Changing pattern of care seeking for abortion complications: Do poor Pakistani women have better options now?

Background: In 2002, Pakistani women experienced 2.4 million unintended pregnancies; nearly 900,000 were terminated by induced abortion. Each year 200,000 women experience serious health complications in Pakistan due to unsafe abortions. This paper will use data from 2 national studies to analyze the changes in pattern of resort to PAC services over time. Methods: 2 cross sectional surveys conducted in 2002 & 2012. Face to face interviews conducted on a structured questionnaire with 154 & 102 health professionals (HPs) & service providers (SP) of 261 & 266 health facilities (HFs). The data is drawn from the HP’s study. Results: The probability of receiving PAC has increased for women; more so for poor. Less % of HPs now thought that women would resort to doctors in government facilities for PAC compared to 2002. Difference is more pronounced for urban poor (79% v 91%) & rural poor (78% v 86%). Even for urban & rural non-poor the trend has shifted downwards (37% v 46% and 51% v 59%). More women would resort to doctor in private facilities except rural poor who would seek traditional service providers e.g. TBAs. Conclusions: There is a possible shift in pattern of resort for seeking PAC from public to private service providers by HPs perspective. Rural poor women are resorting to less skilled providers for PAC.