Quality of family planning counseling among women attending prenatal care at a hospital in Addis Ababa, Ethiopia

ObjectiveTo assess the quality of family planning counseling among women attending a prenatal clinic in Addis Ababa, Ethiopia.MethodsIn a descriptive cross‐sectional study conducted between February and April, 2015, at the prenatal care clinic of Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, pregnant women in their third trimester were interviewed about their experience of family planning counseling. Data were collected via a questionnaire. Logistic regression was used to assess predictors of satisfaction with the counseling service.ResultsDuring the study period, 400 women were interviewed. Only 139 women (34.8%) were counseled about family planning. Among those counseled, 126 (90.6%) decided to use a contraceptive method after delivery and 46 (36.7%) decided to use an injectable contraceptive. Women were more likely to report high satisfaction when their provider asked about their partner’s attitude toward contraceptive methods (adjusted odds ratio 6.6; P<0.001), and when asked about their concerns and worries regarding family planning methods (adjusted odds ratio 5.1; P<0.001).ConclusionVery few women were counseled about contraception during prenatal care. Asking about a partner’s attitude toward contraceptives and discussing women’s fears or worries about contraceptives should be considered during family planning counseling to improve satisfaction and quality of care.Despite a hospital policy of universal counseling, only 35% of women attending prenatal care were counseled about family planning methods.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136375/1/ijgo12110.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136375/2/ijgo12110_am.pd

Discontinuation of long‐acting reversible contraception versus short‐term hormonal methods in urban Ghana: A pilot longitudinal study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144677/1/ijgo12518.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144677/2/ijgo12518_am.pd

A case series study on the effect of Ebola on facility-based deliveries in rural Liberia

Abstract Background As communities’ fears of Ebola virus disease (EVD) in West Africa exacerbate and their trust in healthcare providers diminishes, EVD has the potential to reverse the recent progress made in promoting facility-based delivery. Using retrospective data from a study focused on maternal and newborn health, this analysis examined the influence of EVD on the use of facility-based maternity care in Bong Country, Liberia, which shares a boarder with Sierra Leone - near the epicenter of the outbreak. Methods Using a case series design, retrospective data from logbooks were collected at 12 study sites in one county. These data were then analyzed to determine women’s use of facility-based maternity care between January 2012 and October 2014. The primary outcome was the number of facility-based deliveries over time. The first suspected case of EVD in Bong County was reported on June 30, 2014. Heat maps were generated and the number of deliveries was normalized to the average number of deliveries during the full 12 months before the EVD outbreak (March 2013 – February 2014). Results Prior to the EVD outbreak, facility-based deliveries steadily increased in Bong County reaching an all-time high of over 500 per month at study sites in the first half of 2014 – indicating Liberia was making inroads in normalizing institutional maternal healthcare. However, as reports of EVD escalated, facility-based deliveries decreased to a low of 113 in August 2014. Conclusion Ebola virus disease has negatively impacted the use of facility-based maternity services, placing childbearing women at increased risk for morbidity and death.http://deepblue.lib.umich.edu/bitstream/2027.42/114384/1/12884_2015_Article_694.pd

Abortion Care in Ghana: A Critical Review of the Literature

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109330/1/jmwh12243.pd

Post-abortion contraceptive acceptance and choice among women receiving abortion care at Saint Paul's Hospital, Addis Ababa, Ethiopia: a cross-sectional study

Background: An exploration and comparison of the characteristics and choices of women who did and did not accept post-abortion contraception would help to provide recommendations for more effective and appropriate contraceptive counselling and services. We aimed to determine the contraceptive acceptance rate and factors associated with choice of contraception, in particular modern and long-acting methods, in women after an abortion at a hospital in Addis Ababa, Ethiopia. Methods: We did a cross-sectional study at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, with women who received abortion care services for induced or spontaneous abortions from January to June, 2015. Logistic regression was used to determine factors associated with acceptance and choice of method of contraceptives. Findings: 552 women were included in the study. 478 had spontaneous abortions and 74 had induced abortions. 500 (91%) of them adopted modern contraception post-abortion and 103 (19%) received long-acting reversible contraceptives (LARC). Multivariable analysis showed that being a housewife (adjusted odds ratio [aOR] 3·43, 95% CI 1·20–9·80), being married (3·31, 1·41–7·74), and parity greater than 1 (2·70, 1·04–7·03) had a significant association with the odds of adopting any modern method of contraception after abortion. Adoption of LARC was positively associated with being a student (4·62, 1·50–14·22), parity greater than 1 (2·21, 1·12–4·36), and induced abortion (2·91, 1·46–5·80). Interpretation: The post-abortion contraceptive acceptance rate was higher than other studies done in Ethiopia. However, there should be increased advocacy and multipronged activities by the hospital and federal Ministry of Health to further increase the acceptance of LARC post abortion. Further research to assess follow-up discontinuation rates of contraceptive methods after discharge is an important next step. Funding: Saint Paul's Hospital Millennium Medical College

Reproductive health providers' willingness to provide comprehensive abortion services and knowledge of the abortion law in Addis Ababa, Ethiopia

In Ethiopia, the maternal mortality ratio is 676/100,000 live births with complications from unsafe abortion being the leading cause. The current study was conducted to assess the knowledge of reproductive health practitioners of the law governing abortion in Ethiopia, the willingness of providers to perform abortion procedures, and current comprehensive abortion care (CAC) practice patterns of physicians, midwives, and nurses at one teaching hospital in Addis Ababa, Ethiopia. All currently practicing obstetric/gynecologist faculty and residents, midwives, and nurses working on the obstetrics and gynecology ward at one public teaching hospital in Addis Ababa were invited to participate in this cross-sectional survey. A total of 50 participants completed the survey. 68% of the sample, reported being willing to provide abortion services, if offered the appropriate training. Participants who believe unsafe abortion is a large contributor to poor health of Ethiopian women are almost seven times more likely to be willing to provide CAC services, and physicians are more likely than non-physicians to report being comfortable currently providing CAC services. Obstetric and gynecological providers at St. Paul’s are supportive of providing abortion services, if they are trained in the procedure. Ensuring proper clinical training, as well as sensitization to the recent law change and the burden of unsafe abortion, is of the upmost importance to ensure Ethiopian women have access to safe abortions, as allowed by law.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151763/1/Rominski et al 2015.5 (3).pdfDescription of Rominski et al 2015.5 (3).pdf : Main articl