Health facilities’ capability to provide comprehensive post abortion care in Sub-Saharan Africa: Evidence from a cross-sectional survey across 210 high volume facilities

Rachidatou Compaore; Hedieh Mehrtash; Clara Calvert; Zahida Qureshi; Folasade Adenike  Bello; Adama Baguiya; Ausbert Thoko Msusa; Nafiou Idi; Philip  Govule; Özge Tunçalp; Seni Kouanda

doi:10.1002/ijgo.14056

Health facilities’ capability to provide comprehensive post abortion care in Sub-Saharan Africa: Evidence from a cross-sectional survey across 210 high volume facilities

Rachidatou Compaore, Hedieh Mehrtash, Clara Calvert, Zahida Qureshi, Folasade Adenike Bello, Adama Baguiya, Ausbert Thoko Msusa, Nafiou Idi, Philip Govule, Özge Tunçalp, Seni Kouanda

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Objective: To evaluate the capability of high-volume comprehensive emergency
obstetric care (CEmOC) health facilities on the provision of comprehensive postabortion care (PAC) in Sub-Saharan Africa and to determine the frequency of women with severe abortion-related complications in high capability facilities.

Methods: A cross-sectional analysis conducted across 11 countries in Sub-Saharan
Africa, using facility-level information from the World Health Organization (WHO)
Multi-Country Survey on Abortion-related morbidity (MCS-A) between 2017 and
2018. PAC signal functions were adapted to assess facilities’ capability to deliver
comprehensive PAC through infrastructure, standard comprehensive capability, and extended comprehensive capability to provide PAC. The percentage of facilities with each signal function and distribution of facilities by number of signal functions were calculated for the three capability categories. Distribution of severe abortion complications by facility capability score was assessed

Results: Of 210 high-volume CEmOC facilities included, 47.9% (n = 100) had capability to provide all facility infrastructure signal functions, 54.4% (n = 105) for standard comprehensive PAC, reducing to 17.7% (n = 34) for extended comprehensive PAC capability. Overall, there were gaps in extended capabilities including availability of a functioning ICU (available in 37.3% of facilities) and providers 24/7 (65.5% of facilities reported an obstetrician available 24/7 dropping to 41.3% for anesthesiologists). Facilities’ PAC capability varied across regions. Overall, 34.6% (n = 614) of women with severe abortion-related complications were treated in facilities with the maximum capability score for extended comprehensive PAC.

Conclusion: Although high levels of capability to provide abortion-related care for
most signal functions were evident, significant gaps that impact on the management of severe abortion-related complications remain, particularly related to extended facility capabilities including specialized human resources and ICU.

Original language	English
Pages (from-to)	7-19
Journal	International Journal of Gynecology & Obstetrics
Volume	156
Issue number	Suppl.1
DOIs	https://doi.org/10.1002/ijgo.14056
Publication status	Published - 21 Jan 2022

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Health_facility_capability_submittedAccepted author manuscript, 948 KBLicence: Creative Commons: Attribution (CC-BY)

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Compaore, R., Mehrtash, H., Calvert, C., Qureshi, Z., Bello, F. A., Baguiya, A., Msusa, A. T., Idi, N., Govule, P., Tunçalp, Ö., & Kouanda, S. (2022). Health facilities’ capability to provide comprehensive post abortion care in Sub-Saharan Africa: Evidence from a cross-sectional survey across 210 high volume facilities. International Journal of Gynecology & Obstetrics, 156(Suppl.1), 7-19. https://doi.org/10.1002/ijgo.14056

@article{8e6547ad80694540ac45538ca0ce9aed,

title = "Health facilities{\textquoteright} capability to provide comprehensive post abortion care in Sub-Saharan Africa: Evidence from a cross-sectional survey across 210 high volume facilities",

abstract = "Objective: To evaluate the capability of high-volume comprehensive emergencyobstetric care (CEmOC) health facilities on the provision of comprehensive postabortion care (PAC) in Sub-Saharan Africa and to determine the frequency of women with severe abortion-related complications in high capability facilities.Methods: A cross-sectional analysis conducted across 11 countries in Sub-SaharanAfrica, using facility-level information from the World Health Organization (WHO)Multi-Country Survey on Abortion-related morbidity (MCS-A) between 2017 and2018. PAC signal functions were adapted to assess facilities{\textquoteright} capability to delivercomprehensive PAC through infrastructure, standard comprehensive capability, and extended comprehensive capability to provide PAC. The percentage of facilities with each signal function and distribution of facilities by number of signal functions were calculated for the three capability categories. Distribution of severe abortion complications by facility capability score was assessedResults: Of 210 high-volume CEmOC facilities included, 47.9% (n = 100) had capability to provide all facility infrastructure signal functions, 54.4% (n = 105) for standard comprehensive PAC, reducing to 17.7% (n = 34) for extended comprehensive PAC capability. Overall, there were gaps in extended capabilities including availability of a functioning ICU (available in 37.3% of facilities) and providers 24/7 (65.5% of facilities reported an obstetrician available 24/7 dropping to 41.3% for anesthesiologists). Facilities{\textquoteright} PAC capability varied across regions. Overall, 34.6% (n = 614) of women with severe abortion-related complications were treated in facilities with the maximum capability score for extended comprehensive PAC. Conclusion: Although high levels of capability to provide abortion-related care formost signal functions were evident, significant gaps that impact on the management of severe abortion-related complications remain, particularly related to extended facility capabilities including specialized human resources and ICU.",

author = "Rachidatou Compaore and Hedieh Mehrtash and Clara Calvert and Zahida Qureshi and Bello, {Folasade Adenike} and Adama Baguiya and Msusa, {Ausbert Thoko} and Nafiou Idi and Philip Govule and {\"O}zge Tun{\c c}alp and Seni Kouanda",

note = "Funding Information: The WHO Multi‐Country Survey on Abortion (MCS‐A) is a research project implemented by the WHO across a network of health facilities in Africa. We sincerely thank the women who participated in this study. WHO is grateful to the extensive network of institutions and individuals who contributed to the project design and implementation, including researchers, study coordinators, data collectors, data clerks, and other partners including the staff from the Ministries of Health and WHO country offices.This research was funded by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland. The contents of this article are the sole responsibility of the authors and do not necessarily reflect the views of WHO, or their individual institutions. Publisher Copyright: {\textcopyright} 2022 World Health Organization; licensed by International Federation of Gynecology and Obstetrics. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.",

year = "2022",

month = jan,

day = "21",

doi = "10.1002/ijgo.14056",

language = "English",

volume = "156",

pages = "7--19",

journal = "International Journal of Gynecology & Obstetrics",

issn = "0020-7292",

publisher = "Wiley",

number = "Suppl.1",

}

Compaore, R, Mehrtash, H, Calvert, C, Qureshi, Z, Bello, FA, Baguiya, A, Msusa, AT, Idi, N, Govule, P, Tunçalp, Ö & Kouanda, S 2022, 'Health facilities’ capability to provide comprehensive post abortion care in Sub-Saharan Africa: Evidence from a cross-sectional survey across 210 high volume facilities', International Journal of Gynecology & Obstetrics, vol. 156, no. Suppl.1, pp. 7-19. https://doi.org/10.1002/ijgo.14056

Health facilities’ capability to provide comprehensive post abortion care in Sub-Saharan Africa: Evidence from a cross-sectional survey across 210 high volume facilities. / Compaore, Rachidatou; Mehrtash, Hedieh; Calvert, Clara et al.
In: International Journal of Gynecology & Obstetrics, Vol. 156, No. Suppl.1, 21.01.2022, p. 7-19.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Health facilities’ capability to provide comprehensive post abortion care in Sub-Saharan Africa

T2 - Evidence from a cross-sectional survey across 210 high volume facilities

AU - Compaore, Rachidatou

AU - Mehrtash, Hedieh

AU - Calvert, Clara

AU - Qureshi, Zahida

AU - Bello, Folasade Adenike

AU - Baguiya, Adama

AU - Msusa, Ausbert Thoko

AU - Idi, Nafiou

AU - Govule, Philip

AU - Tunçalp, Özge

AU - Kouanda, Seni

N1 - Funding Information: The WHO Multi‐Country Survey on Abortion (MCS‐A) is a research project implemented by the WHO across a network of health facilities in Africa. We sincerely thank the women who participated in this study. WHO is grateful to the extensive network of institutions and individuals who contributed to the project design and implementation, including researchers, study coordinators, data collectors, data clerks, and other partners including the staff from the Ministries of Health and WHO country offices.This research was funded by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland. The contents of this article are the sole responsibility of the authors and do not necessarily reflect the views of WHO, or their individual institutions. Publisher Copyright: © 2022 World Health Organization; licensed by International Federation of Gynecology and Obstetrics. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

PY - 2022/1/21

Y1 - 2022/1/21

N2 - Objective: To evaluate the capability of high-volume comprehensive emergencyobstetric care (CEmOC) health facilities on the provision of comprehensive postabortion care (PAC) in Sub-Saharan Africa and to determine the frequency of women with severe abortion-related complications in high capability facilities.Methods: A cross-sectional analysis conducted across 11 countries in Sub-SaharanAfrica, using facility-level information from the World Health Organization (WHO)Multi-Country Survey on Abortion-related morbidity (MCS-A) between 2017 and2018. PAC signal functions were adapted to assess facilities’ capability to delivercomprehensive PAC through infrastructure, standard comprehensive capability, and extended comprehensive capability to provide PAC. The percentage of facilities with each signal function and distribution of facilities by number of signal functions were calculated for the three capability categories. Distribution of severe abortion complications by facility capability score was assessedResults: Of 210 high-volume CEmOC facilities included, 47.9% (n = 100) had capability to provide all facility infrastructure signal functions, 54.4% (n = 105) for standard comprehensive PAC, reducing to 17.7% (n = 34) for extended comprehensive PAC capability. Overall, there were gaps in extended capabilities including availability of a functioning ICU (available in 37.3% of facilities) and providers 24/7 (65.5% of facilities reported an obstetrician available 24/7 dropping to 41.3% for anesthesiologists). Facilities’ PAC capability varied across regions. Overall, 34.6% (n = 614) of women with severe abortion-related complications were treated in facilities with the maximum capability score for extended comprehensive PAC. Conclusion: Although high levels of capability to provide abortion-related care formost signal functions were evident, significant gaps that impact on the management of severe abortion-related complications remain, particularly related to extended facility capabilities including specialized human resources and ICU.

AB - Objective: To evaluate the capability of high-volume comprehensive emergencyobstetric care (CEmOC) health facilities on the provision of comprehensive postabortion care (PAC) in Sub-Saharan Africa and to determine the frequency of women with severe abortion-related complications in high capability facilities.Methods: A cross-sectional analysis conducted across 11 countries in Sub-SaharanAfrica, using facility-level information from the World Health Organization (WHO)Multi-Country Survey on Abortion-related morbidity (MCS-A) between 2017 and2018. PAC signal functions were adapted to assess facilities’ capability to delivercomprehensive PAC through infrastructure, standard comprehensive capability, and extended comprehensive capability to provide PAC. The percentage of facilities with each signal function and distribution of facilities by number of signal functions were calculated for the three capability categories. Distribution of severe abortion complications by facility capability score was assessedResults: Of 210 high-volume CEmOC facilities included, 47.9% (n = 100) had capability to provide all facility infrastructure signal functions, 54.4% (n = 105) for standard comprehensive PAC, reducing to 17.7% (n = 34) for extended comprehensive PAC capability. Overall, there were gaps in extended capabilities including availability of a functioning ICU (available in 37.3% of facilities) and providers 24/7 (65.5% of facilities reported an obstetrician available 24/7 dropping to 41.3% for anesthesiologists). Facilities’ PAC capability varied across regions. Overall, 34.6% (n = 614) of women with severe abortion-related complications were treated in facilities with the maximum capability score for extended comprehensive PAC. Conclusion: Although high levels of capability to provide abortion-related care formost signal functions were evident, significant gaps that impact on the management of severe abortion-related complications remain, particularly related to extended facility capabilities including specialized human resources and ICU.

U2 - 10.1002/ijgo.14056

DO - 10.1002/ijgo.14056

M3 - Article

SN - 0020-7292

VL - 156

SP - 7

EP - 19

JO - International Journal of Gynecology & Obstetrics

JF - International Journal of Gynecology & Obstetrics

IS - Suppl.1

ER -

Health facilities’ capability to provide comprehensive post abortion care in Sub-Saharan Africa: Evidence from a cross-sectional survey across 210 high volume facilities

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