From Research to Reality: The Challenges of Introducing Medical Abortion into Service Delivery in Vietnam

Ganatra, Bela; Bygdeman, M.; Thuy, Phan Bich; Vinh, Nguyen Duc; Loi, Vu Manh

doi:10.1016/s0968-8080(04)24022-8

Cited by 15 publications

(15 citation statements)

References 7 publications

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“…Our finding that a woman’s perception of MA as being “more natural” was associated with choosing an MA is consistent with findings from the US, Vietnam, and Latin America 2,8,23. Studies reported that women considered MA to be like having a period23 and less likely to interrupt women’s daily lives 2…”

Section: Discussionsupporting

confidence: 89%

“…Surgical termination using manual vacuum aspiration (MVA) exists at all public health administrative levels in the country, although medical abortion (MA), which was introduced in the country through a clinical study in 1992,2 is only permitted at the central, provincial, and district levels for first-trimester termination and must be performed by obstetricians/gynecologists 2…”

Section: Introductionmentioning

confidence: 99%

“…The last national assessment on MA provision in Vietnam was conducted in 2003,2 and there has been no nationally representative quantitative survey. A cross-sectional exit-interview survey was therefore carried out to explore the perceptions of abortion service users about termination methods in Vietnam in relation to the uptake of MA versus MVA.…”

Section: Introductionmentioning

confidence: 99%

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Women’s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Ngô¹,

Free²,

Le³

et al. 2014

IJWH

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ObjectiveTo explore the perspectives of abortion service users regarding termination methods and abortion service delivery in Vietnam.Materials and methodsStructured exit interviews were conducted between August and November 2011 with women who underwent termination of pregnancy at 62 public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam. All women presenting for termination during the study period were recruited to participate in the study. Following their abortion, women were asked about their perspectives on abortion service delivery and attributes of medical abortion (MA) versus manual vacuum aspiration (MVA). Multiple logistic regression was used to assess the association between current method uptake and each attribute.ResultsA total of 1,233 women were included in the survey: 541 (43.9%) from Hanoi, 163 (13.2%) from Khanh Hoa, and 529 (42.9%) from Ho Chi Minh: 23.1% underwent MA; 78.9% reported that women should be given a choice between MA and MVA; and 77.6% thought that abortion services were accessible. Among the 48% who responded, 30.1% thought that MA should be made available at primary/secondary health care facilities. Among women who had previously undergone both methods, women who reported that MA “feels more natural” (like a menstrual regulation/period) were more likely to choose MA for their current abortion (odds ratio 2.15, 95% confidence interval 1.26–3.69).ConclusionMA uptake is significantly lower than MVA uptake. Further insights to women’s perceptions of MA in Vietnam could help improve abortion service delivery in the country.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Women’s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Ngô¹,

Free²,

Le³

et al. 2014

IJWH

View full text Add to dashboard Cite

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“…In 1992, MA was introduced in Vietnam via a clinical study to expand choice and access to abortion services 6. Clinical trials have since reported high efficacy and acceptability rates for first trimester MA 7–9.…”

Section: Introductionmentioning

confidence: 99%

“…A surgical termination service using MVA exists at all Vietnam’s public health administration levels and is provided by midwives. However, MA using a mifepristone + misoprostol regimen for first trimester termination is only permitted at the central, provincial, and district levels, and is performed by obstetricians/gynecologists 6. MA services are provided at centers for reproductive health, abortion clinics in hospitals, and specialized hospitals at these administrative levels (central, provincial, district) located in urban and periurban areas.…”

Section: Introductionmentioning

confidence: 99%

Attributes and perspectives of public providers related to provision of medical abortion at public health facilities in Vietnam: a cross-sectional study in three provinces

Ngô¹,

Free²,

Le³

et al. 2014

IJWH

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BackgroundThe purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam.MethodsWe conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam’s public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods.ResultsA total of 905 providers from 62 health facilities were included, comprising 525 (58.0%) from Hanoi, 122 (13.5%) from Khanh Hoa, and 258 (28.5%) from Ho Chi Minh City. The majority of providers were female (96.7%), aged ≥25 years (94%), married (84.4%), and had at least one child (89%); 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%), midwives (21.7%), and nurses (3.9%). Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30) and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79) were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with nursing/midwifery training (odds ratio 22.2; 95% confidence interval 3.81–129.41). The most frequently cited advantages of medical abortion for providers were that no surgical skills are required (61.7%) and client satisfaction is better (61.0%).ConclusionProvision of medical abortion in Vietnam is lower than provision of manual vacuum aspiration. While the majority of abortion providers are female midwives in Vietnam, medical abortion provision is concentrated in urban settings among physicians. Individuals providing medical abortion found that the method yields high client satisfaction.

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Vietnam: The Doi Moi Era and Changes in Young People’s Lives

Phan¹,

Bruyn

Tran³

2014

International Handbook of Adolescent Pregnancy

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From Research to Reality: The Challenges of Introducing Medical Abortion into Service Delivery in Vietnam

Cited by 15 publications

References 7 publications

Women’s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Women’s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Attributes and perspectives of public providers related to provision of medical abortion at public health facilities in Vietnam: a cross-sectional study in three provinces

Vietnam: The Doi Moi Era and Changes in Young People’s Lives

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From Research to Reality: The Challenges of Introducing Medical Abortion into Service Delivery in Vietnam

Cited by 15 publications

References 7 publications

Women&rsquo;s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Women&rsquo;s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Attributes and perspectives of public providers related to provision of medical abortion at public health facilities in Vietnam: a cross-sectional study in three provinces

Vietnam: The Doi Moi Era and Changes in Young People’s Lives

Contact Info

Product

Resources

About

Women’s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Women’s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces