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MEETING THE NEEDS OF ADOLESCENT POST-ABORTION CARE PATIENTS IN THE DOMINICAN REPUBLIC

Published online by Cambridge University Press:  08 March 2010

DONNA R. McCARRAHER ,
MARIO CHEN-MOK ,
ANA SOPHIA ORONOZ ,
SONIA BRITO-ANDERSON ,
THOMAS GREY ,
HEIDI TUCKER  and
PATRICIA E. BAILEY
DONNA R. McCARRAHER
Affiliation:
Family Health International, Durham, North Carolina, USA
MARIO CHEN-MOK
Affiliation:
Family Health International, Durham, North Carolina, USA
ANA SOPHIA ORONOZ
Affiliation:
Quintiles, Inc., Research Triangle Park, North Carolina, USA
SONIA BRITO-ANDERSON
Affiliation:
John Snow Inc., Santo Domingo, Dominican Republic
THOMAS GREY
Affiliation:
Family Health International, Durham, North Carolina, USA
HEIDI TUCKER
Affiliation:
Pfizer, Morehead City, North Carolina, USA
PATRICIA E. BAILEY
Affiliation:
Family Health International, Durham, North Carolina, USA
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Summary

Counselling on contraception and contraceptive method provision are key components of post-abortion care (PAC). Some studies have suggested that adolescent PAC patients receive worse care than older women seeking these services. This study aimed to evaluate an intervention whose goal was to improve the counselling and contraceptive uptake of PAC patients, with special attention given to the needs of adolescent patients, in the four public hospitals in the Dominican Republic where PAC services were not being routinely offered. The counselling intervention effort included provider training and the development of adolescent-friendly information, education and communication (IEC) materials. Eighty-eight providers were interviewed at baseline and 6 months after the intervention was implemented. Six months after providers were trained, 140 adolescent PAC patients (≤19 years of age) and 134 older PAC patients (20–35 years) were interviewed about the contraceptive counselling messages and contraceptive methods they received before they were discharged from hospital. The adolescent and older PAC patients were matched on study hospital and time of arrival. Significant improvements were noted in provider knowledge and attitudes. No changes were noted in provider-reported PAC counselling behaviours, with close to 70% of providers reporting they routinely assess patients' fertility intentions, discuss contraception, assess STI/HIV risk and discuss post-abortion complications. Adolescent and older PAC patients reported receiving PAC counselling messages at similar rates. Forty per cent of adolescent PAC patients and 45% of older PAC patients who wanted to delay pregnancy were discharged with a contraceptive method. Adolescents were more likely to receive an injectable contraceptive method whereas older women were discharged with a variety of methods. The PAC counselling intervention increased provider knowledge and improved their attitudes and benefited both adolescent and older patients.

Type
Research Article
Information
Journal of Biosocial Science , Volume 42 , Issue 4 , July 2010 , pp. 493 - 509
Copyright
Copyright © Cambridge University Press 2010

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