Satisfaction and experience of care among women with abortion-related complications from Africa and Latin America and the Caribbean

Abstract

[ABSTRACTS]: BACKGROUND: Although abortion is a frequent event in women’s reproductive life and abortion-related complications have negative consequences for women’s health and wellbeing, little is known about the quality of abortion care. To improve the quality, women’s experience of care and satisfaction, need to be further standardized and studied. This study aims to assess experience and satisfaction with post-abortion care in Africa, and Latin America and the Caribbean (LAC). METHODS: We performed a secondary analysis from the World Health Organization Multi-Country Survey on Abortion. This analysis uses data from women with abortion-related complications who completed the exit survey in the form of an audio computer-assisted self-interview. Using construct validity, exploratory factor analysis and internal consistency coefficients we developed scales based on 12 items on experience of care and on 5 items on satisfaction. We performed logistic regression analyses to gain a better understanding of which clinical and sociodemographic characteristics were associated with poor experience of care and poor satisfaction. RESULTS: Three thousand one hundred seventy-eight women were included (299 from LAC and 2879 from Africa). Most women (85.1%) had mild or moderate abortion-related complications. The mean total score on experience of care was 2.96 (± 2.43), with a possible score range from 0 to 12. The mean total score regarding satisfaction was 1.05 (± 0.96), with a possible score range from 0 to 5. Women with no education were more likely to have poor experience of care compared to women with primary/secondary education. Women with no running water at home, with no adequacy of household income for personal needs, with no ability to save money and who did not earn their own money were more likely to have poor experience of care and poor satisfaction. Women treated in facilities with better capability to provide postabortion care were less likely to have poor satisfaction. CONCLUSIONS: Socioeconomically vulnerable women reported worse experiences and satisfaction with post-abortion care. Facilities with better capabilities improved satisfaction. Utilizing and implementing standardized scales and scores is essential for enhancing post-abortion experience of care improving care quality, and informing effective health policies and practices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material