Abstract:
At the 1994 ICPD, sub-Saharan African (SSA) states pledged, inter alia, to guarantee
quality post-abortion care (PAC) services. We synthesized existing research on PAC
services provision, utilization and access in SSA since the 1994 ICPD. Generally,
evidence on PAC is only available in a few countries in the sub-region. The available
evidence however suggests that PAC constitutes a significant financial burden on public
health systems in SSA; that accessibility, utilization and availability of PAC services have
expanded during the period; and that worrying inequities characterize PAC services.
Manual and electrical vacuum aspiration and medication abortion drugs are increasingly
common PAC methods in SSA, but poor-quality treatment methods persist in many
contexts. Complex socio-economic, infrastructural, cultural and political factors mediate
the availability, accessibility and utilization of PAC services in SSA. Interventions that
have been implemented to improve different aspects of PAC in the sub-region have had
variable levels of success. Underexplored themes in the existing literature include the
individual and household level costs of PAC; the quality of PAC services; the provision of
non-abortion reproductive health services in the context of PAC; and health care providercommunity partnerships.