Availability and Quality of Post-Abortion Care Services in Public Health Facilities in Osun State, Nigeria.

Abstract

Background:  Unsafe abortion contributes significantly to Nigeria’s poor maternal health status.  Post-abortion care (PAC) has the potential to reduce the maternal morbidity and mortality associated with unsafe abortion.  This study assessed the availability and quality of PAC in public healthcare facilities in Osun State, Nigeria.

Materials and Methods:  This cross-sectional study involved 223 (two tertiary, 17 secondary, and 204 primary) public health facilities in Osun State.  Data were collected using questionnaires and facility checklists developed according to global standards.  Availability of PAC was measured by the presence of personnel and materials to render PAC at all times, while PAC quality was measured by the signal functions of PAC and the method used to evacuate retained products of conception. Univariate and bivariate analyses were undertaken and statistical significance was set at p<0.05.  Ethical approval was obtained from Obafemi Awolowo University Teaching Hospitals Complex.

Results:  Only 18.6% (31.4% urban vs 5.9% rural, p<0.001) of PHC facilities had adequate availability of basic PAC, while 16.7% (27.5% urban vs 5.9% rural, p<0.001) of PHC facilities had good quality basic PAC. Among the referral facilities, 42.1% had adequate availability, while 31.6% had good quality comprehensive PAC.

Conclusion:  The is poor availability and quality of PAC in Osun State, and the situation is worse in rural compared to the urban areas, and at PHC level compared to higher levels of care. Improving PAC availability and quality by providing adequate human and material resources will reduce maternal morbidity and mortality, and improve overall maternal health.