Mutua Michael M, Achia Thomas N O, Maina Beatrice W, Izugbara Chimaraoke O
Research Division, African Population and Health Research Center, Nairobi, Kenya.
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Int J Gynaecol Obstet. 2017 Sep;138(3):276-282. doi: 10.1002/ijgo.12239. Epub 2017 Jul 6.
To assess quality of postabortion care (PAC) offered by Kenyan healthcare facilities.
A cross-sectional survey was conducted using data from the Incidence and Magnitude of Unsafe Abortions study, conducted among 326 PAC-providing healthcare facilities throughout Kenya from March 13 to June 30, 2012. Descriptive results with weighted proportions and an ordered probit model were used.
Overall, 408 (41.8%) first-trimester PAC cases were treated using appropriate technology versus 826 (82.6%) second-trimester cases. Private healthcare facilities lagged behind public healthcare facilities on the use of appropriate technology: 264 (47.5%) public and 144 (33.1%) private facilities used such technology for first-trimester abortion, and 664 (89.6%) public versus 162 (68.8%) private for second-trimester abortions). Most healthcare facilities (251, 70.7%) had at least one provider trained in PAC. A total of 273 (80.7%) healthcare facilities reported offering contraception to all PAC patients, mainly short-acting methods. Delivery of PAC services depended on the availability of separate evacuation room (public level 2-3: odds ratio [OR] 22.93; public level 4-6: OR 77.14), and the number of family planning methods offered within the facility (public level 2-3: OR 1.38; public level 4-6 OR 1.57; private level 2-3: OR 2.27; private level 4-5: 4.89).
Effective monitoring of PAC services, particularly among private healthcare facilities, might improve overall quality of services.
评估肯尼亚医疗机构提供的流产后护理（PAC）质量。
采用2012年3月13日至6月30日在肯尼亚全国326家提供PAC服务的医疗机构开展的不安全流产发生率和严重程度研究的数据进行横断面调查。使用加权比例描述性结果和有序概率模型。
总体而言，408例（41.8%）孕早期PAC病例采用了适当技术治疗，而孕中期病例为826例（82.6%）。私立医疗机构在适当技术使用方面落后于公立医疗机构：264家（47.5%）公立和144家（33.1%）私立机构在孕早期流产时使用了此类技术，孕中期流产时公立为664家（89.6%），私立为162家（68.8%）。大多数医疗机构（251家，70.7%）至少有一名接受过PAC培训的提供者。共有273家（80.7%）医疗机构报告为所有PAC患者提供避孕措施，主要是短效方法。PAC服务的提供取决于是否有单独的后送室（公立2 - 3级：比值比[OR] 22.93；公立4 - 6级：OR 77.14），以及机构内提供的计划生育方法数量（公立2 - 3级：OR 1.38；公立4 - 6级：OR 1.57；私立2 - 3级：OR 2.27；私立4 - 5级：4.89）。
对PAC服务进行有效监测，尤其是在私立医疗机构中，可能会提高整体服务质量。
