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Abstract：
BACKGROUND: Postabortion care (PAC), which is an essential element of emergency obstetric care, is underresearched in Niger. The study aims to assess the availability, readiness, and accessibility of facility-based PAC services in Niger.
METHODS: This study uses female and facility data from Performance Monitoring for Action Niger. The female data include a nationally representative sample of women aged 15-49 (n = 3,696). Using GPS coordinates, these female data were linked to a sample of public and private facilities (n = 258) that are expected to provide PAC. We assessed PAC availability and facility readiness to provide basic and comprehensive PAC using the signal functions framework, overall and by facility type. We then calculated the distance between women and their closest facility and estimated the proportion of women living within five kilometers (5 km) of a facility providing any PAC, basic PAC, and comprehensive PAC, overall and by women\'s background characteristics.
RESULTS: Only 36.4% and 14% of eligible facilities had all basic and comprehensive PAC signal functions, respectively. Oxytocics and laparotomy were the most missing signal function for basic and comprehensive PAC, respectively. Private facilities were the least ready to provide the full range of PAC services. While 47% of women lived within 5 km of a facility providing any PAC services, only 33.4% and 7.9% lived within 5 km of a facility providing all basic and all comprehensive PAC signal functions, respectively. Women who were divorced/widowed, had higher levels of education, and were living in urban areas had increased odds of living within 5 km of a facility with any or basic PAC. Women who were never married had increased odds of living within 5 km of a facility with comprehensive PAC, while urban residence was fully predictive of living within 5 km of a facility with comprehensive PAC.
CONCLUSIONS: This study found PAC availability and readiness to be insufficient in Niger, with inadequate and disparate accessibility to facilities providing PAC services. We recommended stakeholders ensure stock of essential commodities and availability of PAC services at primary facilities in order to mitigate the negative maternal health repercussions of unsafe abortion in this setting.
METHODS: This study uses female and facility data from Performance Monitoring for Action Niger. The female data include a nationally representative sample of women aged 15-49 (n = 3,696). Using GPS coordinates, these female data were linked to a sample of public and private facilities (n = 258) that are expected to provide PAC. We assessed PAC availability and facility readiness to provide basic and comprehensive PAC using the signal functions framework, overall and by facility type. We then calculated the distance between women and their closest facility and estimated the proportion of women living within five kilometers (5 km) of a facility providing any PAC, basic PAC, and comprehensive PAC, overall and by women\'s background characteristics.
RESULTS: Only 36.4% and 14% of eligible facilities had all basic and comprehensive PAC signal functions, respectively. Oxytocics and laparotomy were the most missing signal function for basic and comprehensive PAC, respectively. Private facilities were the least ready to provide the full range of PAC services. While 47% of women lived within 5 km of a facility providing any PAC services, only 33.4% and 7.9% lived within 5 km of a facility providing all basic and all comprehensive PAC signal functions, respectively. Women who were divorced/widowed, had higher levels of education, and were living in urban areas had increased odds of living within 5 km of a facility with any or basic PAC. Women who were never married had increased odds of living within 5 km of a facility with comprehensive PAC, while urban residence was fully predictive of living within 5 km of a facility with comprehensive PAC.
CONCLUSIONS: This study found PAC availability and readiness to be insufficient in Niger, with inadequate and disparate accessibility to facilities providing PAC services. We recommended stakeholders ensure stock of essential commodities and availability of PAC services at primary facilities in order to mitigate the negative maternal health repercussions of unsafe abortion in this setting.
摘要：
背景：流产后护理（PAC），这是产科急诊护理的基本要素，在尼日尔研究不足。该研究旨在评估可用性，准备就绪,以及尼日尔基于设施的PAC服务的可及性。
方法：本研究使用来自尼日尔行动绩效监测的女性和机构数据。女性数据包括具有全国代表性的15-49岁女性样本（n=3,696）。使用GPS坐标，这些女性数据与预期提供PAC的公共和私营机构样本(n=258)相关联.我们使用信号功能框架评估了PAC可用性和设施准备情况，以提供基本和全面的PAC，整体和设施类型。然后，我们计算了妇女与其最近设施之间的距离，并估计了生活在提供任何PAC的设施五公里（5公里）范围内的妇女比例，基本PAC，和全面的PAC，总体和女性的背景特征。
结果：只有36.4％和14％的合格设施具有所有基本和全面的PAC信号功能，分别。对于基础和全面的PAC，术中和剖腹手术是最缺乏信号功能的。分别。私人设施最不愿意提供全方位的PAC服务。虽然47%的妇女居住在提供任何PAC服务的设施的5公里范围内，只有33.4％和7.9％居住在提供所有基本和所有综合PAC信号功能的设施的5公里范围内，分别。离婚/丧偶的妇女，有更高的教育水平，并且生活在城市地区，在拥有任何PAC或基本PAC的设施的5公里范围内居住的可能性增加。从未结婚的女性在距离拥有全面PAC的设施5公里范围内生活的可能性增加，而城市住宅完全可以预测居住在拥有全面PAC的设施5公里范围内。
结论：这项研究发现，尼日尔的PAC可用性和准备性不足，对提供PAC服务的设施的可及性不足和不同。我们建议利益攸关方确保基本商品的库存和主要设施提供PAC服务，以减轻这种情况下不安全堕胎对产妇健康的负面影响。
方法：本研究使用来自尼日尔行动绩效监测的女性和机构数据。女性数据包括具有全国代表性的15-49岁女性样本（n=3,696）。使用GPS坐标，这些女性数据与预期提供PAC的公共和私营机构样本(n=258)相关联.我们使用信号功能框架评估了PAC可用性和设施准备情况，以提供基本和全面的PAC，整体和设施类型。然后，我们计算了妇女与其最近设施之间的距离，并估计了生活在提供任何PAC的设施五公里（5公里）范围内的妇女比例，基本PAC，和全面的PAC，总体和女性的背景特征。
结果：只有36.4％和14％的合格设施具有所有基本和全面的PAC信号功能，分别。对于基础和全面的PAC，术中和剖腹手术是最缺乏信号功能的。分别。私人设施最不愿意提供全方位的PAC服务。虽然47%的妇女居住在提供任何PAC服务的设施的5公里范围内，只有33.4％和7.9％居住在提供所有基本和所有综合PAC信号功能的设施的5公里范围内，分别。离婚/丧偶的妇女，有更高的教育水平，并且生活在城市地区，在拥有任何PAC或基本PAC的设施的5公里范围内居住的可能性增加。从未结婚的女性在距离拥有全面PAC的设施5公里范围内生活的可能性增加，而城市住宅完全可以预测居住在拥有全面PAC的设施5公里范围内。
结论：这项研究发现，尼日尔的PAC可用性和准备性不足，对提供PAC服务的设施的可及性不足和不同。我们建议利益攸关方确保基本商品的库存和主要设施提供PAC服务，以减轻这种情况下不安全堕胎对产妇健康的负面影响。
