Résumé : Every year in Latin America about 800,000 women are treated in hospitals for complications due to unsafe abortions. Post-abortion care (PAC) services are often characterized by low quality and high costs. In order to address this, an operations research study was conducted at the Carrion Hospital in Lima, Peru. A baseline survey identified multiple problems, including inadequate linkages to family planning (FP) services and inefficient care leading to an average hospital stay of over 33 hours. The intervention phase included training in post-abortion FP and manual vacuum aspiration (MVA), changes in clinical and counseling protocols, delivery of FP information and services and reorganization of PAC from an in-patient to an out-patient service. PAC services improved dramatically, including an increase in the use of MVA from nil to 89% of appropriate cases and an increase in the proportion of women receiving FP information from 18% to 78%. There were significant cost savings to the hospital, from US$119 for sharp curettage in hospitalized patients in the baseline to US$45 for patients treated with MVA as out-patients. Based on this information, the hospital director lowered the fees charged to patients by half. 3 years after completion of the study, high quality services continue at the hospital. (full text)
Site web : http://www.rhmjournal.org.uk