Challenges and prospects in integrating abortion care with HIV/family planning services as a one-stop maternal health service in Ethiopia
摘要
Challenges such as work overload, insufficient infrastructure, shortage of logistical supplies and healthcare providers and a standalone health service can hinder access to comprehensive healthcare. Integrated health services, therefore, can potentially improve service quality, lower costs, decrease facility visits, and reduce stigma and discrimination, particularly due to the religious, moral, cultural, and political factors surrounding abortion care.
ObjectiveTo describe the challenges and potential advantages of integrating abortion care into HIV and family planning services.
MethodA facility-based cross-sectional quantitative study was conducted in public health centers and hospitals. Stratified random sampling methods were used to include 413 abortion care users and 306 healthcare providers, respectively. Data from individuals seeking abortion care were collected by data collectors using a questionnaire, while data from healthcare providers were obtained through a self-administered questionnaire. The collected data underwent verification, cleaning, and entry into EpiData version 3.1 software, followed by exportation and analysis using SPSS version 25.
ResultThe study included 413 women receiving abortion care and 306 healthcare providers from 58 public health facilities. Healthcare providers identified factors such as enhancing regulatory documents (n = 271; 65.6%), providing training (n = 271; 65.6%), improving infrastructure (n = 268; 64.9%), ensuring a consistent supply of medical resources (n = 253; 60.8%), program monitoring and evaluation (n = 231; 55.9%) and fostering interaction between healthcare facility units (n = 182; 44.1%) as motivating factors for implementing integrated health services. Abortion care users emphasized that making health facilities available (n = 181; 43.8%) and equipping them with necessary materials, equipment, and supplies (n = 288; 69.7%) can enhance integrated abortion care services. The collected data underwent verification, cleaning, and entry into EpiData version 3.1 software, followed by exportation and analysis using SPSS version 25.
ConclusionSuccessful implementation of integrated women’s health services requires a strategic action plan addressing challenges and engaging with motivational factors.