Background
Kenyatta National Hospital receives 30-40 women in need of post-abortion care every day. Restrictive laws and social stigma around abortion leads many Kenyan women to seek help from non-qualified personnel who perform unsafe, illegal abortions. These women often get health complications which can be fatal if not treated. When they visit Kenyatta National Hospital many of them have faced challenges when it comes to accessing the post-abortion services. These problems have included long waiting hours and lack of privacy and family planning services. Many women seeking post-abortion care need a manual vacuum aspiration (MVA) to remove content from the uterus, but only 8% of them were given anaesthesia (a so-called cervical block) and there were no rooms for them to recover in after the procedure.

About the project
This project was created to improve the quality of post-abortion care at Kenyatta National Hospital in Nairobi. The project team set up a MVA recovery room and a private room for post-abortion care and contraceptive counseling. To guide the health workers and ensure high quality of all post-abortion care, a standard operating procedure was developed together with a patient flow chart. The hospital staff were trained on performing a cervical block (local anaesthesia) during MVA procedures and instructed to offer this anaesthesia as a standard care service to patients. In addition to this, nurses trained on post-abortion care began offering counseling and contraceptive methods immediately after the patient had recovered from the MVA procedure.

Results
By the end of the project, the number of patients being offered and accepting a contraceptive method after their MVA procedure increased from 0% to 47.3%. Anaesthesia was given to 8% of the MVA patients before the project and to 13% after the intervention. The project also contributed to a positive attitude change towards post-abortion care among the hospital staff.

Year: 2009