Decrease in use of manual vacuum aspiration in post-abortion care in Malawi: A cross-sectional study from three public hospitals, 2008-2012
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Objectives: To investigate the use of manual vacuum aspiration in post-abortion care in Malawi between 2008-2012. Methods: A retrospective cross-sectional study was done at the referral hospital Queen Elisabeth Central Hospital, and the two district hospitals of Chiradzulu and Mangochi. All records available from women admitted to the gynecological ward from 2008-2012 were reviewed. Women who had undergone uterine evacuation after incomplete abortion were included. The data were collected simultaneously at three study sites during 27th of February and 10th of March 2013. Results: Altogether, 5121 women were included. The use of manual vacuum aspiration after first trimester abortions between 2008-2012 was 34.2%. Overall there was an increase in the use of manual vacuum aspiration from 2008 (19.7%) to 2009 (31.0%), with a rapid decline after 2010 (28.5%) ending at only 4.9% in 2012. There were significant differences between the hospitals. The highest use of manual vacuum aspiration was observed at Mangochi District Hospital (30.3%) and the lowest at Chiradzulu District Hospital (7.4%). The numbers at each hospital varied by year, yet all the hospitals had a steady decrease after 2010. Conclusion: The use of manual vacuum aspiration as part of the post-abortion care in Malawi is rather low, and has decreased during the last few years.