| Abstract: | The efficiency and effectiveness of public sector abortion services in Istanbul as well as their suitability in regulating the fertility of women were assessed in two hospitals in Turkey. The Social Security Hospital performed the surgical procedure of dilatation and curettage with little follow-up, while a Ministry of Health hospital offered the simpler procedure of manual vacuum aspiration with follow-up. In this latter case, the abortion service was part of the family planning unit of the hospital. 3% of the women were younger than 20 years old, most were married with an average of 2.5 living children, and almost half had already had at least one abortion. 11% of the women used the modern IUD and oral pill contraceptive methods. 75%, however, depended upon withdrawal for protection against unwanted pregnancies; method failure was the main reason for unwanted pregnancies. The study found abortion services to be an indispensable part of fertility regulation, especially given the high dependence upon withdrawal for contraception. The comparatively low costs of the Ministry of Health hospital services were incentive for women to seek its services, while women felt that private sector options were not as good. Study findings played a role in the integration of the family planning clinic and the abortion clinic at the Social Security Hospital into one service at the same location, with all women receiving post-abortion counseling on contraceptive use. All cases are required to return for follow-up fifteen days after the intervention. Client satisfaction along with the improvement in service quality mean that the changes may be extended to other hospitals once their longer-term effectiveness has been confirmed. |
