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. 2019 Jan 28;19(1):22.
doi: 10.1186/s12905-018-0687-9.

What contraception do women use after experiencing complications from abortion? an analysis of cohort records of 18,688 postabortion care clients in Tanzania

Colin Baynes  1 , J Kahwa  2 , G Lusiola  2 , F Mwanga  2 , J Bantambya  2 , L Ngosso  2 , M Hiza  3
Affiliations

What contraception do women use after experiencing complications from abortion? an analysis of cohort records of 18,688 postabortion care clients in Tanzania

Colin Baynes et al. BMC Womens Health. .

Abstract

Background: The family planning component of postabortion care (PAC) is critical, as it helps women to prevent unintended pregnancies and reduce future incidence of life-threatening unsafe abortion. In Tanzania, PAC was recently decentralized from tertiary-level district hospitals to primary health care dispensaries in four regions of the country. This analysis describes interventions used to improve access to high quality PAC services during decentralization; examines results and factors that contribute to PAC clients' voluntary uptake of contraception; and develops recommendations for improving postabortion contraceptive services.

Methods: This analysis uses service delivery statistics of 18,688 PAC clients compiled from 120 facilities in Tanzania between 2005 and 2014.

Results: This study suggests that efforts to integrate postabortion family planning into treatment for incomplete abortion contributed to higher postabortion contraceptive uptake (86%). Results indicate that variables associated with significant differences in contraceptive uptake were facility level, age, gestational age at the time of treatment, and uterine evacuation technology used.

Conclusion: The experience of expanding PAC services in Tanzania suggests that integrating contraceptive services with treatment for abortion complications can increase family planning use.

Keywords: Contraceptive uptake; Decentralization; Family planning; Postabortion care; Tanzania.

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Conflict of interest statement

Authors’ information

Not applicable.

Ethics approval and consent to participate

This research was guided by the protocol, applicable laws and regulations, and the principles of research ethics as set forth in the Belmont Report. For this study, need for consent was formally waived. Every care was taken to ensure the privacy and confidentiality of study data. The Tanzanian National Institute of Medical Research (Protocol Number NIMR/HQ/R.8c/Vol.II/767) and the U.S.-based Western Internal Review Board (Protocol Number 1160194) approved the study protocol.

Consent for publication

Not relevant.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The Postabortion Care (PAC) Model
Fig. 2
Fig. 2
Number of clients utilizing PAC services, by year, Tanzania, 2005–2014
Fig. 3
Fig. 3
Percentage of PAC clients taking up a modern FP method or adopting no modern method, 2005–2014.
Fig. 4
Fig. 4
Percentage distribution of PAC clients, by contraceptive method adopted, 2005 to 2014
Fig. 5
Fig. 5
Percentage of PAC clients provided MVA versus sharp curettage, 2005–2014
Fig. 6
Fig. 6
Proportion of PAC clients admitted at a lower-level facility (health center and dispensary)
See this image and copyright information in PMC

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