scholarly journals Family planning practices of women working in the Cambodian garment industry: a qualitative study

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Elisa Oreglia ◽  
Ly Sokhey ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Medical Abortion ◽  
Garment Industry ◽  
Safe Abortion ◽  
Modern Contraception ◽  
Abortion Care ◽  
Garment Factories ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background: Women working in Cambodian garment factories have unmet needs for contraception and safe abortion services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods: We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results: We interviewed 16 women and 13 providers between August and November 2018. Most women were married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to side effects and misconceptions related to with modern contraception. Fear of infertility was particularly reported among young women without children.Conclusion: This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work needs to address this gap by developing appropriate and effective interventions and informative tools for women in the Cambodian garment industry.

scholarly journals Family planning practices of women working in the Cambodian garment industry: a qualitative study

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Elisa Oreglia ◽  
Ly Sokhey ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Medical Abortion ◽  
Garment Industry ◽  
Safe Abortion ◽  
Modern Contraception ◽  
Abortion Care ◽  
Garment Factories ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background: Women working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods: We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results: We interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children. Conclusion: This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work to address this gap could involve the development of appropriate interventions and informative tools for women in the Cambodian garment industry such as through existing client contact-centres or social media, including creation of videos or posts on topics that come from clients questions.

scholarly journals Family planning practices of women working in the Cambodian garment industry: a qualitative study

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Elisa Oreglia ◽  
Ly Sokhey ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Medical Abortion ◽  
Garment Industry ◽  
Safe Abortion ◽  
Modern Contraception ◽  
Abortion Care ◽  
Garment Factories ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background Women working in Cambodian garment factories have unmet needs for contraception and safe abortion services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.Methods We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 minutes and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.Results We interviewed 16 women and 13 providers between August and November 2018. Most women were married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to side effects and misconceptions related to with modern contraception. Fear of infertility was particularly reported among young women without children.Conclusion This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work needs to address this gap by developing appropriate and effective interventions and informative tools for women in the Cambodian garment industry.

scholarly journals The infrastructural capacity of Ghanaian health facilities to provide safe abortion and post-abortion care: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Onikepe Owolabi ◽  
Taylor Riley ◽  
Easmon Otupiri ◽  
Chelsea B. Polis ◽  
Roderick Larsen-Reindorf
Keyword(s):  
Scale Up ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Safe Abortion ◽  
Signal Functions ◽  
Rural Location ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background Ghana is one of few countries in sub-Saharan Africa with relatively liberal abortion laws, but little is known about the availability and quality of abortion services nationally. The aim of this study was to describe the availability and capacity of health facilities to deliver essential PAC and SAC services in Ghana. Methods We utilized data from a nationally representative survey of Ghanaian health facilities capable of providing post-abortion care (PAC) and/or safe abortion care (SAC) (n = 539). We included 326 facilities that reported providing PAC (57%) or SAC (19%) in the preceding year. We utilized a signal functions approach to evaluate the infrastructural capacity of facilities to provide high quality basic and comprehensive care. We conducted descriptive analysis to estimate the proportion of primary and referral facilities with capacity to provide SAC and PAC and the proportion of SAC and PAC that took place in facilities with greater capacity, and fractional regression to explore factors associated with higher structural capacity for provision. Results Less than 20% of PAC and/or SAC providing facilities met all signal function criteria for basic or comprehensive PAC or for comprehensive SAC. Higher PAC caseloads and staff trained in vacuum aspiration was associated with higher capacity to provide PAC in primary and referral facilities, and private/faith-based ownership and rural location was associated with higher capacity to provide PAC in referral facilities. Primary facilities with a rural location were associated with lower basic SAC capacity. Discussion Overall very few public facilities have the infrastructural capacity to deliver all the signal functions for comprehensive abortion care in Ghana. There is potential to scale-up the delivery of safe abortion care by facilitating service provision all health facilities currently providing postabortion care. Conclusions SAC provision is much lower than PAC provision overall, yet there are persistent gaps in capacity to deliver basic PAC at primary facilities. These results highlight a need for the Ghana Ministry of Health to improve the infrastructural capability of health facilities to provide comprehensive abortion care.

scholarly journals Baseline survey on functioning of abortion services in government approved CAC centres in three pilot districts of Nepal

1970 ◽  
Vol 7 (1) ◽  
pp. 31-39
Author(s):  
C Karki ◽  
M Ojha ◽  
RT Rayamajhi
Keyword(s):  
Service Providers ◽  
Medical Abortion ◽  
Abortion Service ◽  
Baseline Survey ◽  
Trimester Abortion ◽  
Safe Abortion ◽  
Time Service ◽  
Abortion Care ◽  
Comprehensive Abortion Care ◽  
The Government

Background: Abortion has been legalized in Nepal since September 2002 and under this law, Comprehensive Abortion Care (CAC) service is being provided through listed service providers and listed health facilities from 2004. Nepal Government has prioritized the national safe abortion program and is working with many government and non government partners for providing this service. Till date medical abortion services are not made available at any of the health facility. Government is now preparing to introduce this service in six selected pilot districts. Objective: This survey was carried out to assess the functioning of existing abortion services in 12 Government approved CAC sites of three districts. Materials and methods: Direct observation of the functioning of these centers, assessment of physical facilities and service provider's skill was done. At the same time service provider's attitude and knowledge on CAC service and other abortion services were also assessed through semi structured interviews. Quality of record keeping and the feasibility of initiating the medical abortion service in these sites were also studied. Result: Number of listed centers in six pilot districts was twenty nine. Study districts have 16 listed centers. Visited sites were twelve; four managed by Government and eight by non government organizations. Thirty three thousand nine hundred and twenty women have availed this service so far: only 4.76% of them received service from Government facilities. Marie Stopes International (MSI) topped the list in providing service to the maximum number of clients (75.64%) and Family planning association of Nepal (FPAN) was the second. MSI centre was also first to initiate the service. Government facilities provide 24 hours service unlike private facilities which are open only up to 5.00 pm. Cost for the service varies from rupees 900/- to rupees 1365/- and is cheaper at Government facilities. Private sectors have separate setups and Government have allocated some space within their already existing infrastructure for CAC service. Private sectors were better in providing the information to public about the availability of service. There were total 20 trained service providers for first trimester abortion service. They are more at Government facilities. They seem to be positive to CAC service and had good knowledge and skill of service delivery. Complications were not recorded at most of the sites. Pain management and infection prevention practice needs improvement at the Government sites. All the sites had identified their referral sites and had one or the other arrangement for referral. Conclusion: CAC service has become accessible and affordable to Nepalese women even at peripheral level. CAC sites are functioning well. Initiation of medical abortion and second trimester abortion services at these sites are feasible and would expand the option and choices available. Key words: Comprehensive abortion care (CAC), medical abortion, unsafe abortion doi: 10.3126/kumj.v7i1.1762       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 31-39     

scholarly journals Continuity of Essential Sexual and Reproductive Health Services During Covid-19 Pandemic in the Who African Region

2021 ◽  
Author(s):  
George Ochieng Otieno ◽  
Leopold Ouedraogo ◽  
Triphonie Nkurunziza ◽  
Chilanga Asmani ◽  
Hayfa Elamin ◽  
...  
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Reproductive Health Services ◽  
Abortion Care ◽  
Sexual Reproductive Health ◽  
Post Abortion Care ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Abstract Background: The COVID-19 pandemic has had a major impact on the capacity of health systems to continue the delivery of essential health services. While health systems around the world are being challenged by increasing demand for care of COVID-19 patients, it is critical to all other services including sexual reproductive health services. Countries are expected to ensure optimal balance between fighting the COVID-19 pandemic and maintenance of essential health services like sexual reproductive health. The purpose of this report was to assess and document continuity of sexual and reproductive health services with a focus on safe abortion, post abortion care and family planning services during the COVID -19 pandemic in selected countries of the World Health Organization Africa Region.Methods: A descriptive survey using a simplified and user-friendly virtual web based rapid needs assessment through a questionnaire was filled in by key informants drawn from the ministries of health from 30 countries in July 2020. The questionnaires were filled in by the World Health Organization staff in charge of sexual reproductive health services in collaboration with their counterparts in the ministries of health and uploaded in excel data sheets and categorized in to thematic areas for analysis.Results: Responses were received from 17 countries out of the 30 countries that received the questionnaires. Of the 17 countries, only 2 (12%) countries reported that sexual and reproductive health services are not integrated in the essential health services package. All the sexual reproductive health elements-family planning/contraception and comprehensive abortion care, including post abortion care are integrated in the essential health services package in 12 (80%) of the 15 countries that have sexual reproductive health integrated. Also,14(82%) countries reporting having ongoing awareness raising campaigns/communication messages about family planning, comprehensive abortion care and post abortion care during the COVID pandemic. 9(59%) of the countries reported reduction in the use of family planning services, 6(35%) indicated no changes in the use of family planning services with only 2(12%) countries providing no response. Conclusion: The survey provides information on the weak health systems of the participating member states of the WHO Africa Region and the magnitude of disruptions of sexual reproductive health services in selected countries. Further, strategies adopted by countries to ensure continuity of sexual reproductive health services amidst COVID -19 like communications, Countries finally identified key areas that need to be supported in family planning/contraception, comprehensive abortion care and post abortion care during the COVID-19 pandemic.

scholarly journals Challenges in the abortion supply chain: a call to action for evaluation research

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ghazaleh Samandari ◽  
Nathalie Kapp ◽  
Christopher Hamon ◽  
Allison Campbell
Keyword(s):  
Supply Chain ◽  
Service Provision ◽  
Evaluation Research ◽  
Medical Abortion ◽  
Critical Component ◽  
Safe Abortion ◽  
Call To Action ◽  
Abortion Care ◽  
Effective Interventions ◽  
Comprehensive Abortion Care

Abstract Background Reducing the burden of unsafe abortion rests considerably on women’s ability to access appropriate and timely treatment or services. A critical component of that care relies on a functional supply chain to ensure availability of abortion drugs and supplies within the health system. Disruptions in the supply of medical abortion drugs delay provision of abortion services and can increase the risks to a woman’s health. We examine the ways in which supply chain management (SCM) affects women’s ability to access safe and timely abortion to meet their reproductive health needs and highlight the gap in evaluation research on which SCM interventions best improve access to safe abortion care. SCM comprises a critical component of efficient and sustainable abortion service provision and is a requisite for expansion of services. Furthermore, governments are responsible for safeguarding links in the abortion supply chain, from registration to distribution of abortion drugs and supplies. Strategic public–private partnerships and use of innovative local or community-based distribution mechanisms can strengthen supply chain systems. Finally, alternatives to the pull-based models of distribution could alleviate bottlenecks in the final steps of abortion supply chains. Programs aimed at increasing access to safe and comprehensive abortion care must include SCM as a foundational component of service provision. Without access to a sustainable and affordable supply of abortion drugs and equipment, any attempt at providing abortion services will be critically limited. More implementation research is needed to identify the most effective interventions for improving SCM.

scholarly journals Safe abortion service and post abortion care: Understanding complications

1970 ◽  
Vol 2 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Sudha Thapa ◽  
Indira Satyal ◽  
Kasturi Malla
Keyword(s):  
Induced Abortion ◽  
Abortion Rate ◽  
Uterine Perforation ◽  
Safe Abortion ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Manual Vacuum Aspiration ◽  
Comprehensive Abortion Care ◽  
Post Abortion

Aim: To see if unsafe abortions are getting lesser after the establishment of comprehensive abortion care (CAC) Unit since March 2004. Methods: Retrospective study of women admitted with complication of abortions [induced (medically/criminal) or spontaneous] during the entire ten years period after the inception of post abortion care (PAC) Unit 2095 May -2007 April; the last 3 years overlapping the service years of CAC Unit establishment. Result: CAC and PAC units both are using manual vacuum aspiration (MVA) to procure uterine evacuation. CAC clients in the last 3 years have reached to a little less than 10,000. This is close to MVA services provided in the PAC Unit in the last 10 years amounting to 11,519. But the number (n=3958) of service provided by the PAC Unit for a complete period of three years 2058-2060 (April 2001 - April 2004) showed a slight increase to (n=4323) as the CAC Unit became functional during the 2061-2063 (15th April 2004- 2007). The complications observed in PAC unit while providing MVA are much more than CAC unit (5.75%: 2%). But the nature of complication is much more serious in CAC Unit, 10 of them needing laparotomy for 20(0.02%) cases of uterine perforation. The induced abortion rate within the hospital, three years before and during CAC services is almost similar (4.07%: 4.34%). Seriousness of the problem has definitely reduced during recent 3 year's period (Baisakh 2061-2063 Chaitra) i.e. 52: 34 except for an unfortunate rise in uterine perforation from 8 to 29 cases, 10 being from the CAC Unit. Conclusion: Though the number of complicated cases of induced abortion seeking hospitalization has not changed much after inception of CAC services in the recent three years, there is definitely a decline in the admission of more serious complicated cases of induced abortion in the recent years with unfortunate rise in number of cases of uterine perforation.   doi:10.3126/njog.v2i1.1476 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 44 - 49 May -June 2007

scholarly journals A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Ontiri ◽  
Lilian Mutea ◽  
Violet Naanyu ◽  
Mark Kabue ◽  
Regien Biesma ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Peer Influence ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background Addressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives. Methods Qualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Results Use of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods. Conclusion This study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.

scholarly journals Low dose Mifepristone (100 mg) for medical termination of pregnancy

2011 ◽  
Vol 3 (1) ◽  
Author(s):  
Shikha Seth ◽  
Arun Nagrath ◽  
Neeru Goel
Keyword(s):  
Side Effects ◽  
Success Rate ◽  
Low Dose ◽  
Medical Abortion ◽  
First Trimester ◽  
Effective Regimen ◽  
Minimal Dose ◽  
Medical Termination ◽  
Gestation Age ◽  
Post Abortion

Background: Abortion is the most common entity in the practice of obstetrics and gynaecology. Different methods and modes have been opted for until now to find an effective regimen with the least complications. We have tried the minimal dose (100 mg) of Mifepristone (PO) instead of the presently recommended 200 mg for medical abortion in early first trimester cases. Objectives: The objective of the study was to determine the efficacy of low dose (100 mg) Mifepristone for medical termination of early pregnancy with oral Misoprostol 800 μg, 24 hours later.Design: A prospective analytical study was conducted on a population of 82 early-pregnant patients who have requested medical abortions.Method: Pregnant women of less than 56 days gestation age from their last menstrual period, requesting medical abortion were selected over a period of 14 months from January 2007 to March 2008. They were given 100 mg Mifepristone orally on Day-1, followed by 800 μg Misoprostol orally 24 hours later on Day-2, keeping the patient in the ward for at least 6 hours. Abortion interval, success rate, post-abortion bleeding and side-effects were noted. Success was defined as complete uterine evacuation without the need for surgical intervention.Results: The total success rate of this minimal dose Mifepristone regimen was 96.25%. Pain and nausea were the predominant side-effects noted. In total 72 (90%) women had completely aborted within 5 hours of taking Misoprostol. Three (3.75%) women only required suction aspiration, hence termed as failed medical abortion. The abortion interval increased with the gestation age. All three failures were of the more-than-42-day gestational age group. The overall mean abortion interval was 4.68 ± 5.32 hours.Conclusion: Mifepristone 100 mg, followed 24 hours later by Misoprostol 800 μg orally, is a safe and effective regimen for medical abortion.

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