scholarly journals Increasing access to safe abortion in rural Rajasthan: Outcomes of a comprehensive abortion care model

2011 ◽  
Author(s):  
Shireen Jejeebhoy ◽  
A.J. Zavier ◽  
Rajib Acharya ◽  
Shveta Kalyanwala
Keyword(s):  
Care Model ◽  
Safe Abortion ◽  
Abortion Care ◽  
Comprehensive Abortion Care

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 Testing the Safe Abortion Care model in Ethiopia to monitor service availability, use, and quality

2011 ◽  
Vol 115 (3) ◽  
pp. 316-321 ◽  
Author(s):  
Karen Otsea ◽  
Janie Benson ◽  
Tibebu Alemayehu ◽  
Erin Pearson ◽  
Joan Healy
Keyword(s):  
Service Availability ◽  
Care Model ◽  
Safe Abortion ◽  
Abortion Care

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 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 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 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 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

Understanding the Abortion Experiences of Young People to Inform Quality Care in Argentina, Bangladesh, Ethiopia, and Nigeria

2021 ◽  
pp. 0044118X2110110
Author(s):  
Laura E. Jacobson ◽  
Ana Maria Ramirez ◽  
Chiara Bercu ◽  
Anna Katz ◽  
Caitlin Gerdts ◽  
...  
Keyword(s):  
Young People ◽  
Quality Care ◽  
First Trimester ◽  
Structural Barriers ◽  
Structured Interviews ◽  
Safe Abortion ◽  
Medication Abortion ◽  
Abortion Care ◽  
The Mean ◽  
Reproductive Healthcare

Young people face social and structural barriers when accessing abortions. High-quality, sexual and reproductive healthcare is needed; however, literature on youth-informed abortion services is limited. This study assesses accounts of youth who obtained an abortion in Argentina, Bangladesh, Ethiopia, and Nigeria and provides recommendations to improve person-centered aspects of abortion quality. We analyzed 48 semi-structured interviews with clients recruited from clinics, safe abortion hotlines, and patent and proprietary medicine vendors. We coded transcripts and conducted a thematic analysis. The mean age was 21 years (range 16–24), and the majority had a first trimester, medication abortion. Prominent themes included access to information; privacy; stigma associated with age or marital status; the decision-making process; and comfort and rapport with providers. Youth-centered abortion care should anticipate the distinct needs of younger clients. Supportive providers have an important role in offering a non-judgmental service that makes young clients feel comfortable and prepared.

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