Burkina Faso: Upgrading postabortion care benefits patients and providers.
During 1996-98, the Reproductive Health Research Network conducted a study to introduce emergency care for women with complications from miscarriage and abortions. Within this project, physicians, nurses, and midwives at two large hospitals in Ouagadougou and Bobo-Dioulasso were trained to provide postabortion care (PAC), including manual vacuum aspiration (MVA), family planning methods, infection prevention, and communication with patients. Changes in knowledge and behavior were measured through an interview with 330 patients with abortion complications and 78 providers before the intervention, and 456 patients and 41 providers after the intervention. Overall, the study demonstrated that the improved emergency medical care for women with miscarriages and unsafe abortions leads to better patient care, shorter hospital stays, lower costs, and increased contraceptive use. However, when performing MVA, verbal assurance alone from the training staff is inadequate for pain control, but rather local anesthesia is essential. The study also revealed that providers switched to MVA as their preferred treatment for PAC, since MVA lowered costs for both hospital and patients due to shorter hospital stays, less anesthesia, and less staff time.