Medium and long-term adherence to postabortion contraception among women having experienced unsafe abortion in Dar es Salaam, Tanzania.
BACKGROUND
Postabortion contraceptive service is considered an effective means in addressing the problem of unsafe abortion; in spite this fact this component remains one of the weakest parts of postabortion care. In this context, the paper aims to describe the impact of a postabortion contraceptive service intervention among women admitted with complications from unsafe abortions and to explore the women's long-term contraceptive adherence.


METHODS
392 women having experienced unsafe abortion were identified by an empathetic approach and offered postabortion contraceptive service, which included counselling on HIV and condom use. Questionnaire interviews about contraceptive use were conducted at the time of inclusion and 12 months after the abortion. Additionally, in-depth interviews were performed 6-12 months after the abortion.


RESULTS
Eighty-nine percent of the women accepted postabortion contraception. Follow-up information was obtained 12 months after the abortion among 59 percent of the women. Among these, 79 percent of the married women and 84 percent of the single women stated they were using contraception at 12 months. Condom use among the single women increased significantly during the 12 months follow up.


CONCLUSIONS
Postabortion contraceptive services appear to be well accepted by women who are admitted with complications after an unsafe abortion and should thus be recognized as an important means in addressing the problem of unsafe abortion. In addition, counselling about HIV and condom use should be considered an essential aspect of postabortion care.
Rasch
Vibeke
V
Department of International Health, Immunology and Microbiology, University of Copenhagen, Denmark. v.rasch@pubhealth.ku.dk
Yambesi
Fortunata
F
Massawe
Siriel
S
D000024:Abortion, Illegal / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000359:Aftercare; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D036301:Qualitative Research; D021841:Safe Sex / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013636:Tanzania; D013997:Time Factors