Percent of postabortion care clients counseled on contraception

Percent of postabortion care clients counseled on contraception

Percent of postabortion care clients counseled on contraception

Of those women receiving either triage, stabilization, referral for emergency treatment, or emergency treatment services for complications related to miscarriage or unsafe abortion during the past year – regardless of location of services – the percentage of women who received  contraceptive  counseling prior to leaving the facility.

This indicator is calculated as:

(Number of women receiving contraceptive counseling/ Total number of women receiving postabortion care services) x 100

Data Requirement(s):

Counts of women presenting to a health facility (private office, health center, or hospital) for emergency treatment of abortion-related complications during a one-year period.  If possible, evaluators should disaggregate clients by those 25 years and older and youth (≤ 24).

If targeting and/or linking to inequity, classify outlets where
counseling is taking place by location (poor/not poor) and disaggregate
by area served.  Exit interviews can be conducted with clients to
determine client’s poverty status.

If possible, evaluators should disaggregate clients by the following age ranges: 10-14, 15-19, and 20-24.

Special studies or service statistics from health facilities providing triage, stabilization, treatment, and/or referral.

Note: In hospitals in developing countries, treatment of abortion complications may be performed in many different locations within the facility, such as the gynecological ward, emergency room, or operating room; data collection should therefore include encounters from all locations.

Contraceptive counseling – and provision – are critical elements of postabortion care (PAC).  This is a useful indicator for monitoring if this element of PAC is being provided and where gaps in quality of care may be.  Numbers of encounters for abortion complications can also provide denominators for other useful indicators, such as the percentage of PAC patients under the age of 20 or the percentage of PAC patients presenting at 12 or fewer weeks of pregnancy. In some individual facilities, such as private offices, health huts, health posts, and health centers, however, the number of encounters for abortion complications may be small so the calculation of percentages may be inappropriate.

This indicator includes both complications due to spontaneous abortion and induced abortions. Service providers often times assume a woman’s future reproductive intentions and her desire for family planning based on whether the abortion was spontaneous or induced abortion.  However, at the time of PAC treatment, counseling should be offered to each woman to help her clarify her reproductive intentions.  Even a woman who has had a spontaneous abortion and wants to become pregnant again immediately, may benefit from delaying a subsequent pregnancy.

While it is often of interest to distinguish between the two types in order to estimate the number of induced abortions, this information may be difficult to obtain, particularly in a legally and/or socially restrictive environment, or inconsistently recorded.  Moreover, many would question the ethics of asking young women if they have had an abortion in restrictive legal settings. Clinical evidence is often inconclusive, and reports may also be heavily biased in restrictive environments. Even where service providers are fairly certain that an abortion-related complication resulted from an induced abortion, they may not record this. This omission results in service data that are potentially misleading in terms of the number of spontaneous versus induced abortions.

postabortion care, quality, family planning

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