Barriers to quality post-abortion care in low and middle-income countries: a systematic review

Post-abortion care (PAC) is a vital component of reproductive healthcare and essential for reducing abortion-related morbidity and mortality. Despite improvements in service availability, barriers affecting the quality and utilization of PAC services remain common across low-and middle-income countries (LMICs). The review was conducted using PubMed, Scopus, Google scholar and Open search database by following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement (PROSPERO registration: CRD420261425414). The peer-reviewed studies published between 2010 and 2026 were screened according to inclusion criteria. Study selection was performed using Rayyan Software, and methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Five major categories of barriers were identified; Knowledge and awareness barriers; Socio-cultural, financial, and geographic barriers; provider-related and quality -of-care barriers; health-system and facility-level barriers; and policy and legal barriers. The common challenges included abortion-related stigma, limited awareness of services, financial hardship, inadequate counselling, shortage of trained providers, weak referral systems, and insufficient infrastructure. Barriers to quality post -abortion care are multidimensional, and addressing these barriers through coordinated interventions may improve access, quality and utilization of post-abortion care services and help bridge the persistent access-quality gap in LMICs.