Abortion Complication
Conditions
Keywords
Near-miss, Risks factors, Maternal health, Abortion, Maternal mortality
Brief summary
To describe and estimate the burden of abortion-related complications, particularly near-miss complications and deaths, and their associated factors among women presenting for abortion-related complications in health facilities supported by Médecins Sans Frontières (MSF) in African fragile and/or conflict-affected settings.
Detailed description
Multi-sites mixed-methods study with 4 components: 1. A quantitative observational descriptive study among women presenting for abortion-related complications to determine the frequency and severity of abortion-related complications including near-miss cases and death. Data will be collected through a medical records review and a quantitative survey among women presenting for abortion-related complications to determine the sociodemographic and clinical characteristics of the women with abortion-related complications, the type of abortion, the type and severity of complications and the clinical management received. It will also give insight into the characteristics of near-miss events following unsafe abortion. 2. A qualitative study about women's experiences associated with a near-miss event (and potentially life threatening): their pathway of access to care including their decision-making process, their own perceptions and opinions and other factors or conditions that might contribute to the near-miss event (in-depth face to face interviews). 3. A rapid health facility assessment with the health professional in charge of Post-Abortion Care will complement the assessment of the quality of management of complications 4. A Knowledge Attitudes, Practice and Behavior quantitative survey among health care providers involved in the management of abortion-related complications will identify provider-associated factors that may contribute to near-miss events.
Interventions
None listed
Sponsors
Ipas
Guttmacher Institute
Medecins Sans Frontieres, Netherlands
Epicentre
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
MEDICAL RECORD REVIEW: Inclusion Criteria: Women * with any signs or symptoms of abortion-related complications, i.e. any signs or symptoms of complications of spontaneous or induced abortion, whatever the abortion stage: inevitable, missed, incomplete, complete abortion . * Or with a presentation primary diagnosis of ectopic pregnancy or molar pregnancy
Exclusion criteria
* Threatened abortion (defined as vaginal bleeding with a closed cervix after having excluded the diagnosis of ectopic pregnancy or molar pregnancy) * History of abortion-related complications and presenting for an unrelated issue * Refusal to participate QUANTITATIVE INTERVIEW: Inclusion criteria: all women included in the medical record review subcomponent and hospitalized (who stayed overnight or more)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| From the Quantitative observational descriptive study: | Between september 2019 and February 2021 | Proportion of near-miss cases among all women presenting for abortion-related complications. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quantitative observational descriptive study: medical record review+quantitative interviews: | Between september 2019 and February 2021 | Facility-based abortion-related complications ratio per annum for the following denominators: live births, all admissions and deliveries |
| Qualitative study (qualitative in-depth interviews): | Between september 2019 and February 2021 | Description of the woman pathway to care |
| Knowledge Attitude Practice and Behavior (KAPB) survey: | Between september 2019 and February 2021 | Proportion of each knowledge, attitude and practice of health facility staff related to Post Abortion Care and Safe Abortion Care |
Countries
Central African Republic, Democratic Republic of the Congo, Nigeria
Outcome results
None listed