Abstract
CONTEXT: The Democratic Republic of the Congo (DRC) decriminalized abortion under certain circumstances in 2018 through the Maputo Protocol. However, little is known about the readiness of the country’s health facilities to provide comprehensive abortion care. METHODS: Data on 1,380 health facilities from the 2017–2018 DRC Service Provision Assessment (SPA) inventory survey were used to assess readiness to provide abortion care in four domains: termination of pregnancy, basic treatment of postabortion complications, comprehensive treatment of postabortion complications and postabortion contraceptive care. Analyses used a modified application of the emergency obstetric care signal function approach; criteria for readiness were based on World Health Organization guidelines. RESULTS: Thirty-one percent of DRC facilities met the criteria for readiness to provide abortions. The proportion of facilities classified as ready was higher among urban facilities than rural ones (50% vs. 26%), and among hospitals than health centers or reference health centers (72% vs. 25% and 45%, respectively). Few facilities were ready to provide either basic or comprehensive treatment of postabortion complications (4% and 1%); readiness to provide these services was greatest among hospitals (14% and 11%). Only a third of facilities displayed readiness to provide postabortion contraceptive care. Inadequate supplies of medication (e.g., misoprostol, antibiotics, contraceptives) and equipment were the greatest barrier to readiness. CONCLUSIONS: Most DRC facilities were not ready to provide comprehensive abortion care. Improving supplies of vital health commodities will improve readiness, and has the potential to reduce the prevalence of unplanned pregnancies and future demand for abortions.
| Original language | English |
|---|---|
| Pages (from-to) | 3-12 |
| Number of pages | 10 |
| Journal | International Perspectives on Sexual and Reproductive Health |
| Volume | 46 |
| DOIs | |
| State | Published - 2020 |
Funding
The data used in this analysis are from the SPA inventory survey conducted in the DRC in 2017–2018.24 The Demographic and Health Survey (DHS) program conducts SPA surveys in partnership with national ministries of health. In the DRC, the 2017–2018 SPA was funded by the United States Agency for International Development (USAID), the United States President’s Malaria Initiative and the Global Fund. The DHS/SPA program designed the survey instruments and provided them in French to the DRC Ministry of Health, whose directorates adapted the survey to the local context. This project was supported by NIH Research Training Grant D43 TW009340 funded by the NIH Fogarty International Center, NINDS, NIMH, NHBLI and NIEHS. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
| Funders | Funder number |
|---|---|
| D43TW009340 | |
| United States Agency for International Development | |
| The Global Fund to Fight AIDS, Tuberculosis and Malaria | |
