Quality of Post-Abortion Care in Burkina Faso, Kenya, and Nigeria

Currently, about 90% of women of childbearing age in Africa live in contexts with restrictive abortion laws. The bulk of women requiring abortion in these contexts resort to unsafe methods and procedures resulting in fatalities, severe disabilities or complications, which require treatment, hospital stays, intensive care, and attendance by highly skilled, yet scarce, health providers. Currently, the decline in unsafe abortion has been much slower than that of safe abortion in SSA. As a result, unsafe-abortion- related mortality and morbidities persist, raising urgent calls for more actionable evidence on the availability, provision, accessibility,and utilization of services for the management of post-abortion complications.

This multi-country study explores the issue of access to, utilization of, and quality of post-abortion in Kenya, Nigeria, and Burkina Faso. In these countries, abortion is legally restricted, permitted only to save the life of a woman and or preserve her physical health. Consequently, there is a high incidence of unsafe abortion and related complications in all three contexts. Burkina Faso, Kenya, and Nigeria are also signatories to the ICPD Programme of Action which enshrines the right of women, in all cases, to quality services for the management of abortion complications, including contraception counseling and provision.

In addition, emerging national, regional, and global policy contexts and instruments including the SDGs, African Union Agenda 2063, the African Common Position, and other national policy instruments continue to emphasize the importance of ensuring quality health for women and girls as key to an inclusive, prosperous, and peaceful Africa, driven by its own citizens and representing a dynamic force in the international arena.

The intermediate outcome of the proposed project is robust evidence on the quality of post-abortion care (PAC) in the study countries. The proposed project will ultimately result in: quality SRH care; reduced inequities in access to abortion care; and decreased preventable and untimely maternal deaths due to unsafe abortion. Through the proposed research, we will generate evidence on the quality of PAC in the study countries and provide the much needed information for developing effective interventions.

Our evidence will serve policy goals such as enhancing access to quality PAC; promoting health equity; guiding policy and programmatic changes; and providing basis for designing, delivering, and scaling up of effective interventions.