Résumé : Preliminary results are presented of an operations research project to evaluate effects of integrating treatment of abortion complications with postabortal family planning information and services at a tertiary level teaching hospital in the province of Callao, Peru. Interviews with patients and staff, clinical records and other hospital registers were the main sources of data. The modifications in the postabortal services were intended to improve the quality of care and reduce costs, as well as integrating family planning services. The postabortal services were consolidated in a new area constructed for the purpose instead of being spread around the entire hospital. Health workers received training in manual vacuum aspiration, interpersonal relations, and family planning counseling. The services were reorganized into an outpatient program. Comparison of 102 patients treated before the intervention and 102 treated after indicated that instrumental uterine curettage had been almost completely replaced by manual vacuum aspiration, the number of pelvic examinations declined, and the average hospital stay was reduced from 33.3 to 6.4 hours. Patients perception of pain decreased and satisfaction with services increased. The proportion using family planning services after the abortion increased from 31% to 64%. The cost of care declined from US $119 to US $45 per patient. Prior to the intervention, patients spent about 10.5% of their time with hospital personnel, while after the intervention the proportion increased to 50%. The information given to patients concerning family planning, medical diagnosis, and follow-up care increased, while warnings about danger signs decreased.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 142998