Measuring Abortion Incidence, Severity of Complications, and Health Facilities’ Capacity to Provide Abortion Care in Refugee Settings in Uganda, BAOBAB STUDY

Sparse evidence is available to support improved programming and reporting on SRHR in refugee settings in the east and horn of Africa, where unsafe abortion is one of the major causes of maternal mortality and morbidity. It is important to design studies that explicitly investigate the sexual and reproductive health needs and outcomes of refugee populations, as it is likely that these factors differ among refugee populations as opposed to the general population. Understanding the state of abortion in a given context, including abortion incidence, safety, and outcomes, is challenging due to the limitations of currently available methodologies.
Objectives: To determine the incidence of induced abortions and the severity of abortion-related complications in refugee settings in Uganda.
Methods: The study employed a quantitative cross-sectional design. The study components included three separate surveys though the study was not nationally representative, but efforts were made to ensure representativeness at the refugee settlement/camp level : i) representative Health Facility Survey (HFS) to estimate the number of women who receive post-abortion care (PAC) following abortion complications, ii) a Knowledgeable Informants Survey (KIS) to captured information on the proportion of all women having abortions who receive facility-based treatment for abortion-related complications, and iv) a Prospective Morbidity Survey (PMS) to provide the data necessary to describe characteristics of women receiving treatment for abortion complications, the severity of complications, the type of treatment received, and the delays in access to PAC. The PMS also included clinical data abstraction from the medical records.
Potential Impact: This will help host governments, humanitarian partners, and donors to seek long-term, innovative, cost-effective SRHR development solutions to bring about change in the health and lives of refugee women and girls.