Experiences of abortion in Nepal and menstrual regulation in Bangladesh: a gender analysis

Bhandari, Amit; Hom, Nang Mo; Rashid, Sabina Faiz; Theobald, Sally

doi:10.1080/13552070802120434

Cited by 4 publications

(10 citation statements)

References 2 publications

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“…We focus on abortion care because it remains unclear what constitutes quality abortion care12 and because improving the quality of abortion care may lead to reductions in community-level abortion stigma13 and abortion-related morbidities and mortality 14–18. Improving abortion quality may also lead to increased post-abortion contraceptive knowledge18 and uptake 19…”

Section: Introductionmentioning

confidence: 99%

Identifying indicators for quality abortion care: a systematic literature review

Dennis

Blanchard

Bessenaar

2016

J Fam Plann Reprod Health Care

102

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A systematic review was conducted of 13 peerreviewed articles and eight reports focused on indicators of quality abortion care. A total of 75 indicators of quality abortion were identified; these indicators address a variety of issues including policy, health systems, trained-provider availability, women's decision making, and morbidity and mortality. There is little agreement about indicators for measuring quality abortion care; more work is needed to ensure efforts to assess quality are informed and coordinated. BACKGROUNDBoth in well-resourced and underresourced health systems, it remains challenging to provide quality health services. This results in variation in the standards of health care delivery and in the outcomes of health care within and between health care systems. As it is a key component of ensuring equitable health care and outcomes, there is growing interest in improving the quality of health care across the globe.

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Section: Introductionmentioning

confidence: 99%

Identifying indicators for quality abortion care: a systematic literature review

Dennis

Blanchard

Bessenaar

2016

J Fam Plann Reprod Health Care

102

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“…Some HCPs’ condescending attitudes toward Rohingya women and their tendency to view Rohingya women as a homogenous group with certain needs and desires could affect the quality of care provided. Research in a non-humanitarian setting in Bangladesh found that gendered norms and HCPs’ perceptions about clients affected the quality of care provided [ 23 ]. Making assumptions about clients’ needs and desires can take away their agency and reproductive decision-making capabilities.…”

Section: Discussionmentioning

confidence: 99%

“…In Bangladesh, research into MR, PAC and FP has mainly focused on non-humanitarian settings [ 17 , 23 , 24 ]. The research has found that women and girls face barriers to accessing MR, PAC and FP services.…”

Section: Introductionmentioning

confidence: 99%

“…The research has found that women and girls face barriers to accessing MR, PAC and FP services. Social norms and stigmas limit their access [ 23 ], and HCPs have been found to impose preconditions not stated in the national MR guidelines, such as having a husband’s permission [ 17 ]. Further, a lack of trained providers and a lack of capacity of health care facilities have been found to limit the access to and availability of MR and PAC [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Further, a lack of trained providers and a lack of capacity of health care facilities have been found to limit the access to and availability of MR and PAC [ 17 ]. Additionally, HCPs’ personal values have led to women being denied services and affected the quality of care provided [ 17 , 23 , 24 ]. Research into CAC in humanitarian settings is limited in general, and few studies have explored HCPs’ experience of providing CAC in such settings.…”

Section: Introductionmentioning

confidence: 99%

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A qualitative study on health care providers’ experiences of providing comprehensive abortion care in Cox’s Bazar, Bangladesh

et al. 2021

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Background Humanitarian settings are characterised by limited access to comprehensive abortion care. At the same time, humanitarian settings can increase the vulnerability of women and girls to unintended pregnancies and unsafe abortions. Humanitarian actors and health care providers can play important roles in ensuring the availability and accessibility of abortion-related care. This study explores health care providers’ perceptions and experiences of providing comprehensive abortion care in a humanitarian setting in Cox’s Bazar, Bangladesh and identifies barriers and facilitators in service provision. Method In-depth interviews (n = 24) were conducted with health care providers (n = 19) providing comprehensive abortion care to Rohingya refugee women and with key informants (n = 5), who were employed by an organisation involved in the humanitarian response. Data were analysed using an inductive content analysis approach. Results The national menstrual regulation policy provided a favourable legal environment and facilitated the provision of comprehensive abortion care, while the Mexico City policy created organisational barriers since it made organisations unable or unwilling to provide the full comprehensive abortion care package. Supplies were available, but a lack of space created a barrier to service provision. Although training from organisations had made the health care providers confident and competent and had facilitated the provision of services, their knowledge of the national abortion law and menstrual regulation policy was limited and created a barrier to comprehensive abortion services. Even though the health care providers were willing to provide comprehensive abortion care and had acquired skills and applied strategies to communicate with and provide care to Rohingya women, their personal beliefs and their perceptions of Rohingya women influenced their provision of care. Conclusion The availability and accessibility of comprehensive abortion care was limited by unfavourable abortion policies, a lack of privacy, a lack of knowledge of abortion laws and policies, health care providers’ personal beliefs and a lack of cultural safety. To ensure the accessibility and availability of quality services, a comprehensive approach to sexual and reproductive health and rights is needed. Organisations must ensure that health care providers have knowledge of abortion policies and the ability to provide quality care that is woman-centred and non-judgmental.

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“Sometimes they used to whisper in our ears”: health care workers’ perceptions of the effects of abortion legalization in Nepal

Puri¹,

Lamichhane²,

Harken

et al. 2012

BMC Public Health

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BackgroundUnsafe abortion has been a significant cause of maternal morbidity and mortality in Nepal. Since legalization in 2002, more than 1,200 providers have been trained and 487 sites have been certified for the provision of safe abortion services. Little is known about health care workers’ views on abortion legalization, such as their perceptions of women seeking abortion and the implications of legalization for abortion-related health care.MethodsTo complement a quantitative study of the health effects of abortion legalization in Nepal, we conducted 35 in-depth interviews with physicians, nurses, counsellors and hospital administrators involved in abortion care and post-abortion complication treatment services at four major government hospitals. Thematic analysis techniques were used to analyze the data.ResultsOverall, participants had positive views of abortion legalization – many believed the severity of abortion complications had declined, contributing to lower maternal mortality and morbidity in the country. A number of participants indicated that the proportion of women obtaining abortion services from approved health facilities was increasing; however, others noted an increase in the number of women using unregulated medicines for abortion, contributing to rising complications. Some providers held negative judgments about abortion patients, including their reasons for abortion. Unmarried women were subject to especially strong negative perceptions. A few of the health workers felt that the law change was encouraging unmarried sexual activity and carelessness around pregnancy prevention and abortion, and that repeat abortion was becoming a problem. Many providers believed that although patients were less fearful than before legalization, they remained hesitant to disclose a history of induced abortion for fear of judgment or mistreatment.ConclusionsProviders were generally positive about the implications of abortion legalization for the country and for women. A focus on family planning and post-abortion counselling may be welcomed by providers concerned about multiple abortions. Some of the negative judgments of women held by providers could be tempered through values-clarification training, so that women are supported and comfortable sharing their abortion history, improving the quality of post-abortion treatment of complications.

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Experiences of abortion in Nepal and menstrual regulation in Bangladesh: a gender analysis

Cited by 4 publications

References 2 publications

Identifying indicators for quality abortion care: a systematic literature review

Identifying indicators for quality abortion care: a systematic literature review

A qualitative study on health care providers’ experiences of providing comprehensive abortion care in Cox’s Bazar, Bangladesh

“Sometimes they used to whisper in our ears”: health care workers’ perceptions of the effects of abortion legalization in Nepal

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