Women’s experiences of post-abortion care services at health facilities in Somaliland – A qualitative study among women with incomplete abortion

Abstract

Objective

Somaliland faces one of the highest maternal mortality and morbidity rates globally. Access to high-quality post-abortion care is essential for managing complications arising from incomplete abortions, including those following miscarriages. This study aimed to explore women’s experiences of incomplete abortion and their encounters with Post abortion care (PAC) services in public healthcare facilities.

Methodology

An inductive qualitative design was employed. In-depth interviews were conducted with women who had experienced incomplete abortions and received PAC. Data were analysed using thematic analysis guided by an inductive approach.

Results

Two key themes emerged from the analysis:(i) Women’s understanding of incomplete abortion and barriers to accessing PAC – This theme explores women’s care seeking and perceptions of causes of miscarriage, the challenges faced in accessing PAC, and the enabling factors that supported their care-seeking behaviour. (ii) Perceptions of care quality and suggestions for improvement – This theme captures women’s experiences with the quality and accessibility of PAC services and their recommendations for improving service delivery.

Conclusions

The study highlights the vital role of family and friend in encouraging women to seek care. However, it reveals significant gaps, particularly in counselling, community awareness, and emergency care. Many women reported continued pain and bleeding after discharge, indicating the need for service improvement. Further quantitative research is needed to assess the capacity of health facilities to deliver comprehensive PAC. The Health authority and policy maker should support further research and increase investment in midwifery training and continuous professional development to improve access to and quality of PAC.