Provision of Comprehensive Abortion Care in Public Health Facilities in Nairobi County

Comprehensive abortion care is rooted in our belief that women must be able to access high-quality, affordable abortion care in the communities where they live and work. This care includes contraception, safe abortion, post abortion care and pain management, law reforms and referrals. The study was to determine the health system factors influencing the uptake of comprehensive abortion care in public health facilities in Nairobi County, Kenya. Specific Objectives were to establish the extent into which health care providers attitude influence the uptake of comprehensive abortion care in Nairobi County, determine the extent into which reproductive health policies influence the uptake of comprehensive abortion care in Nairobi County and to identify health facilities resources influencing uptake of comprehensive safe abortion care in Nairobi County. This was a descriptive cross-sectional survey. The target population was nurses working in Nairobi county referral facilities that provide abortion services. Semi-structured questionnaires with both open and closed ended questions and interview schedule were used. Systematic random sampling was applied and a sample size of 189 was realized for the study. A sample fraction of 0.25 was realized hence every other nurse from the duty roster was included in the study. Interviewer administered questionnaires were given to the respondents who dropped the filled questionnaires at a designated point at the end of the shift. Data collection took one month and 152 returned completed questionnaires which were 80 % response rate. Descriptive statistics were used to describe and summarize data using tables, pie charts and Bar charts while inferential statistics were used to test hypothesis. Qualitative data were analysed in the thematic areas of the study (Health Providers attitude, Application of reproductive health policies and health facilities resources). In determining the relationship between providers attitude, reproductive health policies applications, health facilities resources and uptake of comprehensive abortion care the Pearson correlation coefficient indicated that there was strong correlation between the attitude (r = 0.828, P = 0.0001), reproductive health applications (r = 0.847, P = 0.0001) and very strong association with health facility resources utilization (r = 0.862, P = 0.0001). And this was the same case in both facilities. From all the categories, the computed chi-square values were greater than their corresponding critical values. Similarly their P-values were less than the alpha level of significance. These findings resulted to the rejection of the null hypothesis in favor of the alternative hypothesis and conclusion made that there is a significant association between providers attitude, reproductive health policies application, resource utilization and uptake of comprehensive abortion care. The finding indicated that there was strong positive correlation between providers attitude (reproductive health policies application uptake of comprehensive abortion care. This indicates that the Nurses attitude, application of reproductive policies and utilization of health facilities resources have significant influence on the uptake of comprehensive abortion care. Training of Health care professionals, adherence to reproductive health policies and increased utilization of Health facility Resources for comprehensive abortion care are recommended. Comprehensive abortion care should be integrated with other reproductive health services. There is need for further research on other health facilities within the county and among other trained health professionals. Comprehensive abortion care can positive influence maternal outcomes as women will be encouraged to seek services in formal health institutions, this will drastically reduce unsafe abortion from backstreet, unlicensed clinics operated by unqualified personnel.