Assessment Of Emergency Preparedness Of Private Health Providers In The Delivery Of Quality Safe Abortion In Greater Accra.

Abstract

Background: Worldwide, an estimated 25 million unsafe abortions, representing 45% of all abortions, occurred every year between 2010 and 2014. The reality is that, when women and girls cannot access safe abortion services, there are serious consequences for their health. The use of unsafe methods of abortion may result in the adoption of emergency procedures to ameliorate the health problems associated with this practice. In this regard. The appropriate management of emergency due to abortion care provision has been documented to reduce morbidity and mortality. Objective: the general objective of this 5tudy was to assess emergency preparedness of private health facilities in the delivery of quality Safe abortion care services in the Greater Accra Region of Ghana.

Methods: A descriptive cross-sectional survey using quantitative methods was applied to collect data in the month of June-July 2019. All private health facilities providing comprehensive abortion care within the Accra Metropolitan area were surveyed. Checklists adopted from the world Health Organisation’s Generic Essential Emergency Equipment List and World Health Organisation; United Nations Population Fund’s Inter-Agency List of Essential Medicines for Reproductive Health were applied. Data was entered in Microsoft excel before exporting to STATA Version 15 for analysis. Data cleaning and validation was done to ensure data quality. Descriptive statistics, a crude and adjusted odds ratio with 95% confidence interval from bivariate and multivariate analysis were used to measure association between the dependent and independent variables. A plus<0.05 was considered as statistically significant.

Results: the results showed that more than two essential items (emergency medicine equipment and supplies) were unavailable at 60% of these facilities at the time of this survey. Of greatest concern was the absence of uterotonic drugs (Oxytocin and/or Misoprostol) in 54% of facilities, which participated in the study. There was major deficiency in the availability of essential airway management equipment and emergency referral protocols and transportation. Moreover, the study found that most of the facilities surveyed provided some form of medical emergency management training for the staff – a little over 10% had not had any such training in the past three years.

Conclusion: generally, the study concludes that, while there was unavailability of some essential items for medical emergency management, there was some form of training provided albeit inadequate on same. Thus, the study identifies gaps in the emergency preparedness of private health facilities and makes appropriate recommendations for consideration of policy makers on how to enhance the quality of safe abortion in the country.