Windy M V Wariki
Background: In Indonesia where abortion is prohibited by law, many women often seek unsafe services that result in complications requiring post-abortion care (PAC). This study was design to identify the characteristics of patients who sought PAC and to explore the perceptions and preferences regarding facility selection.
Methods: This hospital-based cross-sectional study was conducted in 2008 at 13 hospitals in North Sulawesi province, Indonesia. In total, 153 women, aged 15-49 years and who had had a recent abortion related complication and sought PAC at hospital were participated in the study. Multivariate logistic regression analysis was performed to assess associations between the potential covariates and the decision of public or private hospital.
Results: After controlling for other variables, age over 35 years (AOR 17.1; p<0.01), monthly income less than US$2.80 a day (AOR 6.9; p<0.05), low economic status (AOR 4.2; p<0.01), and choose the facility because of the low medical expenses (AOR 6.4; p<0.05) were significantly associated with selection of public hospitals [68%(104/153)] for PAC. Patients who were given information about pregnancy complications (OR 3.4; p<0.001), wished to ask questions (OR 2.4; p<0.05), willingly to return to the same hospital for follow-up (OR 3.0; p<0.001), and will recommend others due to good attitude of providers (OR 2.7; p<0.001) and good management (OR 8.1; p<0.001) of private hospital reported to be satisfied with the services [32% (49/153)].
Conclusion: Poor PAC seekers generally prefer public hospitals for the free or low-cost services. However, some poor patients still obtained PAC in the private sector due to perceived betterquality services. Thus, it is important for the government to improve the quality and amount of PAC in the public sector
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