An assessment of abortion services in public health facilities in Mozambique: women's and providers' perspectives.
Complications of unsafe abortion contribute to high maternal mortality and morbidity in Mozambique. In 2002, the Ministry of Health conducted an assessment of abortion services in the public health sector to inform efforts to make abortion safer. This paper reports on interviews with 461 women receiving treatment for abortion-related complications in 37 public hospitals and four health centres in the ten provinces of Mozambique. One head of both uterine evacuation and contraceptive services at each facility was also interviewed, and 128 providers were interviewed on abortion training and attitudes. Women reported lengthy waiting times from arrival to treatment, far longer than heads of uterine evacuation services reported. Similarly, fewer women reported being offered pain medication than head staff members thought was usual. Less than half the women said they received follow-up care information, and only 27% of women wanting to avoid pregnancy said they had received a contraceptive method. Clinical procedures such as universal precautions to prevent infection were less than adequate, in-service training was less than comprehensive in most cases, and few facilities reviewed major complications or deaths. Use of dilatation and curettage was far more common than medical or aspiration abortion methods. Current efforts by the Ministry to improve abortion care services have focused on training of providers in all these matters and integration of contraceptive provision into post-abortion care.
Gallo
Maria F
MF
Research and Evaluation Associate, Ipas, Chapel Hill NC, USA. gallom@ipas.org
Gebreselassie
Hailemichael
H
Victorino
Maria Teresa A
MT
Dgedge
Martinho
M
Jamisse
Lilia
L
Bique
Cassimo
C
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009073:Mozambique; D011247:Pregnancy; D011634:Public Health