DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20214982
Published: 2021-12-27

Impact of contraceptive counselling, an essential element of post-abortion care, on uptake of contraceptives: a cross-sectional study of adolescents who received post-abortion care services in Makueni County, Kenya

Rachel N. Ngugi, James Musovya, Wacuka G. Njoroge, Maurice O. Kodhiambo

Abstract


Background: Contraceptive counselling and provision of contraceptives are essential elements of the post-abortion care model which was first published in 1994 with an aim of promoting post-abortion care as an effective public health strategy. Despite being core elements of this model, they are often overlooked during provision of post-abortion care services as health care workers focus on emergency services and removing the retained products of conception. The aim of this study was to assess the impact of contraceptive counselling on uptake of contraceptives among adolescents presenting for post-abortion care.

Methods: A cross-sectional study involving 100 adolescent girls who presented for post-abortion care at the Kibwezi-east sub-county hospital, Makueni county, Kenya. Self- administered questionnaires were used for data collection and data was analyzed using SPSS version 25. Chi-square was used to compare study participants who received/did not receive contraceptive counselling and their uptake of contraceptives.

Results: The mean age of the 100 participants was 17 years (SD=1.457). 98% of them were formally educated, 57% had the mother as their only guardian and majority of them were of Christian religion (56%). 41% (n=41) received contraceptive counselling services and 59% (n=59) were not counselled. Among the 41 participants who received contraceptive counselling, 92% (n=37) of them took up a contraceptive method and 8% (n=4) did not take up any method and among the 59 participants who did not receive contraceptive counselling, 51% (n=30) of them took up a contraceptive method while 49% (n=29) did not.

Conclusions: Contraceptive counselling remains an integral part of post abortion care and in this study it was found to have a positive correlation with utilization of post abortion contraceptives (rs=0.412, p=0.000).


Keywords


Abortion, Post-abortion care, Contraceptive counselling

Full Text:

PDF

References


Abate E, Smith Y, Kindie W, Girma A, Girma Y. Prevalence and determinants of post-abortion family planning utilization in a tertiary hospital of North West Ethiopia: a cross sectional study. 2020.

Centre for Reproductive Rights. In Harm's Way: The impact of Kenya's restrictive abortion law. New York: Centre for Reproductive Rights. 2020

Corbett M, Turner K. Essential elements of postabortion care: Origins, evolution and future directions.Guttmacher Institute. 2003;29(3). Available at: https://www.guttmacher.org/journals/ipsrh/2003/09/essential-elements-postabortion-care-origins-evolution-and-future-directions. Accessed on 18th September 2019.

Ganatra B, Gerdts, C. Global, regional and subregional classification of abortions by safety, 2010-2014: estimates from a Bayesian hierarchical model. Lancet. 2017;390(10110):2372-81.

Hussain R. Abortion and unintended pregnancy in Kenya. Available at: http://www.guttmacher.org /pubs/IB_UnsafeAbortionKenya.pdf. Accessed on 18 September 2019.

Kenya National Bureau of Statistics, Ministry of Health, National Aids Control Council, Kenya Medical Research Institute, National Council for Population and Development. Kenya Demographic Health Survey. ICF International. 2015.

Markenzius M, Faxelid E, Gemzell-Daniellson K, Odero TMA, Klingberg-Allvin M, Ogutu M. Contraceptive uptake in post abortion care- secondary outcomes from a rendomised controlled trial, Kisumu, Kenya. Plos One. 2018.

Maxwell L, Voetgabe G, Paul G, Mark A. Does the type of abortion provider influence contraceptive uptake after abortion? An analysis of longitudinal data from 64 health facilities in Ghana. BMC Public Health. 2015;15(586).

Nzioka C. Perspectives of adolescent boys on the risks of unwanted pregnancy and sexually transmitted infections: Kenya. Reproductive Health Matters. 2001;9(17):108-17.

Osur J, Orago A, Mwanzo I, Bukusu E. Social Networks and Decision Making for Clandestine Unsafe Abortions: Evidence from Kenya. African Journal of Reproductive Health. 2015;19(1):34-43.

Solo J, Billings DL, Obunga CA, Ominde A, Makumi M. Creating Linkages Between Incomplete Abortion Treatment and Family Planning Services in Kenya. Studies in family planning. 1999;17-27.

Zulu JM, Hallez K, Kass N. Ethics Challenges and guidance related to research involving adolescent post-abortion care: a scoping review.Reproductive health journal. 2018;15(71).