ABSTRACT
This paper investigates similarities and differences between abortion clients of a public-sector clinic and a non-governmental organization (NGO) clinic in Nepal. In 2010, a survey of 1,172 women was conducted in two highly-attended abortion clinics in Kathmandu—one public-sector clinic and another operated by an NGO. Data on the sociodemographic characteristics of clients, their fertility preferences, and use of contraceptives were analyzed. Similarities and differences between the two groups of clients were examined by either chi-square or t-test. The clients of the two clinics were similar with respect to age (27.3±5.7 years), education (26.5% had no education), and number of living children (1.88±1.08). They differed with regard to contraceptive practice, the circumstances resulting in unintended pregnancy, and future fertility preferences. Just over 50% clients of the public and 35% clients of the NGO clinic reported use of contraceptives surrounding the time of unintended pregnancy. The groups also differed in the contraceptive methods used and in reasons for not using any method. The NGO clinic contributed principally to expanding the availability of and access to abortion services.
ABSTRACT
The first manual vacuum aspiration (MVA) services unit in Nepal was established in 1995 at the country's largest national maternity hospital in Kathmandu. This research sought to assess and evaluate the safety, acceptability, and effectiveness of MVA services. This prospective study was conducted during 12 months in 1998, and follow-up was made at six weeks. Two groups of patients were compared: 529 patients treated in the MVA unit and 236 patients who were clinically eligible for treatment in the MVA unit but were treated instead in the main operation theatre (OT) owing to the unavailability of services in the MVA unit during the hours of their admission. The two groups differed with respect to some of their background characteristics but were similar in their clinical characteristics. The MVA group received contraceptive counselling and services and had significantly shorter stays in hospital. However, the direct cost incurred by the patients, regardless of the type of facility they used, was about the same. Follow-up at six weeks revealed that the MVA patients had significantly fewer complaints and were generally more satisfied with the services they had received than their counterparts. Slightly more than half of the women in the MVA group were using contraception at the time of follow-up compared to no women in the OT group. It is concluded that the MVA unit provided safe, effective, and efficient services to about 50% of all the patients admitted to the hospital with post-abortion complications. An additional 25% of the post-abortion patients could be served if the unit were kept open 24 hours a day, saving resources and time for patients and hospital staff. As a parallel development, both MVA and main OT services would need to be more effectively integrated with outside antenatal and family-planning clinics to address the reproductive health needs of women, thereby reducing the number of patients requiring post-abortion care.
Subject(s)
Abortion, Induced/adverse effects , Adolescent , Adult , Female , Health Care Costs , Hospitals, Maternity/economics , Humans , Length of Stay , Nepal , Patient Satisfaction , Pregnancy , Prospective Studies , Quality Control , Safety , Triage , Vacuum Curettage/adverse effectsABSTRACT
La conferencia internacional sobre mejor salud para las mujeres y los niños a través de la planificación familiar, celebrada en Nairobi en 1987, fue patrocinada por la Federación Internacional de Planificación de la Familia (IPPF); el Consejo de Población; UNICEF; el programa de las Naciones Unidas para el Desarrollo (PNUD); el Fondo de las Naciones Unidas para actividades en materia de población (FNUAP); el Banco Mundial; y la Organización Mundial de la Salud(OMS). Una de las recomendaciones de la conferencia fue que las agencias participantes en dicho campo continuaran recopilando y difundiendo los resultados de los últimos estudios sobre los efectos de la planificación familiar sobre la salud y la supervivencia maternoinfantil. La presente publicación es el resultado de dicha recomendación. La primera edición de este documento fue publicada en cooperación con a Federación Internacional de la Familia (IPPF), con financiamiento parcial del FNUAP. Fue lanzado al público en la Cumbre Mundial para la Infancia, 1990, Organización de las Naciones Unidas, Nueva York. La supervivencia infantil y la planificación familiar no son necesariamente un prerrequisito la una de la otra; más bien, ambas se influyen mutuamente. El uso de anticonceptivos puede mejorar la supervivencia infantil, y esta puede aumentar la demanda de la planificación familiar