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Integrating postabortion care, menstrual regulation and family planning services in Bangladesh: a pre-post evaluation

Overview of attention for article published in Reproductive Health, March 2017
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Title
Integrating postabortion care, menstrual regulation and family planning services in Bangladesh: a pre-post evaluation
Published in
Reproductive Health, March 2017
DOI 10.1186/s12978-017-0298-1
Pubmed ID
Authors

Kamal K. Biswas, Erin Pearson, S. M. Shahidullah, Sharmin Sultana, Rezwana Chowdhury, Kathryn L. Andersen

Abstract

In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients whose procedures are often performed using sub-optimal uterine evacuation technology and typically do not receive postabortion contraceptive services. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care. A pre-post evaluation was conducted in the six large intervention facilities. Structured client exit interviews were administered to all uterine evacuation clients presenting in the 2-week data collection period for each facility at baseline (n = 105; December 2011-January 2012) and endline (n = 107; February-March 2013). Primary outcomes included service integration indicators such as provision of menstrual regulation, postabortion care and family planning services in both facility types, and quality of care indicators such as provision of pain management, provider communication and women's satisfaction with the services received. Outcomes were compared between baseline and endline for Directorate General of Family Planning and Directorate General of Health Services facilities, and chi-square tests and t-tests were used to test for differences between baseline and endline. At the end of the project there was an increase in menstrual regulation service provision in Directorate General of Health Services facilities, from none at baseline to 44.1% of uterine evacuation services at endline (p < 0.001). The proportion of women accepting a postabortion contraceptive method increased from 14.3% at baseline to 69.2% at endline in Directorate General of Health Services facilities (p = 0.006). Provider communication and women's rating of the care they received increased significantly in both Directorate General of Health Services and Directorate General of Family Planning facilities. Integration of menstrual regulation, postabortion care and family planning services is feasible in Bangladesh over a relatively short period of time. The intervention's focus on woman-centered abortion care also improved quality of care. This model can be scaled up through the public health system to ensure women's access to safe uterine evacuation services across all facility types in Bangladesh.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 90 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 90 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 20%
Researcher 14 16%
Student > Ph. D. Student 10 11%
Other 8 9%
Student > Bachelor 7 8%
Other 9 10%
Unknown 24 27%
Readers by discipline Count As %
Medicine and Dentistry 29 32%
Social Sciences 14 16%
Nursing and Health Professions 11 12%
Business, Management and Accounting 2 2%
Biochemistry, Genetics and Molecular Biology 1 1%
Other 7 8%
Unknown 26 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 May 2017.
All research outputs
#20,418,183
of 22,968,808 outputs
Outputs from Reproductive Health
#1,328
of 1,421 outputs
Outputs of similar age
#268,657
of 308,219 outputs
Outputs of similar age from Reproductive Health
#30
of 30 outputs
Altmetric has tracked 22,968,808 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,421 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.1. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 30 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.