ACCEPTABILITY OF THE INVOLVEMENT OF HEALTH EXTENSION WORKERS (HEWS) IN MEDICAL ABORTION (MA): THE PERSPECTIVES OF CLIENTS, SERVICE PROVIDERS AND TRAINED HEWS IN EAST SHOA AND ARSI ZONES, OROMIYA REGION, ETHIOPIA  

Authors

  • Mesganaw Fantahun Afework
  • Hailu Yeneneh
  • Awol Seid
  • Shondagne Belete
  • Birhanu Yimer
  • Abreham Gizaw
  • Berhanu Sendek
  • Chala Wegi
  • Hailemichael Gebreselassie
  • Hailegnaw Eshete
  • Heidi Johnston

Abstract

Background:  Involvement of health extension workers (HEWs) in Ethiopia, is a vital step in increasing access and utilization of medical abortion and related services.

Objective: To explore the acceptability of involvement of HEWs in medical abortion by women who seek services, by abortion service providers, and assess willingness and confidence of HEWs.

Methods: In-depth interview was conducted at three purposively selected health facilities in Ethiopia ; namely Marie Stopes Clinic (MSI) Adama clinic, MSI Asella clinic and Adama Government Health Centre from July-August, 2013. The interviews were transcribed verbatim  and analysis was done using Atlas ti software. Themes were abstracted from coded text segments. The findings are presented using quotations, Atlas ti networks and queries.

Results : Thirty eight (26 eligibility, 12 follow up) women  participated in the study and 9 HEWs  and 7 service providers were interviewed. Almost all of the interviewed women, service providers and HEWs accepted HEWs involvement in medical abortion services. The HEWs expressed readiness and confidence.  Concerns related to the involvement of HEWs included confidentiality, privacy, over dependence on abortion rather than preventing unwanted pregnancy, quality and poor referral system.

Conclusions:  Expansion of medical abortion services  by involving HEWs can  contribute to the reduction of  abortion related  morbidity and mortality. Concerns of the study population should be addressed by training of HEWs for medical abortion, creating better awareness and advocacy among women and communities, addressing quality and referral issues with proper planning, implementing and monitoring of activities.

Key words: Medical abortion, Eligibility, Follow up, Health extension worker, Ethiopia

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2015-07-20

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