use of dilatation and curettage under GA or sedation in main theatre, only 30% were offered family planning after evacuation, minimal reproductive health linkaging took place (only 14% and 10% of clients were counselled for HIV and STI's respectively) and no emotional counselling was offered. Few caregivers had a good understanding of the elements of post abortion care with only 40% having been trained on the PAC curriculum. There were weaknesses in the hospitals administrative procedures regarding to supply of equipment (MVA kits, sterilization and high level disinfecting consumables). Conclusion: Post abortion care in Bungoma District Hospital was poor. Recommendations: It is thus recommended the hospital and stakeholders undertake training sessions to improve caregivers' competency. Training is also undertaken at the hospital management level as well as the supplies department to improve the continuous supply of MVA equipment, disinfecting and sterilising materials. Lastly, the hospital management and the obstetrician/gynaecologist implement Ministry of Health recommendations on Post Abortion Care and adopt a protocol on how handle incomplete abortions.