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Abstract
Objective: To assess the practice of post-abortion family planning (PAFP) counselling among Chinese abortion service providers, and identify the influencing factors.
Methods: A cross-sectional questionnaire survey was conducted between July and September 2013 among abortion services providers in 30 provinces in China. Univariate and multivariable logistic regression analyses were used to identify the factors that influenced PAFP counselling.
Results: 94% of the 579 service providers responded to the questionnaire in the survey. The median age was 39 years (range 20–72), and 95% were females. 92% providers showed a positive attitude and had promoted the PAFP counselling services; however, only 57% spent more than 10 min for it. The overall knowledge on PAFP was limited to the participants. After adjusting for potential confounding factors: providers from the middle region (compared with ‘east region’, ORadj = 3.33, 95% CI: 2.12–5.21) conducted more PAFP counseling; providers with more knowledge (ORadj = 2.08, 95% CI: 1.38–3.15) provided more counseling; and compared with ‘middle school and below’, providers with higher education gave more counseling [ORadj(95% CI)] for ‘college’, ‘university’ and ‘master/doctor’ [1.99 (1.01,3.92), 2.32 (1.22,4.40) and 2.34 (1.06,5.17), respectively].
Conclusions: The majority of providers could provide PAFP counselling to women undergone an abortion, but some of them had insufficient time to make it available. Education, knowledge about fertility and reproductive health and residence region were the main factors influencing the practice. Training of health providers and integrating family planning as a part of abortion services are essential to provide adequate PAFP to abortion seekers, thereby reducing the risk of unintended pregnancy.
Chinese abstract
目的：评估中国流产手术操作者给予流产后计划生育(PAFP)咨询的实施情况并确定影响因素。
方法：从2013年7月到9月, 在中国30个省流产手术操作者中进行一项横断面问卷调查。应用单变量和多变量logistic回归分析以确定影响PAFP咨询的因素。
结果：在调查中579名手术操作者中的94%回复了问卷。平均年龄39岁（20-72岁）, 95%为女性。92%的操作者表现出积极的态度, 并促进了PAFP咨询服务；然而, 只有57%的操作者花费10分钟以上的时间。PAFP的总体认识只限于参与者。调整了潜在的混杂因素后：中部地区的操作者（与东部地区相比, ORadj=3.33, 95% CI: 2.12–5.21）给予了更多PAFP咨询；知识更丰富的操作者（ORadj=2.08, 95% CI: 1.38–3.15）提供了更多咨询；与初中及以下学历相比, 受过高等教育的操作者提供了更多咨询[ORadj(95% CI)], 专科、本科、硕士/博士分别为[1.99 (1.01,3.92), 2.32 (1.22,4.40) 和2.34 (1.06,5.17)]。
结论：大多数操作者可以给流产后妇女提供PAFP咨询, 但是他们中的一些人没有提供足够的时间来使其实现。教育、关于生育和生殖健康的知识和住宅区域是影响实施的主要因素。卫生服务提供者的训练和将计划生育作为流产服务的一部分是十分必要的, 从而对拟行流产手术者提供适当的PAFP咨询, 因此降低非计划妊娠的风险。
Acknowledgements
We would like to thank Mr Jing Dong for his contribution for the management of the electronic database system; we thank all the provincial and hospital coordinators, and all the collaborators who involved in this study.
Disclosure statement
The authors have no conflicts of interest. The authors are responsible for the content and the writing of the manuscript.
Funding
This paper is an output from the project ‘Integrating Post-Abortion Family Planning Services into China?s Existing Abortion Services in Hospital Settings – INPAC’. The research leading to these results has received funding from the European Commission Seventh Framework Programme [FP7/2007-2013] under grant agreement no. 282490.