Developing a Scale to Measure Obstetric and Gynaecology Professionals’ Attitudes towards Medical Termination of Pregnancy and Emergency Contraception Services, Kerala, India

Chowdhury, Sunita

doi:10.1177/0972063417699692

Cited by 3 publications

(8 citation statements)

References 14 publications

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“…Data concerning provider knowledge was available in some studies [ 25 , 28 , 31 , 34 , 37 - 41 ]. While most providers surveyed felt ECP was safe [ 28 , 35 , 42 ] more than half of participants in some studies held reservations [ 30 , 34 , 37 , 41 , 43 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…A lack of understanding of the biological mechanism of action underpinning ECP was noted among many study respondents; some were not aware of the disruption of ovulation or said that ECP blocks the implantation of the fertilized ovum, or were not sure of the mechanism [ 30 , 42 - 44 ]. Some providers described ECP as an abortifacient [ 29 , 37 , 39 , 40 , 42 , 43 , 45 - 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…In some studies, providers expressed concern that ECP use might displace regular contraception use [ 25 , 30 , 35 , 37 , 39 , 47 ]. Others said they were confident that by counselling their clients they could prevent them from using ECP as a regular method.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Dawson

Tran

Westley³

et al. 2015

BMC Health Serv Res

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BackgroundEmergency contraceptive pills (ECP) are one of the 13 essential commodities addressed by the UN Commission on Life-Saving Commodities for Women and Children. Although ECP have been available for 20 years, a number of barriers still limit women’s access ECP in low and middle-income countries (LMIC). The workforce who prescribe or dispense ECP are diverse reflecting the varied contexts where ECP are available across the health, commercial and justice sectors and in the community. No reviews currently exist that examine the roles and experiences of the workforce that provide ECP in LMIC.MethodWe present a narrative synthesis of research to: identify provider factors that facilitate and constraint access to ECP; assess the effectiveness of associated interventions and; explore associated health system issues in LMIC. A search of bibliographic databases, meta-indexes and websites was undertaken to retrieve peer reviewed and grey literature. Literature was screened and identified documents examined to appraise quality.ResultsThirty-seven documents were included in the review. Studies focused on formal health workers revealing knowledge gaps concerning the role of private sector and non-health providers who increasingly provide ECP. Data from the findings section in the documents were coded under 4 themes: provider knowledge; provider attitudes and beliefs; provider practice and provider training. The analysis revealed provider knowledge gaps, less than favourable attitudes and practice issues. The findings provide limited insight into products prescribed and/or dispensed, the frequency of provision, and information and advice offered to consumers. Pre and in-service training needs were noted.ConclusionAs the provision of ECPs shifts from the clinic-based health sector to increasing provision by the private sector, the limited understanding of provider performance and the practice gaps revealed in this review highlight the need to further examine provider performance to inform the development of appropriate workforce interventions. A standardized approach to assessing performance using agreed outcomes measures may serve to ensure a systematic way forward that is inclusive of the diverse workforce that deliver ECP. Recommendations are outlined to enhance the performance of providers to improve access to ECP. A framework is offered to help guide this process with indicators.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Dawson

Tran

Westley³

et al. 2015

BMC Health Serv Res

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“…The Achutha Menon Centre for Health Science Studies abortion scale 19 tool was used to assess the health providers' attitudes towards safe abortion. The tool had the following sections.…”

Section: Methodsmentioning

confidence: 99%

“… 18 Various studies done among health providers in Chhattisgarh, Meghalaya, Uttarakhand, and Kerala showed that a high proportion harbored a negative attitude. 11 , 13 , 14 , 19 Moreover, inaccurate or inadequate information on the part of providers especially with respect to newer techniques such as medical abortion constitutes a significant challenge to abortion access in India.…”

Section: Introductionmentioning

confidence: 99%

Availability, Utilization, and Health Providers' Attitudes Towards Safe Abortion Services in Public Health Facilities of a District in West Bengal, India

Pyne¹,

Ravindran

2020

Women's Health Reports

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Background: The provision of safe abortion services upholds the realization of justice in sexual and reproductive health. Many state-level studies in India have identified poor availability of abortion services in the public sector and negative attitudes toward abortion among health providers, as potential barriers to access. Materials and Methods: A cross-sectional study was done to document the availability and utilization of medical termination of pregnancy (MTP or abortion) services and to assess public sector health providers' attitudes towards safe abortion. It was carried out in a representative district of West Bengal, using a facility checklist and a validated attitude scale. Results: Only 11 of 42 public health facilities had both trained doctors and equipment to provide MTP services. Twelve facilities provided MTP services, of which only three urban-based secondary-level facilities provided second trimester MTPs. There were female providers in just 2 of the 12 MTP-providing facilities. Among the 64 health providers interviewed, 40% were trained to provide MTP. According to the attitude scale, 38% had a negative attitude toward the provision of safe abortion services. There was no statistically significant association between attitudes of health providers and provision of MTP. However, there appeared to be a subtle process of gatekeeping in operation, such as making MTP conditional on acceptance of contraception, requiring the husband's consent, and so on. Conclusions: The study shows the poor availability of abortion services in public sector facilities in a district of West Bengal, although all public health facilities from the primary health center level upwards are authorized to provide abortion services.

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Differential access to facilities for medical termination of pregnancy and delivery in India: A secondary analysis

Sharma¹,

Jaiswal²,

Singh³

et al. 2021

Clinical Epidemiology and Global Health

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Introduction: Emerging evidence suggests a difference in access to facilities for medical termination of pregnancy (MTP) and delivery among women in different regions of the country. However, we lack assessments at a large scale across all geographies. Our study aims to describe the percent contribution of private and public sectors in institutional deliveries and MTP in India. Methods: A secondary data analysis using the Health Management Information System statistics was performed. We obtained selective data regarding the total number of MTP and deliveries conducted at public and private institutions. The standard reports of the period between April 2018 and March 2019 were analyzed. The states (n = 29) and union territories (n = 7) were dichotomized into regions, namely north, south, east, west, north-east, and central. Results: A large part of women underwent deliveries and abortions in the private sector in the southern and western states of India like Kerala, Tamil Nadu, Andhra Pradesh, Goa, and Maharashtra. Women in most of the northern states opted for public facilities for deliveries as well as abortions, except Punjab and Haryana. On the contrary, states like Bihar, Nagaland, and Union territories like Delhi and Dadra and Nager Haveli had a high percentage of abortions in the private sector and deliveries in public health facilities. Conclusion: This differential access highlights the need to assess the underlying factors for immediate actions by the policy-makers. Ensuring safe and good quality delivery and abortion services is the means to assure the sexual and reproductive health rights of women by the government.

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Developing a Scale to Measure Obstetric and Gynaecology Professionals’ Attitudes towards Medical Termination of Pregnancy and Emergency Contraception Services, Kerala, India

Cited by 3 publications

References 14 publications

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance

Availability, Utilization, and Health Providers' Attitudes Towards Safe Abortion Services in Public Health Facilities of a District in West Bengal, India

Differential access to facilities for medical termination of pregnancy and delivery in India: A secondary analysis

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