Factors influencing provision of post abortion care among health care workers in Uasin Gishu County, Kenya

Abstract

Ending unsafe abortion is a pressing public-health and human-rights imperative. In Kenya, unsafe abortion is among the five main reasons associated with maternal ill health and deaths and will remain so until safe abortion is more accessible across the country. In responding to unsafe abortion as a major but preventable reason for maternal deaths in Kenya, the Medical Services Ministry developed a Post-Abortion Care (PAC) policy to guide in forcing down unsafe abortion related ill-health and deaths in accordance with the 2010 constitution. It remains unclear how widely the PAC model is being implemented by health care providers who may be facing several challenges, consequently undermining prevention of maternal deaths. This study assessed factors that influence provision of post abortion care among health care workers in Uasin Gishu County. Specifically, the study established factors that influence provision of PAC among health care workers in relation to their knowledge, perception, practices and measures put in health facilities for provision of PAC. A Cross-sectional descriptive study was conducted in 18 health facilities providing reproductive health services in the County, targeting medical officers, Clinical officers and Nurses. Sample size was obtained using coefficient of variation formulae. Stratified and simple random sampling was applied. Data was collected using a structured schedule and analysed using SPSS. Pearson’s correlation computed to test association between knowledge and practice of PAC among health workers was significant at p< 0.001. Spearman’s correlation between Perception and measures in place for provision of PAC was also significant at p < 0.001. Binary logistic regression indicated that knowledge, practice and measures in place were significant predictors of provision of PAC, [Chi-Square=5.868, df= 4 and p=0.001 (<0.05)]. Perception was not significant. The study concluded that health providers had a knowledge gap on abortion law especially on the terms under which PAC can be executed lawfully. Lack of training on PAC and ill-equipped facilities was also established as a barrier to provision of PAC. The study recommended a pressing need to enlighten health providers on the subject of abortion legal framework and training on modern PAC practices so as to heighten their competence. The county government inevitably should ensure availability of essential commodities and supplies in readiness to scale up provision of PAC and prevent further maternal deaths.