Improving Post Abortion Care (PAC) Delivery in Sub-Saharan Africa: A Literature Review

• 作者: Alphonse Nyong Ngalame Benova Lenka Bilkissou Moustapha Claude Ndoua Noa Darolles Wekam Mwadjie Diane Modjo Kamdem Emile Telesphore Mboudou Eugene Justine Kongnyuy Fulbert George Nkwele Mangala Gregory Ekane Halle Humphry Tatah Neng Julius Sama Dohbit Rakya Inna Robert Tchounzou Therese Delvaux
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: Post Abortion Care (PAC) MISOPROSTOL CONTRACEPTION Midlevel Cadres Sub-Saharan Africa
• 年，卷（期）: 2020,（9）
• 页码范围: 1295-1306
• 页数: 12页
• 分类号: R16

摘要

Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effective modern contraception. The overall objective was to review current literature on PAC in SSA and make recommendations for improvement especially in Cameroon. A literature review was conducted on PAC in SSA published </span><span style="font-family:Verdana;">during</span><span style="font-family:Verdana;"> 2000-2018. The following databases were searched</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> MEDLINE, POPLINE, COCHRANE Library, African Index Medicus and GOOGLE Scholar. Thirty articles were reviewed from 16 countries ranging from observational studies to systematic reviews with meta-analysis. Major outcomes: 1) Manual vacuum aspiration (MVA) and misoprostol are equally safe and effective. 2) There is comparable</span><span style="font-family:""> </span><span style="font-family:Verdana;">effectiveness between physicians and trained mid-level cadres in PAC management. 3) PAC contraception uptake was increased when offered immediately before patient leaves the facility. 4) Gaps to PAC service use include inadequate access, low quality care and less adolescent-friendly environment. Task shifting of PAC to trained mid-level staff, decentralization of medical PAC using misoprostol, offering post abortion counselling and contraception to clients before leaving the health facility, encouraging linkage and provider-community partnership in PAC and reinforcement of advocacy for less restrictive abortion laws in Cameroon are recommended.