The Quality of Post Abortion Care Package Offered to Women Presenting to Two Referral Hospitals in Bomet County

Abstract

In 2011, WHO reported 56 million abortions worldwide majority in the developing world. Maternal mortality in Kenya is high at 488/100,000 live births, with abortion related deaths contributing to the top five causes of maternal mortality. The Comprehensive post abortion care package (CPAC), which offers holistic care, has been shown to decrease the rate of maternal mortality and morbidity. This study aims to determine if all the elements of CPAC are offered to women presenting to hospitals in Bomet County. A quantitative Cross-sectional study was undertaken at two referral hospitals in Bomet County. 100 respondents who presented with abortion complications were surveyed in three months with a mean age of 26.6 years. Results indicate poor access to care with 70% accessing care after 24 hours despite life threatening complications. Gaps were noted in contraceptive uptake with only 36% getting a contraceptive at discharge and of these, most were short-term methods. Young people less than 25 years were less likely to be given a contraceptive unlike their counterparts in the faith-based facility OR 0.22(0.06, 0.83) P value <0.02. On spiritual care and emotional counseling, 100% of respondents reported having been emotionally affected by the abortion but only 66% reported care in that area. Only 46% of the patients were tested and counseled for HIV and STIs. Linkage to care was poor indicated by late access to care, there was an improper referral system and inadequacies in follow-up after discharge were also noted. Only 30% of the respondents received the whole CPAC package as required. Results indicate gaps in how frequently the elements of CPAC are provided which affects quality. Efforts need to be put in place to advocate for adherence to CPAC as stipulated in the guidelines with the aim of reducing maternal mortality.