Creativity, serendipity, and collaboration: Cross-cutting features of successful task-sharing in comprehensive safe abortion care

Sorhaindo, Annik

doi:10.1002/ijgo.13011

Cited by 4 publications

References 11 publications

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Expanding health worker roles and decentralizing safe abortion and postabortion care: Experiences in diverse settings

Sorhaindo

Ganatra

2020

Int J Gynecol Obstet

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Expanding health worker roles and decentralizing safe abortion and postabortion care: Experiences in diverse settings

Sorhaindo

Ganatra

2020

Int J Gynecol Obstet

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Experiences of abortion care in Australia: a qualitative study examining multiple dimensions of access

Wickramasinghe,

Fisher,

Taft

et al. 2024

BMC Pregnancy Childbirth

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Background The United Nations’ Sustainable Development Goals identify universal access to sexual and reproductive health services as a global priority. Yet barriers to abortion access remain, including legal restrictions, cost, stigma, and limited services and information. The aim was to identify barriers to and facilitators of abortion care access experienced in Australia. Methods This qualitative phenomenological study examined abortion access in Australia, where abortion is decriminalised, from March 2020 to December 2022. We used social media and flyers in clinics to recruit adults who had sought abortion care, then interviewed them in-depth. We mapped participant experiences to five dimensions of access identified by Levesque et al.’s patient-centred access to healthcare framework: approachability, acceptability, availability and accommodation, affordability, and appropriateness. Results The 24 participants lived across Australia and sought abortion during the COVID-19 pandemic. Approachability : Before seeking abortion, most did not know where to access information about the service and where to obtain it. Acceptability : Many were uncomfortable disclosing their abortion to family or friends; they reported that healthcare providers demonstrated varying levels of support. Availability and accommodation : Regional participants travelled far and faced long wait-times, exacerbated by pandemic restrictions. Affordability : Participants described financial stress paying for the service, travel, and related expenses. Appropriateness : Most participants expected judgemental care. Experiences varied widely: many participants experienced unempathetic, rushed, or judgemental interactions with healthcare staff, and many also reported at least one non-judgmental and supportive interaction on the same pathway to care. Discussion Abortion seekers experienced varying obstacles when seeking care. The findings illustrate the need for population- and system-level initiatives such as: providing accurate information about and normalising abortion; implementing system-level strategies to reduce wait times, travel, and costs, especially for rural populations; and developing regulatory and quality improvement initiatives to increase the workforce and its readiness to provide high-quality, non-judgemental abortion care. Challenges seeking care during pandemic restrictions illustrate the importance of social support during care and choice between abortion modalities and service types. Consumer voices can help understand the diverse pathways to abortion care and inform solutions to overcome the multidimensional barriers to access. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-024-06758-8.

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Client’s experiences on the provision of person-centered abortion care in public health facilities across four regions of Ethiopia: a cross-sectional study

Chekol,

McCaffrey,

Dijkerman

et al. 2023

Preprint

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Background Ethiopia has made remarkable progress in expanding access to and provision of comprehensive abortion care. However, complications due to unsafe abortion still contributes to a significant proportion of maternal mortality in the country. As efforts to increase accessibility, availability, acceptability, and quality of comprehensive abortion care continue, evaluating service quality is critical. This study assesses the quality of comprehensive abortion care in public health facilities, from clients’ perspectives, in four regions of Ethiopia to examine how person-centered care differs based on facility and service characteristics. Methods We conducted 1,870 client exit surveys in 2018 using structured questionnaires with women who received induced abortion or postabortion care services from 76 public health facilities across four regions: Tigray, Amhara, Oromia, and Southern Nations, Nationalities, and People’s. We calculated descriptive, bivariate, and multivariable statistics to examine service characteristics associated with 30 person-centered care outcomes grouped into five domains. Results Comprehensive abortion care clients reported high levels of person-centered care, with participants reporting exceptionally positive experiences for outcomes in the dignity and respect domain and trust, privacy, and confidentiality domain. However, there was notable room for improving client experiences across three domains of person-centered abortion care: autonomy, communication and supportive care, and health facility environment. In the multivariate analysis, client-reported quality outcomes differed significantly by diagnosis, region, health facility type, and procedure type. Findings specifically reveal that clients in Amhara, at tertiary and primary hospitals, and who received postabortion care report lower person-centered care. Conclusions The positive experiences reported by comprehensive abortion care clients highlight the impact of the Ethiopian government’s strategy to increase abortion access in the public health sector. However, numerous disparities in person-centered care were identified, providing insight into opportunities to advance the quality of comprehensive abortion care. Recommendations include investment in initiatives to improve postabortion care client experiences, better integration of reproductive health services at higher-level facilities, and leveraging qualitative methods to research regional differences. These findings can direct regional-level and facility-based person-centered abortion care interventions to ensure the most effective impact on the health outcomes and human rights of people seeking comprehensive abortion care in Ethiopia.

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Creativity, serendipity, and collaboration: Cross-cutting features of successful task-sharing in comprehensive safe abortion care

Cited by 4 publications

References 11 publications

Expanding health worker roles and decentralizing safe abortion and postabortion care: Experiences in diverse settings

Expanding health worker roles and decentralizing safe abortion and postabortion care: Experiences in diverse settings

Experiences of abortion care in Australia: a qualitative study examining multiple dimensions of access

Client’s experiences on the provision of person-centered abortion care in public health facilities across four regions of Ethiopia: a cross-sectional study

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