Medical technologies and abortion care in Eastern Uganda

Kagaha, Alexander; Manderson, Lenore

doi:10.1016/j.socscimed.2020.112813

Cited by 3 publications

(2 citation statements)

References 41 publications

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“…In the context of conscientious objection, we identified an article finding that some providers claimed conscientious objection in the public sector, and then provided the service (for a fee) in the private sector 41. Relatedly, people seeking abortion in legally restrictive environments could be diverted to the private sector, where there was a higher financial payoff for the risk assumed by the provider 77. In contrast, a study on a programme that contracted out maternity care in India found that at least some private providers felt that the contracting merely outsourced the risk of maternal mortality to private providers; these providers lacked the protection of a government employer 78…”

Section: Resultsmentioning

confidence: 99%

“…41 Relatedly, people seeking abortion in legally restrictive environments could be diverted to the private sector, where there was a higher financial payoff for the risk assumed by the provider. 77 In contrast, a study on a programme that contracted out maternity care in India found that at least some private providers felt that the contracting merely outsourced the risk of maternal mortality to private providers; these providers lacked the protection of a government employer. 78 In sum, though limited in scope, the articles reviewed suggest that poor regulation of the private sector contributed to fragmentation and the impingement of financial motives in a way that could undercut fulfilment of healthcare worker responsibilities, altering their role to be more focused on making money.…”

Section: Inadequate Stewardship Of the Private Sectormentioning

confidence: 99%

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A narrative review of challenges related to healthcare worker rights, roles and responsibilities in the provision of sexual and reproductive services in health facilities

Schaaf,

Lavelanet,

Codjia

et al. 2023

BMJ Glob Health

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IntroductionThis paper identifies and summarises tensions and challenges related to healthcare worker rights and responsibilities and describes how they affect healthcare worker roles in the provision of sexual and reproductive health (SRH) care in health facilities.MethodThe review was undertaken in a two-phase process, namely: (1) development of a list of core constructs and concepts relating to healthcare worker rights, roles and responsibilities to guide the review and (2) literature review.ResultA total of 110 papers addressing a variety of SRH areas and geographical locations met our inclusion criteria. These papers addressed challenges to healthcare worker rights, roles and responsibilities, including conflicting laws, policies and guidelines; pressure to achieve coverage and quality; violations of the rights and professionalism of healthcare workers, undercutting their ability and motivation to fulfil their responsibilities; inadequate stewardship of the private sector; competing paradigms for decision-making—such as religious beliefs—that are inconsistent with professional responsibilities; donor conditionalities and fragmentation; and, the persistence of embedded practical norms that are at odds with healthcare worker rights and responsibilities. The tensions lead to a host of undesirable outcomes, ranging from professional frustration to the provision of a narrower range of services or of poor-quality services.ConclusionSocial mores relating to gender and sexuality and other contested domains that relate to social norms, provider religious identity and other deeply held beliefs complicate the terrain for SRH in particular. Despite the particularities of SRH, a whole of systems response may be best suited to address embedded challenges.

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Section: Resultsmentioning

confidence: 99%

Section: Inadequate Stewardship Of the Private Sectormentioning

confidence: 99%

A narrative review of challenges related to healthcare worker rights, roles and responsibilities in the provision of sexual and reproductive services in health facilities

Schaaf,

Lavelanet,

Codjia

et al. 2023

BMJ Glob Health

View full text Add to dashboard Cite

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Reproductive materialism and justice for women with abortion care needs in Uganda

Kagaha

Manderson

2022

Global Public Health

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Power, policy and abortion care in Uganda

Kagaha

Manderson

2020

Health Policy and Planning

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Unsafe abortion practices remain the major contributor to maternal death in Uganda, impeding the achievement of universal health coverage and quality of maternal health care. Using an ethnographic design and critical discourse analysis, we explored the operations of power in setting maternal healthcare priorities, as evident at the 2018 Reproductive, Maternal, Neonatal, Child and Adolescents Health Conference. Observational data were collected of the policy-making activities, processes and events and key informant interviews were conducted with 27 participants. We describe how neoliberal and state governance through the structure and organization of policy-making, epistemic governance and universal concepts of ‘high-impact’ interventions, results-based financing, cost-effectiveness and accountability converge to suppress the articulation of local conditions associated with unsafe and risky abortion. By defining maternity along the continuum of birth and emphasizing birthing women, priority-setting was directed towards interventions promoting women’s normative role as mothers while suppressing unmet abortion care needs. Finally, discursive and communicative materials controlled how women of reproductive age in Uganda managed reproduction.

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Medical technologies and abortion care in Eastern Uganda

Cited by 3 publications

References 41 publications

A narrative review of challenges related to healthcare worker rights, roles and responsibilities in the provision of sexual and reproductive services in health facilities

A narrative review of challenges related to healthcare worker rights, roles and responsibilities in the provision of sexual and reproductive services in health facilities

Reproductive materialism and justice for women with abortion care needs in Uganda

Power, policy and abortion care in Uganda

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