Abstract:
BACKGROUND : Malawi has one of the highest maternal mortality rates in the world, with unsafe abortion as a major
contributor. Curettage is most frequently used as the surgical method for treating incomplete abortions, even
though it is costly for an impoverished health system and the less expensive and safe manual vacuum aspiration
(MVA) method is recommended.
METHODS : The aim of this 2016–17 study is to explore health worker’s perception of doing MVA 1 year after an
educational intervention. Focus group discussions were recorded, transcribed verbatim, and analyzed using content
analysis for interpreting the findings. A knowledge, attitude and practice survey was administered to health
professionals to obtain background information before the MVA training program was introduced.
RESULTS : Prior to the training sessions, the participants demonstrated knowledge on abortion practices and had
positive attitudes about participating in the service, but preferred curettage over MVA. The training was well
received, and participants felt more confident in doing MVA after the intervention. However, focus group
discussions revealed obstacles to perform MVA such as broken equipment and lack of support. Additionally, the
training could have been more comprehensive. Still, the participants appreciated task-sharing and team work.
CONCLUSION : Training sessions are considered useful in increasing the use of MVA. This study provides important
insight on how to proceed in improving post-abortion care in a country where complications of unsafe abortion
are common and the health system is low on resources.
