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Abstract：
BACKGROUND: Little is known about postabortion care (PAC) services in Burkina Faso, despite PAC\'s importance as an essential and life-saving component of emergency obstetric care. This study aims to evaluate PAC service availability, readiness, and accessibility in Burkina Faso.
METHODS: Data for this study come from the Performance Monitoring for Action (PMA) Burkina Faso project and the Harmonized Health Facility Assessment (HHFA) conducted by the Institut de Recherche en Sciences de la Santé and the Ministry of Health. PMA data from a representative sample of women aged 15-49 (n = 6,385) were linked via GPS coordinates to HHFA facility data (n = 2,757), which included all public and private health facilities in Burkina Faso. We assessed readiness to provide basic and comprehensive PAC using the signal functions framework. We then calculated distance to facilities and examined percent within 5 kms of a facility with any PAC, basic PAC, and comprehensive PAC overall and by women\'s background characteristics.
RESULTS: PAC services were available in 46.4% of health facilities nationwide; only 38.3% and 35.0% of eligible facilities had all basic and comprehensive PAC signal functions, respectively. Removal of retained products of conception was the most common missing signal function for both basic and comprehensive PAC, followed by provision of any contraception (basic) or any LARC (comprehensive). Nearly 85% of women lived within 5 km of a facility providing any PAC services, while 50.5% and 17.4% lived within 5 km of a facility providing all basic PAC and all comprehensive PAC signal functions, respectively. Women with more education, greater wealth, and those living in urban areas had greater odds of living within 5 km of a facility with offering PAC, basic PAC, or comprehensive PAC.
CONCLUSIONS: Results indicate a need for increased PAC availability and readiness, prioritizing basic PAC services at the primary level-the main source of care for many women-which would reduce structural disparities in access. The current deficiencies in PAC signal a need for broader strengthening of the primary healthcare services in Burkina Faso to reduce the burden of unsafe abortion-related morbidity and mortality while improving maternal health outcomes more broadly.
METHODS: Data for this study come from the Performance Monitoring for Action (PMA) Burkina Faso project and the Harmonized Health Facility Assessment (HHFA) conducted by the Institut de Recherche en Sciences de la Santé and the Ministry of Health. PMA data from a representative sample of women aged 15-49 (n = 6,385) were linked via GPS coordinates to HHFA facility data (n = 2,757), which included all public and private health facilities in Burkina Faso. We assessed readiness to provide basic and comprehensive PAC using the signal functions framework. We then calculated distance to facilities and examined percent within 5 kms of a facility with any PAC, basic PAC, and comprehensive PAC overall and by women\'s background characteristics.
RESULTS: PAC services were available in 46.4% of health facilities nationwide; only 38.3% and 35.0% of eligible facilities had all basic and comprehensive PAC signal functions, respectively. Removal of retained products of conception was the most common missing signal function for both basic and comprehensive PAC, followed by provision of any contraception (basic) or any LARC (comprehensive). Nearly 85% of women lived within 5 km of a facility providing any PAC services, while 50.5% and 17.4% lived within 5 km of a facility providing all basic PAC and all comprehensive PAC signal functions, respectively. Women with more education, greater wealth, and those living in urban areas had greater odds of living within 5 km of a facility with offering PAC, basic PAC, or comprehensive PAC.
CONCLUSIONS: Results indicate a need for increased PAC availability and readiness, prioritizing basic PAC services at the primary level-the main source of care for many women-which would reduce structural disparities in access. The current deficiencies in PAC signal a need for broader strengthening of the primary healthcare services in Burkina Faso to reduce the burden of unsafe abortion-related morbidity and mortality while improving maternal health outcomes more broadly.
摘要：
背景：对布基纳法索的堕胎后护理（PAC）服务知之甚少，尽管PAC作为产科急诊护理的重要和挽救生命的重要组成部分。本研究旨在评估PAC服务的可用性，准备就绪,布基纳法索的无障碍环境。
方法：本研究的数据来自布基纳法索的绩效监测行动（PMA）项目和由圣桑泰科学研究所和卫生部进行的协调卫生设施评估（HHFA）。通过GPS坐标将来自15-49岁女性代表性样本（n=6,385）的PMA数据与HHFA设施数据（n=2,757）相关联，其中包括布基纳法索的所有公共和私人医疗机构。我们评估了使用信号功能框架提供基本和全面的PAC的准备情况。然后，我们计算了与设施的距离，并检查了与任何PAC设施相距5公里以内的百分比，基本PAC，和全面的PAC整体和女性的背景特征。
结果：全国46.4％的医疗机构提供PAC服务；只有38.3％和35.0％的合格设施具有所有基本和全面的PAC信号功能，分别。去除残留的受孕产物是基本和综合PAC最常见的缺失信号函数，然后提供任何避孕（基本）或任何LARC（全面）。将近85％的妇女居住在提供任何PAC服务的设施的5公里范围内，50.5%和17.4%居住在提供所有基本PAC和所有全面PAC信号功能的设施的5公里范围内，分别。受过更多教育的妇女，更大的财富,那些生活在城市地区的人在提供PAC的设施5公里范围内生活的可能性更大，基本PAC，或全面的PAC。
结论：结果表明需要增加PAC的可用性和准备程度，在初级一级优先考虑基本的PAC服务，这是许多妇女的主要护理来源，这将减少获得服务的结构性差异。PAC目前的缺陷表明，布基纳法索需要更广泛地加强初级保健服务，以减轻与不安全堕胎相关的发病率和死亡率的负担，同时更广泛地改善孕产妇健康结果。
方法：本研究的数据来自布基纳法索的绩效监测行动（PMA）项目和由圣桑泰科学研究所和卫生部进行的协调卫生设施评估（HHFA）。通过GPS坐标将来自15-49岁女性代表性样本（n=6,385）的PMA数据与HHFA设施数据（n=2,757）相关联，其中包括布基纳法索的所有公共和私人医疗机构。我们评估了使用信号功能框架提供基本和全面的PAC的准备情况。然后，我们计算了与设施的距离，并检查了与任何PAC设施相距5公里以内的百分比，基本PAC，和全面的PAC整体和女性的背景特征。
结果：全国46.4％的医疗机构提供PAC服务；只有38.3％和35.0％的合格设施具有所有基本和全面的PAC信号功能，分别。去除残留的受孕产物是基本和综合PAC最常见的缺失信号函数，然后提供任何避孕（基本）或任何LARC（全面）。将近85％的妇女居住在提供任何PAC服务的设施的5公里范围内，50.5%和17.4%居住在提供所有基本PAC和所有全面PAC信号功能的设施的5公里范围内，分别。受过更多教育的妇女，更大的财富,那些生活在城市地区的人在提供PAC的设施5公里范围内生活的可能性更大，基本PAC，或全面的PAC。
结论：结果表明需要增加PAC的可用性和准备程度，在初级一级优先考虑基本的PAC服务，这是许多妇女的主要护理来源，这将减少获得服务的结构性差异。PAC目前的缺陷表明，布基纳法索需要更广泛地加强初级保健服务，以减轻与不安全堕胎相关的发病率和死亡率的负担，同时更广泛地改善孕产妇健康结果。
