Status of Comprehensive Abortion Care Service in Paschim Bardhaman District, West Bengal -- A Mixed-Method Study.

Background: Delivering quality comprehensive abortion care (CAC) service, accessible and affordable to all care seekers, at every tier is essential to reduce maternal morbidity and mortality. Objectives: The study aimed to assess the infrastructural availability of the health facilities, describe beneficiary characteristics, and to explore constraints in CAC service provision from the providers' perspectives. Materials and Methods: A mixed-method study was conducted during December 2019 to February 2020 in Paschim Bardhaman District, West Bengal. All 10 public health facilities of the district providing CAC services were visited for infrastructural assessment. Record review of all care seekers from 2015 to 2018 was done to assess their characteristics. In-depth interview of the administrative heads of facilities and district level program officers was done to explore constraints faced in service provision. Quantitative data were analyzed by SPSS version 20, and qualitative data were analyzed thematically using NVivo software. Results: Physical infrastructure was adequate in only 40% of the facilities; however, drugs and contraceptives were universally available. About 49.5% of the care seekers had induced abortion; 63.5% underwent manual vacuum aspiration; 21.5% did not return for follow-up, and only 50% adopted postabortal contraception. Major issues explored were lack of trained manpower, logistics and physical infrastructure, and inadequate supervision and monitoring. Conclusion: The study highlighted gaps in preparedness of the health facilities for the provision of quality CAC services including some major constraints from the provider's perspectives. [ABSTRACT FROM AUTHOR]