Thinking Quality in Safe Abortion Care: Results of a Mystery Client Survey of ‘Abortion Clinics’ in Ghana.

Background: Despite the legalization of abortion in Ghana, little is known about service quality in hospitals.

Objectives: The study assessed the quality of care being provided to abortion seekers in hospitals in Ghana.

Methods: A mystery client survey was conducted in public, NGO, and private abortion-providing facilities in six regions of Ghana between September and November 2018. Ten females from tertiary institutions in Ghana were recruited and trained for data collection. Results: A total of 118 facility visits were made. About 63% of these visits were in private facilities due to their wide availability in the regions. Counseling services were rated best in public facilities compared to private and NGO facilities. Discussions on options available for abortion, pain relief, side effects, and complications were rated far below excellent in NGO and private facilities. Professional knowledge of care, friendliness, provider biases, waiting time, operating hours, directional signs, infection prevention, discrepancies between displayed prices, and actually bills for services were key quality concerns.

Conclusions: The quality of induced abortion services being provided in health facilities in Ghana as per clients' perspectives is generally unsatisfactory. A nationwide quality assessment of all facilities providing abortion and related services is recommended to guide policy decisions.