Table 1 Indicators of high-quality early abortion care explored in this review, adapted from Dennis et al. [26]
Theme | Subtheme | Indicators of high quality |
|---|---|---|
Structure | Law and Policy | •Abortion care must be accessible and not limited by administrative or policy barriers. •Regulations, guidelines and other policy documents have been developed, approved by national/sub-national governments, and/or disseminated to health care facilities that are supportive of access to safe abortion care consistent with WHO guidance. |
Infrastructure | •Efficient, high-quality referral systems are in place. •Essential equipment, supplies and medications are available in sufficient quantity to address needs. •Abortion is provided in a facility with space for privacy. | |
Process | Technical Competency | •Appropriate pain management techniques are in place. •Physical assessments of general and sexual and reproductive health are performed (including confirmation of gestational age). •Staff follow approved guidelines and protocols for medical, surgical, and incomplete abortion. •Staff use appropriate technologies. •Follow-up care is provided, where client’s experience with abortion and pregnancy status are assessed. |
Information Provision | •Staff explain all aspects of abortion care to clients (current condition, treatment plan, follow-up needs, and potential post-abortion complications and how to obtain appropriate post-abortion care). •Staff provide clients the opportunity to express concerns, ask questions, and receive accurate, understandable answers. | |
Client-provider interactions | •Staff offer respectful care. •Staff work to ensure privacy during the visit. •Staff provide confidential care. •Staff hold non-judgemental attitudes. •Staff–client interactions promote an atmosphere of trust. | |
Ancillary Services | •Staff directly provide or offer referrals for a range of sexual and reproductive health services, including contraception and screening and treatment for HIV and STIs. | |
Outcome | Abortion Outcomes | •There is low number of admissions for treatment of abortion complications. •There is a low percentage of maternal deaths as a result of abortiona. |
Client Satisfaction | •Clients are satisfied with abortion care |