Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members

Abstract Background Unsafe abortion is a leading cause of maternal mortality. In Afghanistan, which has experienced decades of armed conflict and where abortion is highly restricted, maternal mortality is high at 638 maternal deaths per 100,000 live births. Post-abortion care (PAC) is a lifesaving p...

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Autores principales:	Shiromi M. Perera, Haroon Achakzai, Monica M. Giuffrida, Meghana Jayne Kulkarni, Devin C. Nagle, Mohammad Kameen Wali, Sara E. Casey
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Post-abortion care Afghanistan Reproductive health Barriers Gynecology and obstetrics RG1-991 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/7229dbb9cb0643e19607d30b915f5881
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spelling	oai:doaj.org-article:7229dbb9cb0643e19607d30b915f58812021-11-07T12:20:47ZBarriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members10.1186/s12905-021-01529-51472-6874https://doaj.org/article/7229dbb9cb0643e19607d30b915f58812021-11-01T00:00:00Zhttps://doi.org/10.1186/s12905-021-01529-5https://doaj.org/toc/1472-6874Abstract Background Unsafe abortion is a leading cause of maternal mortality. In Afghanistan, which has experienced decades of armed conflict and where abortion is highly restricted, maternal mortality is high at 638 maternal deaths per 100,000 live births. Post-abortion care (PAC) is a lifesaving package of interventions to reduce morbidity and mortality related to induced or spontaneous abortion, but is rarely provided and often of poor quality, particularly in humanitarian settings. In July 2018, we conducted a study to identify the factors that influence access to and use of PAC services at Sharana Provincial Hospital. Methods In-depth interviews (IDIs) were conducted with ten women who had received PAC services at Sharana Hospital, and eight focus group discussions (FGDs) were conducted with 40 married women and 40 married men aged 18–45 from four villages surrounding Sharana Hospital. Results PAC clients and community participants discussed similar barriers to seeking PAC, including cost, distance to the health facility, the need for male accompaniment to seek care, perceived and actual quality of care, stigma and shame. Despite the mentioned stigma around abortion, community members expressed willingness to help women to receive PAC. Conclusions Our results suggest that while some barriers are not unique to PAC, others, especially those related to stigma around abortion, may be specific to PAC. It is important for the Ministry of Public Health and its partners to prioritize addressing these barriers to ensure that women have access to this critical life-saving care.Shiromi M. PereraHaroon AchakzaiMonica M. GiuffridaMeghana Jayne KulkarniDevin C. NagleMohammad Kameen WaliSara E. CaseyBMCarticlePost-abortion careAfghanistanReproductive healthBarriersGynecology and obstetricsRG1-991Public aspects of medicineRA1-1270ENBMC Women's Health, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Post-abortion care Afghanistan Reproductive health Barriers Gynecology and obstetrics RG1-991 Public aspects of medicine RA1-1270
spellingShingle	Post-abortion care Afghanistan Reproductive health Barriers Gynecology and obstetrics RG1-991 Public aspects of medicine RA1-1270 Shiromi M. Perera Haroon Achakzai Monica M. Giuffrida Meghana Jayne Kulkarni Devin C. Nagle Mohammad Kameen Wali Sara E. Casey Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members
description	Abstract Background Unsafe abortion is a leading cause of maternal mortality. In Afghanistan, which has experienced decades of armed conflict and where abortion is highly restricted, maternal mortality is high at 638 maternal deaths per 100,000 live births. Post-abortion care (PAC) is a lifesaving package of interventions to reduce morbidity and mortality related to induced or spontaneous abortion, but is rarely provided and often of poor quality, particularly in humanitarian settings. In July 2018, we conducted a study to identify the factors that influence access to and use of PAC services at Sharana Provincial Hospital. Methods In-depth interviews (IDIs) were conducted with ten women who had received PAC services at Sharana Hospital, and eight focus group discussions (FGDs) were conducted with 40 married women and 40 married men aged 18–45 from four villages surrounding Sharana Hospital. Results PAC clients and community participants discussed similar barriers to seeking PAC, including cost, distance to the health facility, the need for male accompaniment to seek care, perceived and actual quality of care, stigma and shame. Despite the mentioned stigma around abortion, community members expressed willingness to help women to receive PAC. Conclusions Our results suggest that while some barriers are not unique to PAC, others, especially those related to stigma around abortion, may be specific to PAC. It is important for the Ministry of Public Health and its partners to prioritize addressing these barriers to ensure that women have access to this critical life-saving care.
format	article
author	Shiromi M. Perera Haroon Achakzai Monica M. Giuffrida Meghana Jayne Kulkarni Devin C. Nagle Mohammad Kameen Wali Sara E. Casey
author_facet	Shiromi M. Perera Haroon Achakzai Monica M. Giuffrida Meghana Jayne Kulkarni Devin C. Nagle Mohammad Kameen Wali Sara E. Casey
author_sort	Shiromi M. Perera
title	Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members
title_short	Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members
title_full	Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members
title_fullStr	Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members
title_full_unstemmed	Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members
title_sort	barriers to seeking post-abortion care in paktika province, afghanistan: a qualitative study of clients and community members
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7229dbb9cb0643e19607d30b915f5881
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Barriers to seeking post-abortion care in Paktika Province, Afghanistan: a qualitative study of clients and community members

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