Objectives To evaluate medical abortion effectiveness and safety in women at 13 or more weeks gestation provided care through Women on Web's telemedicine service. Study Design We conducted a retrospective case study of abortions at 13 or more weeks gestation provided by Women on Web between 2016 and 2019. Women received mifepristone and misoprostol or misoprostol alone for abortion. We extracted demographic characteristics and outcome data for cases with pregnancy continuation outcomes. Results We identified 144 women who used medical abortion at 13 or more weeks; 131 (91%) provided abortion outcome data. Almost all, 118 (90%) received mifepristone and misoprostol. The population had an average age of 26 ± 5.8 years, 102 (78%) reported a gestational age of 13 to 15 weeks, 114 (87%) had experienced prior pregnancy, and represented all world regions. Overall, 13 (10%) women reported a continuing pregnancy, with 5 (5%) among women 13 to 15 weeks and 8 (28%) among those ≥16 weeks ( p = 0.001); 38 (29%) reported adverse events (heavy bleeding, fever), 53 (43%) sought additional care from a health provider, and 18% of all cases received treatment with D&C/aspiration. Conclusions Efficacy of self-administered medical abortion decreases as gestational age increases, risking continuation of pregnancy. Provision through telemedicine at 13 to 15 weeks appears safe and effective. Implications Limited data suggest that medical abortion through telemedicine services may be a safe option through 15 weeks gestation in settings where there is ready access to the formal health system. More research with adequate sample sizes and high rates of follow-up is needed to inform on the safety of telemedicine for pregnancies 13 weeks and greater.

The COVID-19 pandemic has had a significant impact on HIV services globally, including communitybased outreach programmes. This article draws on a qualitative study of HIV outreach workers for men who have sex with men (MSM) in Jakarta, Indonesia undertaken between July and September 2020. The research documented the impact of the COVID-19 pandemic on HIV outreach programmes for MSM based on interviews, focus group discussions and video diaries collected from outreach workers. As a result of the pandemic, and in response to the guidelines issued by international donors and the Indonesian government, outreach workers shifted activities to 'virtual outreach' where possible. However, outreach workers consistently performed in-person work to address what they referred to as 'urgent' cases (e.g. required them to attend the clinic). Regardless of delivery mode, the steps comprising outreach work during the pandemic aligned with the 'cascade of care', which forms the dominant policy narrative for the management of HIV. Outreach work during the pandemic therefore continued to be based primarily on the objective of maintaining testing and treatment rates. Although outreach workers responded innovatively to the pandemic, including to the risk of COVID-19 infection, they were limited by the prevailing emphasis on targets in HIV programmes

<p>The law restricting abortion in Indonesia and Malaysia doesn’t prevent any abortion, but instead, it forces women to take the health and life risk by using an unsaved abortion method. However, medical abortion in women’s residence by using mifepristone and misoprostol is very safe and effective, as mentioned in a research done by the WHO (2012). The research analyzes the figure of needs of Women on the Web service in 2015. Women on Web portal is visited by 355,004 visitors from Indonesia and 33,781 from Malaysia in 2015. As much as 1.989 women from Indonesia and 1.109 from Malaysia contacted the helpdesk of Women on Web. The figures show that there is a big need of information and access to safe medical abortion in Indonesia and Malaysia.</p>

Penelitian ini di latar belakangi dengan pentingnya motivasi belajar dan kemampuan spasial siswa. Penelitian ini bertujuan untuk mengetahui (1) Mengetahui apakah kemampuan spasial siswa menggunakan model Problem Based Learningberbantu geogebra lebih baik daripada kemampuan spasial siswa menggunakan model  konvensional pada materi dimensi tiga; (2) Mengetahui pada katagori  motivasi belajar siswa manakah yang lebih baik antara tinggi, sedang dan rendah; (3) Mengetahui apakah terdapat interaksi antara model pembelajaran dengan motivasi belajar; (4) Mengetahui pada model Problem Based Learningmanakah yang lebih baik antara motivasi belajar tinggi, sedang dan rendah; (5) Mengetahui apakah terdapat pengaruh model pembelajaran terhadap motivasi belajar siswa pada materi dimensi tiga; (6) Mengetahui apakah pada motivasi belajar tinggi, kemampuan spasial siswa dengan model Problem Based Learning lebih baik daripadamodel model pembelajaran konvensional; (7) Mengetahui apakah pada motivasi belajar sedang, kemampuan spasial siswa dengan model Problem Based Learning lebih baik daripadamodel model pembelajaran konvensional; (8) Mengetahui apakah pada motivasi belajar rendah, kemampuan spasial siswa dengan model Problem Based Learning lebih baik daripadamodel model pembelajaran konvensional. Populasi penelitian adalah seluruh siswa kelas XII. Melalui cluster random samplingterpilih sampel penelitian yaitu X MM sebagai kelas eksperimen dan kelas XII TKR sebagai kelas kontrol. Teknik pengumpulan data dengan menggunakan metode dokumentasi, tes, dan angket. Hasil penelitian menunjukkan (1) Tidak terdapat perbedaan yang signifikan pada kemampuan spasial menggunakan model Problem Bassed Learning ataupun model Konvensional. (2) Tidak ada perbedaan yang signifikan pada kategori motivasi belajar siswa dengan menggunakan model Problem Bassed Learning ataupun model Konvensional terhadap kemampuan spasial. (3) Tidak terdapat interaksi antara model pembelajaran dengan motivasi belajar. Sehingga dengan model pembelajaran dan kategori motivasi manapun sama baiknya.