Percent of service delivery points providing postabortion care services that meet a defined standard of quality
The essential elements of postabortion care (PAC) consist of:
- Community and service provider partnerships;
- Treatment of incomplete and unsafe abortion;
- Contraceptive and family planning (FP) services; and
- Reproductive and other health services.
While providing these essential elements of PAC at a service delivery point (SDP), the following components of quality should be present:
- Appropriate technologies (for safe, effective uterine evacuation)
- Technical performance (e.g. training, adherence to infection prevention protocols, correct pain management practices)
- Patient-provider interactions (e.g. demonstrating respect, privacy, confidentiality)
- Information and counseling (e.g. FP counseling and provision, HIV/STI referral for testing and counseling)
- Equipment, supplies and medications (e.g. for uterine evacuation, infection prevention, and pain management; FP supplies)
This indicator is calculated as:
|# of SDPs providing PAC services that meet a defined quality standard x 100 __________________________________________________________
Total # of SDPs offering PAC services
Scores for each facility on data collection instruments developed to assess the quality of services at a network of facilities; for the denominator, counts of SDPs offering PAC services
Checklists; observation of services; informal patient and provider interviews; and review of facility records such as surgical logbooks for routine monitoring or supervision of the quality of PAC services
Facility audits, patient interviews, and/or observation of patient-provider interaction for more in-depth special studies
Although measurement of service quality is challenging, managers and providers can use the indicators outlined in this database and other existing resources to routinely assess their own programs. For instance, there are several specific indicators for quality in Indicators for the Essential Elements of Postabortion Care, developed by the EngenderHealth ACQUIRE project and the PAC Consortium, Essential Elements Task Force (2006.) The type of services available will depend on the level of the facility within the broader health care system. Health care systems should strive to decentralize PAC services so that women have access to emergency care within a reasonable time and distance from their homes.
Researchers have conducted a number of PAC operations research projects in Latin America and Africa, taking care to ensure informed consent and protection of patient confidentiality in studies on abortion-related services. This research has documented changes in quality after the introduction of PAC interventions in a variety of health care settings.
The complexity of clinical service provision requires the monitoring of many aspects of care. Appropriate infection prevention practices, for example, require that providers carry out a number of different steps in the process of clinical care.
quality, postabortion care, safe motherhood (SM)
Indicators for the Essential Elements of Postabortion Care. EngenderHealth ACQUIRE project and the PAC Consortium, Essential Elements Task Force. 2006.