Health facility factors affecting the provision of post-abortion care services in Trans- Nzoia County, Western Kenya

Abstract

Introduction: globally, millions of women suffer from abortion and its complications, and they require post-abortion care (PAC) services. The existence of suboptimal PAC services aggravates the situation. The study investigated health facility factors affecting the provision of post-abortion care by primary healthcare facilities in Trans-Nzoia County, Kenya. Methods: a cross-sectional study that adopted a mixed methods design where one hundred and sixty primary healthcare facilities were sampled across the five sub-counties. Qualitative data were analyzed using NVIVO, while quantitative analysis was performed using SPSS version 21. Descriptive statistics were used for continuous variables. The association between categorical independent variables and the dependent variable, with a p-value of 0.05 considered significant. Qualitative data were transcribed verbatim and organized into themes. Results: one hundred and sixty primary healthcare facilities were sampled across the five sub-counties. Public facilities were 64 (49.2%), private 51 (39.2%), and faith-based organizations 15 (11.5%). The majority of the facilities, 72 (55.4%), were operational five days a week. Community Health Promoters (CHPs) highlighted a lack of 24-hour services in PHC facilities. The cost of PAC services was statistically high, with a p-value of < 0.001, patient waiting time p-value of < 0.001. The main reason for the prolonged waiting time is the inability to pay for PAC services in 82 (63.1%) facilities. The distribution of nurses in PHC facilities was significant with a p-value of 0.03.

Conclusion: the findings show that health facility factors affecting PAC services in PHC facilities in Trans Nzoia County were facility operating hours, staffing levels for nurses, and availability of a budget specific to PAC services. Consequently, the study recommends the use of the health facility factors to inform PAC interventions.