Int. J. Environ. Res. Public Health 2018, 15(2), 370; https://doi.org/10.3390/ijerph15020370
The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi
Maria Lisa Odland 1,*
, Gladys Membe-Gadama 2, Ursula Kafulafula 3, Geir W. Jacobsen 1, James Kumwenda 4 and Elisabeth Darj 1,5,6
, Gladys Membe-Gadama 2, Ursula Kafulafula 3, Geir W. Jacobsen 1, James Kumwenda 4 and Elisabeth Darj 1,5,6
1
Department of Public Health and Nursing, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
2
Queen Elizabeth Central Hospital, Blantyre, Malawi
3
Kamuzu College of Nursing, Blantyre, Malawi
4
Mangochi District Hospital, Mangochi, Malawi
5
Department of Woman´s Health and Children´s Health, Uppsala University, SE-751 85 Uppsala, Sweden
6
Department of Gynecology, St. Olav´s Hospital, NO-7030 Trondheim, Norway
*
Author to whom correspondence should be addressed.
Received: 1 February 2018 / Revised: 14 February 2018 / Accepted: 19 February 2018 / Published: 21 February 2018
(This article belongs to the Special Issue Teenage Reproductive Health: Pregnancy, Contraception, Unsafe Abortion, Fertility)
Abstract
Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to be treated to avoid further harm. Although manual vacuum aspiration (MVA) is a safe and cheap method of evacuating the uterus, the most commonly used method in Malawi is curettage. Medical treatment is used sparingly in the country, and the Ministry of Health has been trying to increase the use of MVA. The aim of this study was to investigate the treatment of incomplete abortions in three public hospitals in Southern Malawi during a three-year period. All medical files from the female/gynecological wards from 2013 to 2015 were reviewed. In total, information on obstetric history, demographics, and treatment were collected from 7270 women who had been treated for incomplete abortions. The overall use of MVA at the three hospitals during the study period was 11.4% (95% CI, 10.7–12.1). However, there was a major increase in MVA application at one District Hospital. Why there was only one successful hospital in this study is unclear, but may be due to more training and dedicated leadership at this particular hospital. Either way, the use of MVA in the treatment of incomplete abortions continues to be low in Malawi, despite recommendations from the World Health Organization (WHO) and the Malawi Ministry of Health. View Full-TextKeywords:
incomplete abortions; unsafe abortions; uterine evacuation; post-abortion care; manual vacuum aspiration; female health; maternal mortality; low-income countries; Malawi
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Odland, M.L.; Membe-Gadama, G.; Kafulafula, U.; Jacobsen, G.W.; Kumwenda, J.; Darj, E. The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions: A Descriptive Study from Three Public Hospitals in Malawi. Int. J. Environ. Res. Public Health 2018, 15, 370.
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