Community-based abortion care: Final evaluation findings from Western Kenya

Abstract

The presentation shares findings from the final evaluation of an intervention project entitled Community-Based Abortion Care (COBAC), designed to prevent unsafe abortion in rural Western Kenya. The COBAC strategy, which mainstreams community involvement in the prevention of unsafe abortion, supplements the traditional medical approach to post-abortion care (PAC). In Kenya, 35% - 50% of maternal deaths are due to complications from unsafe abortion. The COBAC interventions include: Community sensitisation and mobilisation, including peer education and the use of film, to increase awareness of reproductive health services; Facilitating herbalists and other community-based health workers as referral points for women needing PAC; Building the capacity of professional healthcare providers to provide efficient reproductive health services, especially PAC services; Creating linkages between informal, mid-level and upper-level healthcare providers The final evaluation assesses quality of care at participating facilities, change in demand for family planning and PAC, community involvement in the COBAC program, and attitude change towards unintended pregnancy and abortion services. Mid-term evaluation results already revealed that maternal deaths from unsafe abortion have decreased from 14 in 2001 to 1 in 2002 and none in 2003. Since COBAC activities began, facilities offering PAC services have increased from 1 to 17. There is a significant increase in use of family planning with 63% of the community obtaining non-prescriptive contraceptives from community-based health workers. The findings validate linkages between the community and trained formal providers as a strategy to increase access to high quality PAC services and decrease maternal mortality. Learning Objectives: Learning objectives Participants will be able to • 1. Develop effective, low cost, community-based, innovative strategies for decreasing maternal mortality; • 2. Describe two initiatives for increasing contraceptive access in Suba; • 3. Discuss successful strategies for community education and initiative in pregnancy prevention and prevention of unsafe abortion; • 4. Discuss strategies appropriate for linking informal health providers to formal providers to improve reproductive health outcomes.