Integration of comprehensive abortion-care services in a Maternal and Child Health clinic in Cambodia.

OBJECTIVES To document the pilot experience of provision of safe abortion/post-abortion services implemented in 2002 at the Mother Child Health clinic in Sihanoukville, Cambodia, and to profile clients and assess their uptake of post-abortion contraception. METHODS The initial package of safe abortion/post-abortion clinics (SAPAC) services included counselling on family planning and prevention of sexually transmitted infections, pain management, Manual Vacuum Aspiration procedure and standard universal precautions at an affordable price (US$12.5). SAPAC services became operational in August 2002. The data of medical records from 1 August 2002 to 31 December 2005 (2224 clients) were analysed. RESULTS The mean number of clients per month attending SAPAC services ranged from 26 in 2002 to 64 in 2005. Fifty-three per cent were housewives, 24% worked in sales or services, 8% in factories, 11% in bars or karaoke lounges and 3% were brothel-based sex workers. Ninety-three per cent of clients came for induced abortion and 7% sought post-abortion care. Pain management was used in 99% of cases. The overall rate of complications during intervention was 2.1% and dropped from 9.4% in 2002 to 1.3% in 2005. After SAPAC implementation, fewer women in Sihanoukville sought abortion services without any quality control and a safer technique was used. On average, 40% of patients took up contraception after the abortion. CONCLUSIONS Integrating comprehensive abortion-care services at a peripheral government health facility is feasible. There is a demand for such services provided at an affordable price in Sihanoukville, Cambodia.