{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:02:19Z","timestamp":1787169739740,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/igo\/legalcode"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the relationship between insecurity and quality of care provided for abortion complications in high\u2010volume hospitals in the Democratic Republic of Congo (DRC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the WHO Multi\u2010Country Survey on Abortion complications, we analyzed data for 1007 women who received care in 24 facilities in DRC. For inputs of care, we calculated the percentage of facilities in secure and insecure areas meeting 12 readiness criteria for infrastructure and capability. For process and outcomes of care, we estimated the association between security and eight indicators using generalized estimating equation models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Facilities in secure areas were more likely to report functioning electricity (93.3% vs 66.7%), availability of an obstetrician 24\/7 (42.9% vs 28.6%), and the ability to offer several short\u2010acting contraceptives (83.3% vs 57.1%). However, a higher percentage of facilities in insecure areas reported the availability of a telephone or radio (100% vs 80.0%). Women in insecure areas appeared more likely to experience poor quality clinical care overall than women in secure areas (aOR 2.56; 95% CI, 1.13\u20135.82,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.03). However, there was no association between security and incomplete medical records (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.20), use of dilatation and curettage (D&amp;C) (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.84), women reporting poor experience of care (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.22), satisfaction with care (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.25), and severe maternal outcomes (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.56). There was weak evidence of an association between security and nonreceipt of contraceptives (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.07), with women in insecure areas 70% less likely to report no contraception (aOR 0.31, 95% CI, 0.09\u20131.09). Use of D&amp;C was high in secure (43.7%) and insecure (60.4%) areas.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Quality of care did not seem to be very different in secure and insecure areas in DRC, except for some key infrastructure, supply, and human resources elements. The frequent use of D&amp;C for uterine evacuation, the lack of good record keeping, and the lack of contraceptives should be urgently addressed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.14031","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T04:23:32Z","timestamp":1639110212000},"page":"20-26","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The relationship between insecurity and the quality of hospital care provided to women with abortion\u2010related complications in the Democratic Republic of Congo: A cross\u2010sectional analysis"],"prefix":"10.1002","volume":"156","author":[{"given":"Jean\u2010Jos\u00e9","family":"Wolomby\u2010Molondo","sequence":"first","affiliation":[{"name":"D\u00e9partement de Gyn\u00e9cologie et Obst\u00e9trique Cliniques Universitaires de Kinshasa Universit\u00e9 de Kinshasa  Kinshasa Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Calvert","sequence":"additional","affiliation":[{"name":"Centre for Global Health Usher Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachelle","family":"Seguin","sequence":"additional","affiliation":[{"name":"Independent Researcher  Longueuil Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahida","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Health Sciences University of Nairobi  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zge","family":"Tun\u00e7alp","sequence":"additional","affiliation":[{"name":"UNDP\/UNFPA\/UNICEF\/WHO\/World Bank Special Programme of Research Development and Research Training in Human Reproduction (HRP) Department of Sexual and Reproductive Health and Research World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Filippi","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Trends in Maternal Mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division","author":"World Health Organization","year":"2019"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112526"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1363\/3820512"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31395-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13031-015-0051-8"},{"key":"e_1_2_9_7_1","first-page":"1610275","article-title":"Mortality in Rohingya refugee camps in Bangladesh: historical, social, and political context","volume":"27","author":"Parmar PK","year":"2019","journal-title":"Sex Reprod Health Matters"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2005.00397.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13451"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/10402659.2011.571601"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41018-020-00074-4"},{"key":"e_1_2_9_12_1","unstructured":"Family Planning 2020.FP2020: the arc of progress 2019\u20132020. 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