Evidence map›Paper›PMID 36897212›Full record

ArticleSexual and reproductive health matters2023

An assessment of facility readiness for comprehensive abortion care in 12 districts of Pakistan using the WHO Service Availability and Readiness Assessment tool.

Palitha Gunarathna Mahipala, Sabeen Afzal, Qudsia Uzma, Atiya Aabroo, Nilmini Hemachandra, Katy Footman, Heidi Bart Johnston, Bela Ganatra, Tahira Ezra Reza, Ahsan Maqbool Ahmad and 6 more

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In one paragraph

Article in Sexual and reproductive health matters, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
4.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 5 institutions in 3 countries.

Palitha Gunarathna MahipalaWHO Representative & Head of Mission, World Health Organization Country Office, Islamabad, Pakistan.
Sabeen AfzalDeputy Director Programs, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan.
Qudsia UzmaTechnical Officer RMNCAH, World Health Organization Country Office, Islamabad, Pakistan. Correspondence: uzmaq@who.int.
Atiya AabrooDeputy Director Programs, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan.
Nilmini HemachandraTechnical Officer RMNCAH, World Health Organization Country Office for Myanmar, Yangon, Myanmar.
Katy FootmanConsultant, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Heidi Bart JohnstonTechnical Officer, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Bela GanatraUnit Head, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Tahira Ezra RezaDirector, Centre for Global Public Health-Pakistan, collaborative centre for Institute of Global Public Health, University of Manitoba, Islamabad, Pakistan; Technical Advisor, Health Services Academy, Islamabad, Pakistan.
Ahsan Maqbool AhmadSenior Technical Advisor, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan; Senior Technical Advisor, Centre for Global Public Health-Pakistan, collaborative centre for Institute of Global Public Health, University of Manitoba, Islamabad, Pakistan; Technical Advisor, Health Services Academy, Islamabad, Pakistan.
Hasan Bin HamzaSRHR Advisor, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan.
Maida UmarStatistician/ Data analyst, Health Services Academy, Islamabad, Pakistan.
Kauser HanifMNCH Specialist, Centre for Global Public Health-Pakistan, collaborative centre for Institute of Global Public Health, University of Manitoba, Islamabad, Pakistan; MNCH Specialist, Health Services Academy, Islamabad, Pakistan.
Sayema AwaisSRHR Coordinator, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan.
Mariyam SarfrazAssociate Professor, Health Services Academy, Islamabad, Pakistan.
Ellen ThomTeam Lead for Healthier Population Cluster, World Health Organization, Islamabad, Pakistan.
Health Services Academy · PKMinistry of National Health Services Regulation and Coordination · PKWorld Health Organization · CHWorld Health Organization - Pakistan · PKMinistry of Health · MM

Funding

World Health Organization 001
6 · The paper itself

Abstract

Although Pakistan's Essential Package of Health Services was recently updated to include therapeutic and post-abortion care, little is known about current health facility readiness for these services. This study assessed the availability of comprehensive abortion care, and readiness of health facilities to deliver these services, within the public sector in 12 districts of Pakistan. A facility inventory was completed in 2020-2021 using the WHO Service Availability and Readiness Assessment, with a newly developed abortion module. A composite readiness indicator was developed based on national clinical guidelines and previous studies. Just 8.4% of facilities reported offering therapeutic abortion, while 14.3% offered post-abortion care. Misoprostol (75.2%) was the most common method provided by facilities that offer therapeutic abortion, followed by vacuum aspiration (60.7%) and dilatation and curettage (D&C) (59%). Few facilities had all the readiness components required to deliver pharmacological or surgical therapeutic abortion, or post-abortion care (<1%), but readiness was higher in tertiary (22.2%) facilities. Readiness scores were lowest for "guidelines and personnel" (4.1%), and slightly higher for medicines and products (14.3-17.1%), equipment (16.3%) and laboratory services (7.4%). This assessment highlights the potential to increase the availability of comprehensive abortion care in Pakistan, particularly in primary care and in rural areas, to improve the readiness of health facilities to deliver these services, and to phase out non-recommended methods of abortion (D&C). The study also demonstrates the feasibility and utility of adding an abortion module to routine health facility assessments, which can inform efforts to strengthen sexual and reproductive health and rights.

Indexed as

Abortion, InducedHealth Services AccessibilityFemaleHealth FacilitiesHumansPakistanPregnancyWorld Health Organizationabortionhealth facility assessmentPakistanpost-abortion careservice availabilityservice readiness

Identifiers

PMID36897212
PMCPMC10013260
OpenAlexW4323806053

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.