Characteristics of service providers and their Knowledge, Attitudes and Practice (KAP) on post-abortion contraception services: two cross-sectional studies in China
ESC Congress Library. Wang S. 05/28/14; 50420; A-002 Disclosure(s): INPAC (2012-2016)and PAFP (2006-2009)projects are collaborative research projects funded by European Commission (EC) under the sixth and Seventh Framework Programme (FP6 and FP7). The INPAC consortium: - International Centre for Reproductive Health (ICRH),Ghent University, Belgium; - Chinese Society for Family Planning - Chinese Medical Association (CSFP-CMA); - Fudan University (FU), China; - National Research Institute for Family Planning (NRIFP), China; - Sichuan University (SCU), China; - Aarhus University - Danish Epidemiology School Centre (AU-DESC), Denmark; - Liverpool School of Tropical Medicine (LSTM), UK.
Dr. Shuchen Wang
Dr. Shuchen Wang
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Abstract
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1. Objectives: China has a high abortion rate with 19,0% - 57,9% repeated abortions between different populations. Post abortion contraception (PAC) is considered as an effective way of reducing the rates of unintended pregnancy and repeated abortions. Service providers (SPs) provide PAC services to abortion users play a crucial role in this system. However, published data concerning the characteristics and KAP of the abortion or PAC service providers is limited. We conducted two surveys in China aiming at identifying the characteristics of the SPs, determining their KAP in abortion and PAC services.


2. Method: Two cross-sectional surveys were conducted in 2009 and 2013 respectively. The methods used in the two time periods were similar: in each participating hospitals, abortion SPs were invited to fill out a structured questionnaire voluntarily and anonymously. Twenty-four hospitals from 3 cities in 2009 and 90 hospitals from 30 provinces in 2013  participated in the studies.


3. Results: Total of 654 respondents in 2009 and 593 in 2013 were included in the analysis. The characteristics of the participants were similar in the two studies, among them, 96% females with an average age of 38,2 years (SD 9,6). Most of them were experienced professionals with a mean seniority of 15,3 years (SD 9,8). The proportion of  medical doctors among the abortion SPs changed from 53% in 2009 to 73% in 2013 (p<0,001). The two studies showed that 95% participating SPs had positive attitudes and intentions on providing PAC counseling to clients. However, 50-80% SPs failed to answer questions on use of contraceptive methods and on PAC services. About 20% respondents have never or only occasionally provided PAC service to women and 45% never to the male partners. Perceived barriers for providing effective PAC services include time limitation [with a 10,8 minutes (SD 8,4) average counseling time, 22% SPs were overloaded in 2009 and 60% in 2013 (p<0,001)], no/limited access to technical guidelines and appropriate education/counseling materials (nearly 30%), inadequate consulting rooms and consulting skills (21%), and lack of policy and management boards supports (68%).


4. Conclusions: Our data showed that abortion SPs  have positive attitudes and intentions on providing PAC services to women and their male partners. There are possible barriers of providing PAC services due to the shortage of human resources, lack of knowledge, limited access to technical guidelines and counseling skills,  inadequate friendly counseling environment and the demands of government and management supports.

1. Objectives: China has a high abortion rate with 19,0% - 57,9% repeated abortions between different populations. Post abortion contraception (PAC) is considered as an effective way of reducing the rates of unintended pregnancy and repeated abortions. Service providers (SPs) provide PAC services to abortion users play a crucial role in this system. However, published data concerning the characteristics and KAP of the abortion or PAC service providers is limited. We conducted two surveys in China aiming at identifying the characteristics of the SPs, determining their KAP in abortion and PAC services.


2. Method: Two cross-sectional surveys were conducted in 2009 and 2013 respectively. The methods used in the two time periods were similar: in each participating hospitals, abortion SPs were invited to fill out a structured questionnaire voluntarily and anonymously. Twenty-four hospitals from 3 cities in 2009 and 90 hospitals from 30 provinces in 2013  participated in the studies.


3. Results: Total of 654 respondents in 2009 and 593 in 2013 were included in the analysis. The characteristics of the participants were similar in the two studies, among them, 96% females with an average age of 38,2 years (SD 9,6). Most of them were experienced professionals with a mean seniority of 15,3 years (SD 9,8). The proportion of  medical doctors among the abortion SPs changed from 53% in 2009 to 73% in 2013 (p<0,001). The two studies showed that 95% participating SPs had positive attitudes and intentions on providing PAC counseling to clients. However, 50-80% SPs failed to answer questions on use of contraceptive methods and on PAC services. About 20% respondents have never or only occasionally provided PAC service to women and 45% never to the male partners. Perceived barriers for providing effective PAC services include time limitation [with a 10,8 minutes (SD 8,4) average counseling time, 22% SPs were overloaded in 2009 and 60% in 2013 (p<0,001)], no/limited access to technical guidelines and appropriate education/counseling materials (nearly 30%), inadequate consulting rooms and consulting skills (21%), and lack of policy and management boards supports (68%).


4. Conclusions: Our data showed that abortion SPs  have positive attitudes and intentions on providing PAC services to women and their male partners. There are possible barriers of providing PAC services due to the shortage of human resources, lack of knowledge, limited access to technical guidelines and counseling skills,  inadequate friendly counseling environment and the demands of government and management supports.

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