Quality of abortion and postabortion care from the perspective of clients attending Muhima, Kibagabaga, and Kacyiru hospitals: A facility-based, prospective cross-sectional study

Abstract

1. Objectives To evaluate implementation of abortion and postabortion care services, and to evaluate patients’ satisfaction of abortion and postabortion care settings and services. 2. Methods This was a facility-based prospective cross-sectional study, done over 6 weeks during June and July 2022. We obtained approval from IRB-CMHS and ethics committees at study sites. After informed consent, we conducted exit interviews (individually and in a private room) of women aged between 18-49 years, treated for spontaneous or induced abortion, using a questionnaire which included socio-clinical data and patient-centered quality indicators. Data were entered in Excel 2010 then analyzed in SPSS version 21. We used tables and charts for categorical data, mean and median values for continuous data. The chi-square (X2) test was used for statistical data interpretation, statistical significance for associations were taken at a p value = or < 0.05. 3. Results The study recruited 180 participants. Participants’ mean age was 26.72 years (SD: 6.367), and mean gestational age was 11.7 weeks (SD: 3.718). Mean hospital stay was 1.57 days (max. five). Fifty seven (31.6%) clients had voluntarily induced abortion, 54 (30%) clients had at least one previous voluntary abortion, and some had up to four. Forty-four clients (24.4%) said that abortion care services were not affordable (N=180). Only 51.1 to 75% of clients said they received post-abortion education and counseling, 17 (9.44%) said that the staff was not respectful and was not willing to provide abortion care, and 9 among them (52.9%, N=17) had consulted for safe abortion. In general 88.9% clients were satisfied with abortion care. 4. Conclusion Overall clients’ satisfaction was high, but the rate of post-abortion education and counseling was low, maybe because providers are busy, not aware of PAC services, or forget. Some clients who have either induced or spontaneous abortion face disrespectful care even at formal health facilities. Some providers tend to overlook abortion clients in general; others judge or are hesitant to take care of clients who consult for voluntary abortion (termination of pregnancy).