ArticleBMC health services research2014
Barriers and facilitators in the provision of post-abortion care at district level in central Uganda - a qualitative study focusing on task sharing between physicians and midwives.
Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 5 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- The cost of post-abortion care (PAC): a systematic review.BMC health services research · 2022Pooled it
- Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2019Pooled it
- Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature.Systematic reviews · 2018Pooled it
- Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance.BMC health services research · 2015Pooled it
- Health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia: a systematic literature review of qualitative and quantitative data.BMC public health · 2015Pooled it
- Evaluating women's acceptability of treatment of incomplete second trimester abortion using misoprostol provided by midwives compared with physicians: a mixed methods study.BMC women's health · 2022Trial
- Comparison of the effectiveness and safety of treatment of incomplete second trimester abortion with misoprostol provided by midwives and physicians: a randomised, controlled, equivalence trial in Uganda.The Lancet. Global health · 2022Trial
- Trial
- Knowledge, attitude, and practice of manual vacuum aspiration in managing incomplete abortion at lower-level health facilities of Northern Uganda.BMC health services research · 2026Article
- Retained fetal bones after second-trimester dilation and curettage (D&C): report of two cases and review of literature.International journal of surgery case reports · 2026Article
- Second-line virologic failure and elevated bilirubin as a potential surrogate marker of ART adherence among people living with HIV in Eastern Uganda.AIDS research and therapy · 2026Article
- Abortion learning mechanisms for nurses and midwives: a scoping review of evidence.Sexual and reproductive health matters · 2025Article
- Balancing pragmatism, norms and power relations: a qualitative study among post-abortion intrauterine device users in central Uganda.Sexual and reproductive health matters · 2025Article
- Assessing facility capacity to provide safe abortion and post-abortion care in Liberia: a 2021 signal function survey across 48 public health facilities.BMC public health · 2025Article
- Two decades of research capacity strengthening and reciprocal learning on sexual and reproductive health in East Africa - a point of (no) return.Global health action · 2024Article
- "Sometimes you have knowledge but lack the equipment to save a life": perspectives on health system barriers to post-abortion care in Liberia and Sierra Leone.Archives of public health = Archives belges de sante publique · 2024Article
- Task Shifting and Task Sharing Implementation in Africa: A Scoping Review on Rationale and Scope.Healthcare (Basel, Switzerland) · 2023Article
- Second trimester post-abortion family planning uptake and associated factors in 14 public health facilities in Central Uganda: a cross-sectional study.Contraception and reproductive medicine · 2023Article
- Main barriers to services linked to voluntary pregnancy termination on three grounds in Chile.Frontiers in public health · 2023Article
- Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAbortion is restricted in Uganda, and poor access to contraceptive methods result in unwanted pregnancies. This leaves women no other choice than unsafe abortion, thus placing a great burden on the Ugandan health system and making unsafe abortion one of the major contributors to maternal mortality and morbidity in Uganda. The existing sexual and reproductive health policy in Uganda supports the sharing of tasks in post-abortion care. This task sharing is taking place as a pragmatic response to the increased workload. This study aims to explore physicians' and midwives' perception of post-abortion care with regard to professional competences, methods, contraceptive counselling and task shifting/sharing in post-abortion care.
methodsIn-depth interviews (n = 27) with health care providers of post-abortion care were conducted in seven health facilities in the Central Region of Uganda. The data were organized using thematic analysis with an inductive approach.
resultsPost-abortion care was perceived as necessary, albeit controversial and sometimes difficult to provide. Together with poor conditions post-abortion care provoked frustration especially among midwives. Task sharing was generally taking place and midwives were identified as the main providers, although they would rarely have the proper training in post-abortion care. Additionally, midwives were sometimes forced to provide services outside their defined task area, due to the absence of doctors. Different uterine evacuation skills were recognized although few providers knew of misoprostol as a method for post-abortion care. An overall need for further training in post-abortion care was identified.
conclusionsTask sharing is taking place, but providers lack the relevant skills for the provision of quality care. For post-abortion care to improve, task sharing needs to be scaled up and in-service training for both doctors and midwives needs to be provided. Post-abortion care should further be included in the educational curricula of nurses and midwives. Scaled-up task sharing in post-abortion care, along with misoprostol use for uterine evacuation would provide a systematic approach to improving the quality of care and accessibility of services, with the aim of reducing abortion-related mortality and morbidity in Uganda.
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Registered trials
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