A longitudinal study on different models of postabortion care in Tanzania.
OBJECTIVE
To identify women having unsafe abortions and elucidate whether an acceptable follow-up rate among these women can be retrieved.


METHODS
One thousand three hundred and fifty-seven women attended Temeke Municipal Hospital, Dar es Salaam with an abortion-related diagnosis.


METHODS
Women having unsafe abortions were identified by an empathetic dialogue, offered a contraceptive service and asked to return for follow-up. Three different ways of achieving follow-up information were tested. In phase 1, a combination of hospital-based and home-based interviews was utilized, in phase 2, an additional 1-month control visit was added to the protocol, and in phase 3, the contraceptive counseling and service was provided by technically well-skilled counselors.


RESULTS
Seven hundred and eighty-eight women were identified as having had unsafe abortions and 491 women as spontaneous abortions. Women having unsafe abortions were younger, more often single and of higher parity than women having spontaneous abortions. The follow-up rate achieved varied from 47%-72%, being lowest in phase 1 and highest in phase 3. The two most common reasons for loss to follow-up were the interviewer's inability to locate the respondent's house either because of an unspecific or a remote address (58%) and migration (29%).


CONCLUSIONS
If hospital-based and confidential home-based interviews are used combined and if the women having unsafe abortions are counseled by technically well-skilled counselors, it is possible to achieve a reasonable follow-up rate among women having unsafe abortions.
Rasch
Vibeke
V
Department of International Health, Institute of Public Health, University of Copenhagen, Denmark. v.rasch@dadlnet.dk
Massawe
Siriel
S
McHomvu
Yasinta
Y
Mkamba
Mashombo
M
Bergström
Staffan
S
D000028:Abortion, Induced / Q000009:adverse effects / Q000706:statistics & numerical data*; D000328:Adult; D003270:Contraceptive Agents; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008507:Medically Underserved Area; D010343:Patient Admission / Q000706:statistics & numerical data*; D011181:Postnatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D012449:Safety; D013636:Tanzania
D003270:Contraceptive Agents