What Contraception Do Women Use After Experiencing Complications From Abortion? An Analysis of Cohort Records of 18,688 Postabortion Care Clients in Tanzania

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

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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Abortion, Incomplete / psychology
  • Abortion, Induced / psychology
  • Abortion, Induced / statistics & numerical data*
  • Adult
  • Aftercare / psychology
  • Aftercare / statistics & numerical data*
  • Cohort Studies
  • Contraception / psychology
  • Contraception / statistics & numerical data*
  • Contraception Behavior / psychology
  • Contraception Behavior / statistics & numerical data*
  • Contraceptive Agents / therapeutic use*
  • Family Planning Services / standards
  • Female
  • Humans
  • Pregnancy
  • Pregnancy, Unplanned / physiology
  • Quality of Health Care
  • Tanzania
  • Young Adult

Substances

  • Contraceptive Agents