摘要
Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effective modern contraception. The overall objective was to review current literature on PAC in SSA and make recommendations for improvement especially in Cameroon. A literature review was conducted on PAC in SSA published </span><span style="font-family:Verdana;">during</span><span style="font-family:Verdana;"> 2000-2018. The following databases were searched</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> MEDLINE, POPLINE, COCHRANE Library, African Index Medicus and GOOGLE Scholar. Thirty articles were reviewed from 16 countries ranging from observational studies to systematic reviews with meta-analysis. Major outcomes: 1) Manual vacuum aspiration (MVA) and misoprostol are equally safe and effective. 2) There is comparable</span><span style="font-family:""> </span><span style="font-family:Verdana;">effectiveness between physicians and trained mid-level cadres in PAC management. 3) PAC contraception uptake was increased when offered immediately before patient leaves the facility. 4) Gaps to PAC service use include inadequate access, low quality care and less adolescent-friendly environment. Task shifting of PAC to trained mid-level staff, decentralization of medical PAC using misoprostol, offering post abortion counselling and contraception to clients before leaving the health facility, encouraging linkage and provider-community partnership in PAC and reinforcement of advocacy for less restrictive abortion laws in Cameroon are recommended.
Saharan Africa (SSA) contributes 29% of the global unsafe abortions with 62% of abortion-related deaths. This is due to restrictive abortion laws, low quality post abortion care (PAC) and inadequate access to effective modern contraception. The overall objective was to review current literature on PAC in SSA and make recommendations for improvement especially in Cameroon. A literature review was conducted on PAC in SSA published </span><span style="font-family:Verdana;">during</span><span style="font-family:Verdana;"> 2000-2018. The following databases were searched</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> MEDLINE, POPLINE, COCHRANE Library, African Index Medicus and GOOGLE Scholar. Thirty articles were reviewed from 16 countries ranging from observational studies to systematic reviews with meta-analysis. Major outcomes: 1) Manual vacuum aspiration (MVA) and misoprostol are equally safe and effective. 2) There is comparable</span><span style="font-family:""> </span><span style="font-family:Verdana;">effectiveness between physicians and trained mid-level cadres in PAC management. 3) PAC contraception uptake was increased when offered immediately before patient leaves the facility. 4) Gaps to PAC service use include inadequate access, low quality care and less adolescent-friendly environment. Task shifting of PAC to trained mid-level staff, decentralization of medical PAC using misoprostol, offering post abortion counselling and contraception to clients before leaving the health facility, encouraging linkage and provider-community partnership in PAC and reinforcement of advocacy for less restrictive abortion laws in Cameroon are recommended.
作者
Alphonse Nyong Ngalame
Robert Tchounzou
Humphry Tatah Neng
Fulbert George Nkwele Mangala
Rakya Inna
Diane Modjo Kamdem
Bilkissou Moustapha
Julius Sama Dohbit
Eugene Justine Kongnyuy
Claude Ndoua Noa
Benova Lenka
Gregory Ekane Halle
Darolles Wekam Mwadjie
Therese Delvaux
Emile Telesphore Mboudou
Alphonse Nyong Ngalame;Robert Tchounzou;Humphry Tatah Neng;Fulbert George Nkwele Mangala;Rakya Inna;Diane Modjo Kamdem;Bilkissou Moustapha;Julius Sama Dohbit;Eugene Justine Kongnyuy;Claude Ndoua Noa;Benova Lenka;Gregory Ekane Halle;Darolles Wekam Mwadjie;Therese Delvaux;Emile Telesphore Mboudou(Gynecology & Obstetrics Unit, Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH), Douala, Cameroon;Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon;Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon;Faculty of Medicine and Biomedical Sciences (FMBS), University of Ngaoundere, Ngaoundere, Cameroon;Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon;United Nations Population Fund (UNFPA), Bamako, Mali;Institute of Tropical Medicine (ITM), Antwerpen, Belgium)
