title: Comprehensive abortion care: evidence of improvements in hospital-level indicators in Tigray, Ethiopia.
abstract: OBJECTIVE
  Approximately 18% of maternal deaths in East Africa is attributable to unsafe abortion. Availability of comprehensive abortion care (CAC) services at all levels of the healthcare system, including medical abortion, has the potential to increase access to safe abortion thereby reducing the burden of unsafe abortion. This study sought to assess trends in abortion-related morbidity indicators in referral hospitals.
  
  
  METHODS
  Researchers conducted a secondary data analysis on retrospectively collected data.
  
  
  METHODS
  Data analysed were collected from four hospitals in the Tigray region of Ethiopia that took part in a CAC pilot project. Providers were trained in mid-2009 to provide abortion services using all available technologies. Data records from hospitals were collected in 2012 for the years 2006 through 2012; 2006/2007 data were too sparse to include in the analyses.
  
  
  RESULTS
  Trends in abortion-related services show a significant decrease in treatment of incomplete abortion, inverting the relationship between safe terminations and treatment of incompletes as a percentage of total abortions. Medication abortion was nearly non-existent in 2008, but increased steadily, representing 80% of total procedures in 2012. The inclusion of medication abortion and availability of CAC also contributed to a decline in inpatient procedures and prevalence of complications.
  
  
  CONCLUSIONS
  The trends observed in the data demonstrate how increased availability of CAC services at all levels of the healthcare system, among other factors, can contribute to reductions in the burden of unsafe abortion at referral hospitals.
authors.affiliation: UC Berkeley Bixby Center for Population, Health and Sustainability, School of Public Health, UC Berkeley, Berkeley, California, USA.
authors.forename: Ndola
authors.initials: N
authors.lastname: Prata
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bell
authors.forename: Amanual
authors.initials: A
authors.lastname: Gessessew
keywords: Obstetrics; Public Health