Abortion-related Morbidity and Mortality in Conflict-affected and Fragile Settings Study

Epicentre2,500 enrolled

Overview

To describe and estimate the burden of abortion-related complications, particularly near-miss complications and deaths, and their associated factors among women presenting for abortion-related complications in health facilities supported by Médecins Sans Frontières (MSF) in African fragile and/or conflict-affected settings.

Multi-sites mixed-methods study with 4 components: 1. A quantitative observational descriptive study among women presenting for abortion-related complications to determine the frequency and severity of abortion-related complications including near-miss cases and death. Data will be collected through a medical records review and a quantitative survey among women presenting for abortion-related complications to determine the sociodemographic and clinical characteristics of the women with abortion-related complications, the type of abortion, the type and severity of complications and the clinical management received. It will also give insight into the characteristics of near-miss events following unsafe abortion. 2. A qualitative study about women's experiences associated with a near-miss event (and potentially life threatening): their pathway of access to care including their decision-making process, their own perceptions and opinions and other factors or conditions that might contribute to the near-miss event (in-depth face to face interviews). 3. A rapid health facility assessment with the health professional in charge of Post-Abortion Care will complement the assessment of the quality of management of complications 4. A Knowledge Attitudes, Practice and Behavior quantitative survey among health care providers involved in the management of abortion-related complications will identify provider-associated factors that may contribute to near-miss events.

Study Type

OBSERVATIONAL

Enrollment

2,500

Conditions

Abortion Complication

Eligibility

Sex: FEMALE

Medical Language ↔ Plain English

MEDICAL RECORD REVIEW: Inclusion Criteria: Women * with any signs or symptoms of abortion-related complications, i.e. any signs or symptoms of complications of spontaneous or induced abortion, whatever the abortion stage: inevitable, missed, incomplete, complete abortion . * Or with a presentation primary diagnosis of ectopic pregnancy or molar pregnancy Exclusion Criteria: * Threatened abortion (defined as vaginal bleeding with a closed cervix after having excluded the diagnosis of ectopic pregnancy or molar pregnancy) * History of abortion-related complications and presenting for an unrelated issue * Refusal to participate QUANTITATIVE INTERVIEW: Inclusion criteria: all women included in the medical record review subcomponent and hospitalized (who stayed overnight or more) Exclusion criteria: Participation to the interview as potentially harmwful to the woman according to her health care provider, Refusal to participate. QUALITATIVE INTERVIEW: Inclusion criteria: Women eligible for the quantitative interview and who experienced at least 1 criterion of near-miss event or potentially life-threatening conditions Exclusion criteria: Participation to the interview as potentially harmwful to the woman according to her health care provider, Refusal to participate. RAPID FACILITY ASSESSMENT: Key-informant: the provider in charge of the service providing post-abortion care KAPB SURVEY: Inclusion criteria: Health professionals (i.e. doctors, midwives, clinical officers, medical officers, nurses, aidmidwives, aid-nurses) involved in PAC and SAC services in the study site health facility Literate Exclusion criteria: Refusal to participate.

Locations (3)

Castor Maternity Center

Bangui, Central African Republic

Maternity center of the Hopital General de Référence

Masisi, Democratic Republic of the Congo

Maternity center of the general Jahun Hospital

Jahun, Nigeria