Department of Reproductive Health, Faculty of Medicine, Gulu University, Gulu, Uganda.
Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
Womens Health (Lond). 2024 Jan-Dec;20:17455057241295896. doi: 10.1177/17455057241295896.
Abortion-related complications are the third leading cause of maternal mortality in Uganda, accounting for approximately one-fourth of all maternal deaths. Most are preventable through adequate use of the full package of postabortion care (PAC) services.
We aimed to assess the level of utilization of PAC services and the associated sociodemographic, obstetric, gynecological, and system-related factors at a high-volume tertiary health facility in Northern Uganda.
A cross-sectional survey was conducted among women receiving PAC at the Gulu Regional Referral Hospital from March 2023 to June 2023. Participants were recruited consecutively and exit interviews were conducted using structured questionnaires.
Utilization of PAC was defined as the use of four or more of the following: counseling, emergency treatment, family planning services, linkage to other sexual and reproductive health services, and community health service provider cooperation. Modified Poisson regression analysis was used to determine the independent predictors of PAC utilization.
A total of 364 participants were enrolled in the study. Overall, 21.1% ( = 77) of the participants had used four or more PAC services. Having a supportive partner (adjusted prevalence ratio (aPR): 1.9, 95% confidence interval (CI): 1.19-2.88, = 0.006), knowledge on PAC services (aPR: 1.7, 95% CI: 1.19-2.48, = 0.004), low parity (aPR: 2.2, 95% CI: 1.16-4.35, = 0.016), nulliparity (aPR: 2.4 95% CI: 1.19-4.73, = 0.014), and provision of privacy(physical privacy during prescription, counseling, procedures) (aPR: 2.3 95% CI: 1.14-4.47, = 0.02), were significantly associated with utilization of PAC.Overall, only one in five participants utilized four or more PAC services. Use of four or more PAC services was significantly associated with women having a supportive partner, knowledge of PAC services, low parity, nulliparity, and provision of privacy while receiving PAC services.
Approaches such as advocating male partner involvement, bridging the knowledge gap through health education, and promoting respectful care may improve the utilization of PAC services.
堕胎相关并发症是乌干达孕产妇死亡的第三大主要原因，约占所有孕产妇死亡的四分之一。通过充分利用全面的流产后护理（PAC）服务，大多数并发症是可以预防的。
我们旨在评估在乌干达北部一家高容量的三级保健机构中，PAC 服务的利用水平以及相关的社会人口、产科、妇科和系统相关因素。
这是一项 2023 年 3 月至 6 月在古卢地区转诊医院接受 PAC 的妇女的横断面调查。参与者连续招募，并使用结构化问卷进行退出访谈。
PAC 的利用被定义为使用以下四项或更多项：咨询、紧急治疗、计划生育服务、与其他性健康和生殖健康服务的联系以及社区卫生服务提供者的合作。使用修正泊松回归分析确定 PAC 利用的独立预测因素。
共有 364 名参与者参加了这项研究。总体而言，21.1%（77 人）的参与者使用了四项或更多项 PAC 服务。有一个支持的伴侣（调整后的患病率比（aPR）：1.9，95%置信区间（CI）：1.19-2.88，P=0.006）、对 PAC 服务的了解（aPR：1.7，95%CI：1.19-2.48，P=0.004）、低产次（aPR：2.2，95%CI：1.16-4.35，P=0.016）、初产妇（aPR：2.4，95%CI：1.19-4.73，P=0.014）和提供隐私（开处方、咨询、程序期间的身体隐私）（aPR：2.3，95%CI：1.14-4.47，P=0.02）与 PAC 的利用显著相关。总体而言，只有五分之一的参与者使用了四项或更多项 PAC 服务。利用四项或更多项 PAC 服务与妇女有一个支持的伴侣、对 PAC 服务的了解、低产次、初产妇和提供隐私显著相关，而接受 PAC 服务。
提倡男性伴侣参与、通过健康教育弥合知识差距以及促进尊重关怀的方法可能会提高 PAC 服务的利用。
