The most recent study on unwanted pregnancy and post-abortion
complications was carried out by the Population Council in 2002, and
provided national-level estimates of the prevalence of induced abortion,
as well as information on abortion providers, abortion methods and the
conditions under which induced abortions were being performed. The
present study was conducted to assess whether and how these conditions
have changed over the past 10 years, including changes in abortion
practices, abortion-related complications and the provision of
post-abortion care (PAC), or any changes in regional patterns. In
addition, the study aimed to provide a more in-depth understanding of
gaps and needs in PAC services.
Chapter 1 provides the global and local context for the present study
and highlights the need for data to identify priority actions to be
taken at the national level to reduce the incidence of unsafe abortion.
It gives an overview of the issue of abortion in Pakistan, and compares
it with the situation in developing countries and the developed world.
Chapter 2 describes the study design and overall methodology. It
describes the sampling procedures used in the surveys of health
facilities and of health professionals, and the data collection tools
and methodology. The training of medical researchers prior to the start
of field work, some major issues faced during data collection, and
procedures for data management and analysis are also discussed.
Chapter 3 describes, as reported by health professionals, the various
methods used by women themselves to induce their own abortions and the
pregnancy termination services used by providers. It also discusses the
typical profile of clients seeking pregnancy termination and describes
typical abortion providers among urban and rural, poor and non-poor
women, comparing these findings with those of the earlier 2002 study.
Chapter 4 discusses health professionals' reports about the
characteristics of women experiencing post-abortion complications, the
proportion of abortions likely to result in complications and the type
and level of health facilities that women needing treatment go to. This
chapter also describes the preparedness of services to provide
post-abortion care, the type of staff available and the various medical
procedures used to treat women suffering the health complications of
unsafe abortions. Chapter 4 also examines the status of staff trained in
procedures to manage abortion-related complications.
Chapter 5 analyses the burden on the health delivery system, both public
and private, from treating patients with post-abortion complications. It
presents the average annual number of cases treated as out-patients and
as inpatients, by province and type and level of facility. The findings
are compared with those of the 2002 study to show changes in caseloads
across the four major provinces of Pakistan.
Chapter 6 analyses the proportion of facilities providing various types
of family planning methods and describes the attitudes of health
professionals and service providers toward the role of contraception and
post-abortion family planning counselling services.
Chapter 7 explores the demand side of the issue of post-abortion care by
assessing barriers and challenges women face in seeking care in a
variety of settings mainly in rural Pakistan where there is a greater
lack of services.
Chapter 8 concludes the report by discussing the overall lessons learnt
from the study and makes recommendations for future actions at the
program and policy level.
Sathar, Z.A.; Singh, S.; Shah, S.H.; Rashida, G.; Kamran, I.; Eshai, K. Post-Abortion Care in Pakistan: A National Study. Population Council, Islamabad, Pakistan (2013) xv + 120 pp.
Post-Abortion Care in Pakistan: A National Study