Self-reported follow-up care needs can be met in both facility and self-managed abortion: evidence from low- and middle-income countries
Presenter Biography
Laura Jacobson is a PhD candidate in health system and policy and her research focuses on abortion quality of care, medication abortion self-use, and health system accountability. In addition, Laura supports abortion research activities as a consultant with Ibis Reproductive Health and the World Health Organization.
Institution
OHSU
Program/Major
Health Systems and policy
Degree
PhD
Presentation Type
Presentation
Start Date
4-4-2024 11:21 AM
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Keywords
abortion, self-managed abortion, health systems, global health
Abstract
Objective: To understand in-facility follow-up care-seeking behavior among both people who self-managed medication abortions (SMA) and those who obtained facility-managed care in six countries and to explore factors that contribute to meeting individual’s self-reported care needs that are core to person-centered care.
Study Design: We conducted a qualitative thematic analysis of 67 in-depth interviews conducted with facility or SMA seekers. We first classified individuals as having their care needs met or not, and whether they sought follow-up care. We then identified predisposing, enabling, or need factors that contributed to having care needs met or not.
Results: A total of n=67 participants were included in this analysis from six countries. The majority of participants (n=59, 88%) had their care needs met and half (n=33, 49%) sought follow-up care in a facility. Most participants, both at facilities and through SMA, reported their needs were met. Having support from family or accompaniment groups (activists who provide abortion guidance outside of clinical settings), knowing what to expect, and living close to a facility were key enabling factors that allowed individuals to have their care needs met via a facility follow-up visit or to feel confident completing their abortion at home. Inhibiting factors including health system challenges; stigma from providers; legal risk; unsupportive family; and uncertainty prevented some from having their care needs met.
Conclusion: Medication abortion follow-up care needs can be met both in and outside of health facilities. Attention towards supporting enabling factors to meet client needs is essential to person-centered abortion care provision.
Self-reported follow-up care needs can be met in both facility and self-managed abortion: evidence from low- and middle-income countries
Objective: To understand in-facility follow-up care-seeking behavior among both people who self-managed medication abortions (SMA) and those who obtained facility-managed care in six countries and to explore factors that contribute to meeting individual’s self-reported care needs that are core to person-centered care.
Study Design: We conducted a qualitative thematic analysis of 67 in-depth interviews conducted with facility or SMA seekers. We first classified individuals as having their care needs met or not, and whether they sought follow-up care. We then identified predisposing, enabling, or need factors that contributed to having care needs met or not.
Results: A total of n=67 participants were included in this analysis from six countries. The majority of participants (n=59, 88%) had their care needs met and half (n=33, 49%) sought follow-up care in a facility. Most participants, both at facilities and through SMA, reported their needs were met. Having support from family or accompaniment groups (activists who provide abortion guidance outside of clinical settings), knowing what to expect, and living close to a facility were key enabling factors that allowed individuals to have their care needs met via a facility follow-up visit or to feel confident completing their abortion at home. Inhibiting factors including health system challenges; stigma from providers; legal risk; unsupportive family; and uncertainty prevented some from having their care needs met.
Conclusion: Medication abortion follow-up care needs can be met both in and outside of health facilities. Attention towards supporting enabling factors to meet client needs is essential to person-centered abortion care provision.