Factors influencing delivery of post abortion care services in Meru County, Kenya
Abstract
Globally, an estimated 8.5 million women experience abortion-related complications, resulting in 47,000 maternal deaths annually. Most complications occur in developing countries with the most severe morbidity and mortality occurring in sub-Saharan Africa. Kenya has a high maternal mortality rate of 362 per 100,000 live births attributable to five major causes with abortion-related complications estimated to contribute up to thirty percent of al these deaths. Meru county has an estimated Maternal Mortality Rate (MMR) of 202 per100,000 live births with limited documented data on post-abortion care services. This descriptive cross-sectional study design sought to document factors that influence the delivery of post abortion care services in Meru County to contribute to the body of knowledge on reducing MMR in Kenya. The study covered four objectives: 1) To determine availability of essential medical equipment for delivery of PAC services, 2) To determine availability of essential medicines for delivery of PAC services, 3) To establish health care provider's capacity to deliver PAC services, and 4) To establish health care providers' attitude towards providing Post Abortion Care services. The study found out that there was an inadequate number of staff trained on selected PAC procedures e.g., Medical Uterine Evacuation and Para-Cervical block. Further, lack of essential equipment such as MVA and EVA kits and drugs such as mifepristone, misoprostol and methotrexate significantly hindered the provision of PAC services in Meru County. The study revealed a significant positive relationship between the provision of PAC services and awareness of WHO guidelines on PAC (CI:95%, R=50.1, P=0.03). The study concluded that apart from personnel training on specific PAC service delivery skills, availing essential medical equipment and commodities and specific clinical guidelines and or protocols are essential for the provision of PAC services in Meru county. The study recommends provision of the necessary infrastructure and equipment, essential medicines, training health providers on specific PAC skills, and availing operational guidelines on PAC to Health Care workers to facilitate delivery of PAC services.