Number/percent of service delivery points that offer contraception to postabortion care clients
The total number and percent of service delivery points (SDPs) offering family planning counseling and methods to postabortion care (PAC) patients.
The numerator includes all SDPs offering family planning after a woman receives treatment of abortion complications. The denominator includes the total number of SDPs offering PAC in a given country.
This indicator is calculated as:
# of SDPs offering family planning counseling and methods to postabortion care patients x 100 _________________________________________________________________
Total # of SDPs offering PAC
Count of the total number of health facilities offering PAC and total number of health facilities routinely offering family planning to women who have received PAC services
Service statistics; provider and patient interviews; and observation of services; interviews with patients or actual observation of services (preferred); provider interviews (useful); logbooks and patient records (potentially useful but often incomplete or inaccurate)
The recovery period after PAC services is an opportunity for health providers to offer comprehensive reproductive care.
Providers should offer counseling on family planning following any PAC service, because women can regain their fertility as soon as 14 days after an abortion and before the next menses. As an essential element of PAC, before leaving the health facility every woman treated for complications from an abortion should be aware that pregnancy can occur immediately and use of a contraceptive method can prevent an unwanted pregnancy, if the woman wishes a method. For those women who select a method at the time of treatment, counseling should include: assessment of the woman‘s personal situation, contraceptive options (almost all methods can be started immediately following PAC procedures), method use, side effects of the method selected, and resupply options. In countries where STI/HIV/AIDS is prevalent, providers should encourage dual protection (Rogo, Lema, and Rae, 1999).
Possible alternative indicators may include:
- Percent of PAC patients who receive family planning counseling at the time of service;
- Percent of PAC patients who accept a contraceptive method at the time of service; and
- Percent of PAC patients at risk of HIV/STI referred for testing and counseling
PAC clients should not be referred for family planning. Contraceptives should be available on site and in the same location (i.e. room or ward) where the PAC services are offered. If an SDP offers contraceptives as part of PAC, but the client must obtain her chosen method at a different part of the hospital (which may require more waiting time, more paperwork, and have different hours of operation), this should be a red flag for evaluators to address.
access, quality, family planning, postabortion care