The potential role of the private sector in expanding postabortion care in Addis Ababa, Amhara and Oromia regions of Ethiopia

Abstract

Abstract Background: Unsafe abortion is a major contributor of maternal mortality and morbidity in Ethiopia. High disease burden and underdeveloped infrastructure entail involvement of all partners in responding to health needs in the country. The private sector has apparently not been exploited to the fullest extent so far. Objective: To assess the potential of private facilities in expanding access to postabortion care (PAC). Methods: A cross-sectional study of private health facilities in Addis Ababa, Amhara and Oromia was conducted in 2001-2, using a pretested questionnaire and a checklist. Results: We assessed 88, 31 and 32 facilities in Addis Ababa, Amhara and Oromia, respectively. Treatment was provided by 44%, 52% and 63% of the eligible facilities in Addis Ababa, Amhara and Oromia, respectively. Manual vacuum aspiration (MVA) was used in treating 61% of Addis Ababa patients whereas sharp curettage was used in over 80% of those in Amhara and Oromia. About 80% of women did not get postabortion family planning methods. Patient-provider interaction was generally satisfactory. High-level disinfection (HLD) of non-autoclavable instruments needed improvement. All medium and above clinics have at least one GP and many have nurse/midwives. The vast majority of facilities not giving the service would like to provide comprehensive PAC if staff are trained and equipment made available in the market. Conclusion: Private health facilities can contribute substantially if given the necessary guidance and support with proper monitoring and evaluation. [Ethiop.J.Health Dev. 2003;17(3):157-165]