Barriers and facilitators in the provision of post-abortion care at district level in central Uganda - A qualitative study focusing on task sharing between physicians and midwives

BMC Health Services Research

Volumn 14, Issue , 2014, Pages

  Paul, Mandira ^a,b   Gemzell Danielsson, Kristina ^a   Kiggundu, Charles ^c   Namugenyi, Rebecka ^d   Klingberg Allvin, Marie ^a,e  

^a KAROLINSKA INSTITUTE   (Sweden)

^b UPPSALA UNIVERSITY   (Sweden)

^c MULAGO HOSPITAL   (Uganda)

^d MAKERERE UNIVERSITY   (Uganda)

^e DALARNA UNIVERSITY   (Sweden)

Author keywords

Contraceptive counselling; Induced abortion; Misoprostol; Post abortion care; Task sharing; Uganda

Indexed keywords

ARTICLE; FEMALE; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HUMAN; INDUCED ABORTION; INTERVIEW; METHODOLOGY; MIDWIFE; PHYSICIAN; PHYSICIAN ATTITUDE; POSTOPERATIVE CARE; QUALITATIVE RESEARCH; UGANDA;

ABORTION, INDUCED; FEMALE; HEALTH POLICY; HEALTH SERVICES ACCESSIBILITY; HUMANS; INTERVIEWS AS TOPIC; MIDWIFERY; PHYSICIAN'S ROLE; PHYSICIANS; POSTOPERATIVE CARE; QUALITATIVE RESEARCH; UGANDA;

EID: 84892579578     PISSN: None     EISSN: 14726963     Source Type: Journal    
DOI: 10.1186/1472-6963-14-28     Document Type: Article

References (58)

1. Unsafe abortion: the preventable pandemic. Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH, The Lancet 2006 368 1908 1919 10.1016/S0140-6736(06)69481-6 (Pubitemid 44794523)
2. World Health Organizaton, Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008 Geneva, Switzerland: World Health Organization 6 2011
3. Unsafe abortion and postabortion care-an overview. Rasch V, Acta Obstet Gynecol Scand 2011 90 692 700 10.1111/j.1600-0412.2011.01165.x 21542813
4. Prada E, Mirembe F, Ahmed FH, Nalwadda R, Kiggundu C, Abortion and postabortion care in Uganda: a report from health care professionals and health facilities New York: The Alan Guttmacher Institute 2005
5. World Health Organizaton, Safe abortion: technical and policy guidance for health systems Geneva, Switzerland: World Health Organization 2 2012
6. Schorge J, Schaffer J, Halvorson L, Hoffman B, Bradshaw K, Cunningham F, Williams gynecology Dallas, Texas: Mc Graw Hill Medical 2008
7. Meeting health care needs of women experiencing complications of miscarriage and unsafe abortion: USAID's postabortion care program. Curtis C, J Midwifery Womens Health 2007 52 368 375 10.1016/j.jmwh.2007.03.005 17603959 (Pubitemid 46978071)
8. Treatment of incomplete abortion and miscarriage with misoprostol. Blum J, Winikoff B, Gemzell-danielsson K, Ho PC, Schiavon R, Weeks A, Int J Gynaecol Obstet 2007 99 (Suppl 2) 186 S189 17961569
9. Misoprostol to treat missed abortion in the first trimester. Gemzell-Danielsson K, Ho PC, Gómez Ponce de León R, Weeks A, Winikoff B, Int J Gynaecol Obstet 2007 99 Suppl 2 182 S185 17961567
10. Implementation of misoprostol for postabortion care in Kenya and Uganda: a qualitative evaluation. Osur J, Baird TL, Levandowski BA, Jackson E, Murokora D, Glob Health Action 2013 6 1 11
11. Is misoprostol a safe, effective and acceptable alternative to manual vacuum aspiration for postabortion care? Results from a randomised trial in Burkina Faso, West Africa. Dao B, Blum J, Thieba B, Raghavan S, Ouedraego M, Lankoande J, Winikoff B, BJOG 2007 114 1368 1375 10.1111/j.1471-0528.2007.01468. x 17803715 (Pubitemid 47609935)
12. An assessment of postabortion care in three regions in Ethiopia, 2000 to 2004. Fetters T, Tesfaye S, Andersen K, Int J Gynecol Obstet 2008 101 100 106 10.1016/j.ijgo.2008.01.011
13. A randomized controlled trial of 400-μg sublingual misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion in two Egyptian hospitals. Dabash R, Ramadan MC, Darwish E, Hassanein N, Blum J, Winikoff B, Int J Gynaecol Obstet 2010 111 131 135 10.1016/j.ijgo.2010.06.021 20801444
14. Medical versus surgical methods for first trimester termination of pregnancy. Say L, Brahmi D, Kulier R, Campana A, Am G, Cochrane Database Syst Rev 2002 4 rt No.: CD003037 doi:10.1002/14651858.CD003037.pub2
15. A randomized trial of misoprostol compared with manual vacuum aspiration for incomplete abortion. Weeks A, Alia G, Blum J, Winikoff B, Ekwaru P, Durocher J, Mirembe F, Obstet Gynecol 2005 106 540 547 10.1097/01.AOG.0000173799.82687. dc 16135584 (Pubitemid 41208786)
16. Introducing misoprostol for the treatment of incomplete abortion in Nigeria. Dah T, Akiode A, Awah P, Fetters T, Okoh M, Ujah I, Oji E, Afr J Reprod Health 2011 15 42 50 22571104
17. Misoprostol as the primary agent for medical abortion in a low-income urban setting. Borgatta L, Mullally B, Vragovic O, Gittinger E, Chen A, Contraception 2004 70 121 126 10.1016/j.contraception.2004.03.007 15288216 (Pubitemid 38993488)
18. Misoprostol: first-line therapy for incomplete miscarriage in the developing world. Gemzell-Danielsson K, Fiala C, Weeks A, BJOG 2007 114 1337 1339 10.1111/j.1471-0528.2007.01491.x 17949375 (Pubitemid 47609942)
19. Global availability of misoprostol. Campbell M, Holden M, Int J Gynecol Obstet 2006 94 151 S152
20. Ipas CLACAI, Misoprostol and medical abortion in Latin America and the Caribbean USA: Chapel Hill 2010
21. Human resources for health: overcoming the crisis. Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, Cueto M, Dare L, Dussault G, Elzinga G, Fee E, Habte D, Hanvoravongchai P, Jacobs M, Kurowski C, Michael S, Pablos-Mendez A, Sewankambo N, Solimano G, Stilwell B, de Waal A, Wibulpolprasert S, Lancet 2004 364 1984 1990 10.1016/S0140-6736(04)17482-5 15567015 (Pubitemid 39574602)
22. Task shifting in maternal and child health care: an evidence brief for Uganda. Nabudere H, Asiimwe D, Mijumbi R, Int J Technol Assess Health Care 2011 27 173 179 10.1017/S0266462311000055 21450128
23. Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence. Dawson AJ, Buchan J, Duffield C, Homer CSE, Wijewardena K, Health Policy Plan 2013 1 13 doi:10.1093/heapol/czt026
24. Provision of abortion by mid-level providers: international policy, practice and perspectives. Berer M, Bull World Health Organ 2009 87 58 63 10.2471/BLT.07.050138 19197405
25. Nurse-midwives' attitudes towards adolescent sexual and reproductive health needs in Kenya and Zambia. Warenius LU, Faxelid EA, Chishimba PN, Musandu JO, Ong'any AA, Nissen EB-M, Reprod Health Matters 2006 14 119 128 10.1016/S0968-8080(06)27242-2 16713886 (Pubitemid 43732448)
26. Health care providers' attitudes towards termination of pregnancy: a qualitative study in South Africa. Harries J, Stinson K, Orner P, BMC Public Health 2009 9 296 307 10.1186/1471-2458-9-296 19689791
27. Influence of physician attitudes on willingness to perform abortion. Aiyer AN, Ruiz G, Steinman A, Ho GY, Obstet Gynecol 1999 93 576 580 10.1016/S0029-7844(98)00467-0 10214836 (Pubitemid 29147079)
28. Attitudes and practices of private medical providers towards family planning and abortion services in Nigeria. Konofua FEO, Hittu SOS, Ronsaye FO, Gunsakin DO, Gbomwan SO, Acta Obstet Gynecol Scand 2005 84 270 280 15715536
29. Health providers' perception towards safe abortion service at selected health facilities in Addis Ababa. Abdi J, Gebremariam MB, Afr J Reprod Health 2011 15 31 36
30. Ethics of justice and ethics of care. Values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education: a survey by questionnaire and interview. Klingberg-Allvin M, Van Tam V, Nga NT, Ransjo-Arvidson A-B, Johansson A, Int J Nurs Stud 2007 44 37 46 10.1016/j.ijnurstu.2005.11.018 16413553 (Pubitemid 44932103)
31. Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives. Nalwadda G, Mirembe F, Byamugisha J, Faxelid E, BMC Public Health 2010 10 530 543 10.1186/1471-2458-10-530 20813069
32. Uganda Bureau of Statistics (UBOS) and Macro International Inc. 2007, Uganda demographic health survey 2006 Kampala, Uganda and Calverton, Maryland, USA: Uganda Bureau of Statistics and Macro International Inc. 2007 40
33. Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives. Nalwadda G, Mirembe F, Tumwesigye NM, Byamugisha J, Faxelid E, BMC Health Serv Res 2011 11 220 229 10.1186/1472-6963-11-220 21923927
34. Faced with a double-edged risk: Ugandan university students' perception of the emergency contraceptive pill in Uganda. Mirembe JKBFM, Gemzell-danielsson K, Faxelid E, Afr J Reprod Health 2009 13 47 60
35. The incidence of induced abortion in Uganda. Singh S, Prada E, Mirembe F, Kiggundu C, Int Fam Plan Perspect 2005 31 183 191 10.1363/3118305 16439346 (Pubitemid 47028625)
36. Singh S, Moore AM, Bankole A, Mirembe F, Wulf D, Prada E, Unintended pregnancy and induced abortion in Uganda: causes and consequences New York: Guttmacher Institute 2006
37. Emergency obstetric care as the priority intervention to reduce maternal mortality in Uganda. Mbonye AK, Asimwe JB, Kabarangira J, Nanda G, Orinda V, Int J Gynaecol Obstet 2007 96 220 225 10.1016/j.ijgo.2006.12.017 17292370
38. Ministry of Health, The national policy guidelines and service standards for sexual and reproductive health and rights Kampala, Uganda: The Reproductive Health Division, Department of Community Health 3 2006 1 48
39. Guttmacher Institute, CEHURD (Center for Health, Human Rights and Development), Fact sheet: abortion in Uganda Kampala, Uganda and New York, USA: Guttmacher Institute 2013 2
40. East Central and Southern African Health Community (ECSA-HC), Task shifting in Uganda: case study Washington, DC: Futures Group, Health Policy Initiative, Task Order 1 2010
41. Using thematic analysis in psychology. Braun V, Clarke V, Qual Res Psychol 2006 3 71 101 10.1191/1478088706qp055br
42. Perspectives of midwives and doctors on adolescent sexuality and abortion care in Vietnam. Klingberg-Allvin M, Nga NT, Ransjö-Arvidson A-B, Johansson A, Scand J Public Health 2006 34 414 421 10.1080/14034940500429046 16861192 (Pubitemid 44138059)
43. Barriers to sustainable MVA supply in Ghana: challenges for the low-volume, low-income providers. Graff M, Amoyaw DA, Afr J Reprod Health 2009 13 73 80 20690275
44. Determinants of contraceptive acceptance among Cambodian abortion patients. Mcdougall J, Fetters T, Clark KA, Rathavy T, Stud Fam Plann 2009 40 123 132 10.1111/j.1728-4465.2009.00195.x 19662804
45. Postabortion family planning: addressing the cycle of repeat unintended pregnancy and abortion. Curtis C, Huber D, Moss-Knight T, Int Perspect Sex Reprod Health 2010 36 44 48 10.1363/3604410 20403805
46. Creating linkages between incomplete abortion treatment and family planning services in Kenya. Solo JL, Billings D, Aloo-Obunga C, Ominde A, Makumi M, Stud Fam Plann 1999 30 17 27 10.1111/j.1728-4465.1999.00017.x 10216893 (Pubitemid 29308287)
47. Nath S, Supplementary report: case studies: Getting Research into Policy and Practice (GRIPP) John Snow International; Europe 2007 1 117 http://pdf.usaid.gov/pdf-docs/PNADK002.pdf
48. Ministry of Health, Pharmacy stock status reports: National Medical Stores, Joint Medical Stores, National TB & Leprocy Programme Kampala, Uganda: Ministry of Health, Pharmacy Division 2012
49. Misoprostol for treatment of incomplete abortion at the regional hospital level: results from Tanzania. Shwekerela B, Kalumuna R, Kipingili R, Mashaka N, Westheimer E, Clark W, Winikoff B, BJOG An Int J Obstet Gynaecol. 2007 114 1363 1367 10.1111/j.1471-0528.2007.01469.x (Pubitemid 47609936)
50. Oral misoprostol as an alternative to surgical management for incomplete abortion in Ghana. Taylor J, Diop A, Blum J, Dolo O, Winikoff B, Int J Gynaecol Obstet 2011 112 40 44 10.1016/j.ijgo.2010.08.022 21122848
51. Choices on contraceptive methods in post-abortion family planning clinic in the northeast Brazil. Ferreira ALC, Souza AI, Lima RA, Braga C, Reprod Health 2010 7 5 10.1186/1742-4755-7-5 20459754
52. Factors associated with choice of post-abortion contraception in Addis Ababa, Ethiopia. Prata N, Bell S, Holston M, Gerdts C, Melkamu Y, Afr J Reprod Health 2011 15 55 62 22571106
53. Sedgh G, Hussain R, Bankole A, Singh S, Women with an unmet need for contraception in developing countries and their reasons for not using a method New York: Guttmacher Institute 2007
54. Reducing unmet need for family planning: Evidence-based strategies and approaches. Kolls A, Progr Appr Technol Health 2008 25 1 8
55. Nurse-midwives role for the expansion of comprehensive post abortion care services: the case of Kenya and Uganda. Yumkella F, Third Afr Popul Conf Durban South Afr Popul 1999 3 193 209
56. Meeting the need for emergency obstetric care in Mozambique: work performance and histories of medical doctors and assistant medical officers trained for surgery. Pereira C, Cumbi A, Malalane R, Vaz F, McCord C, Bacci A, Bergström S, BJOG 2007 114 1530 1533 10.1111/j.1471-0528.2007.01489.x 17877775 (Pubitemid 350077422)
57. Use of task-shifting to rapidly scale-up HIV treatment services: experiences from Lusaka, Zambia. Morris MB, Chapula BT, Chi BH, Mwango A, Chi HF, Mwanza J, Manda H, Bolton C, Pankratz DS, Stringer JSA, Reid SE, BMC Health Serv Res 2009 9 5 10.1186/1472-6963-9-5 19134202
58. Task shifting and sharing in Tigray, Ethiopia, to achieve comprehensive emergency obstetric care. Gessessew A, Barnabas GA, Prata N, Weidert K, Int J Gynaecol Obstet 2011 113 28 31 10.1016/j.ijgo.2010.10.023 21315350