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“Confidence comes with frequent practice”: health professionals’ perceptions of using manual vacuum aspiration after a training program
The aim of this study was to explore health worker’s perception of using manual vacuum aspiration (MVA) 1 year after an educational intervention. The health personnel in Malawi who treat women with incomplete abortions are medical interns, clinical officers and nurses/midwives. The training was designed as a refresher course as health personnel usually are trained how to do MVA during their studies. Altogether, 53 health personnel received the training and filled out questionnaires on knowledge, attitude and practice before the training had started. After 1 year, focus group discussions were arranged with 33 of the previously trained health personnel. There was an almost equal number of nurses, clinical officers and medical interns in the survey and in the focus groups, which included fairly equal numbers of male and female participants and a good age spread among the participants. Even though the participants demonstrated knowledge on the benefits of using MVA prior to the training, most of the health personnel used curettage because of a lack of confidence, broken equipment and high gestational age of the expectant mothers. The training sessions were considered useful, but could have been extended to several days and have included actual patients. Our findings provide 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.