IMPACT OF UNSAFE ABORTIONS ON HEALTH Service DELIVERY

Impact of unsafe abortions on health service delivery



ACKNOWLEDGEMENT

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

ABSTRACT

Aims: The aim of the study was to assess the perceived impact of management of women referred for unsafe abortion and its complications on health service delivery from the perspective of the provider.

Objectives: To gather information from staff who take primary care of women with unsafe abortions and its complications at health facilities in Kintampo North and South districts on, treatment, management and perceived share of emergency obstetric care (EmOC) resources for this group and to identify staff attitude in managing these clients.

Methods: This is an exploratory qualitative study. 13 participants were recruited and informed consent was obtained from them. The 13 participants were from 3 hospitals, 4 health centres and 3 private clinics in Kintampo North and South districts. Interviews were digitally voice recorded and transcribed. Analysis was by way of thematic analysis, searching for recurring terms in all transcripts using Microsoft word.

Results: Most health facilities reported 5-10% of their clients come for unsafe abortion and related complications. All health workers (HWs) stated the true figures of unsafe abortions and its complications is not being reflected, with the majority occurring on the ground in the communities, hence a large first delay is present in Kintampo. HWs state that these clients weigh disproportionately on facility resources. All HWs interviewed despise the act of abortions yet feel there is a need for safe abortion services to be implemented in Ghana.

Conclusion: The Ghanaian law on abortion should be reviewed and safe abortion services introduced, alongside nurse and midwifery training in the use of manual vacuum aspiration (MVA) for the management of unsafe abortion complications. A module in abortion and abortion complications should be launched as part of the existing health education programme in schools, to help combat the stigma attached to abortion and to help reduce the first delay.

TABLE OF CONTENTS

ACKNOWLEDGEMENT2

ABSTRACT3

CHAPTER 1: INTRODUCTION6

OUTLINE6

RATIONALE6

AIMS AND OBJECTIVES9

SIGNIFICANCE OF THE STUDY10

RESEARCH QUESTIONS10

RESEARCH SETTING10

DEFINITIONS AND TERMINOLOGY11

CHAPTER 2: LITERATURE REVIEW14

EPIDEMIOLOGY OF UNSAFE ABORTION14

BACKGROUND DETERMINANTS OF UNSAFE ABORTION16

REASONS THE ABORTION WAS UNSAFE16

METHODS OF UNSAFE ABORTIONS16

DEATHS FROM UNSAFE ABORTION17

BARRIERS TO SERVICE PROVISION18

BARRIERS TO SEEKING CARE19

BARRIERS IN POLICIES AND PROGRAMS20

HUMAN RIGHTS20

CHAPTER 3: METHODOLOGY22

RESEARCH DESIGN22

RECRUITMENT22

LANGUAGE22

ETHICS22

DATA COLLECTION23

TRANSPORTATION23

DATA SAMPLING23

DATA ANALYSIS24

REIMBURSEMENT24

LIMITATIONS24

CHAPTER 4: ANALYSIS AND DISCUSSION26

ANALYSIS35

DISCUSSION38

CHAPTER 5: CONCLUSION & RECOMMENDATIONS44

REFERENCES47

Impact of unsafe abortions on health service delivery

CHAPTER 1: INTRODUCTION

OUTLINE

This research focuses on the impact of unsafe abortions on health service delivery and comprises of the following chapters:

Introduction

Literature Review

Methodology

Results and Discussion

Conclusion

RATIONALE

This study highlights many issues related to unsafe abortions on health service delivery and gives a broad analysis of unsafe abortion and its complications on health service delivery from the perspective of the provider. The World Health Organisation (WHO) defines an unsafe abortion as “A procedure to terminate an un-wanted pregnancy by people lacking appropriate skills or in an environment which lacks minimum medical ...