Health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia: a systematic literature review of qualitative and quantitative data
Identifieur interne : 000715 ( Pmc/Curation ); précédent : 000714; suivant : 000716Health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia: a systematic literature review of qualitative and quantitative data
Auteurs : Ulrika Rehnström Loi [Suède] ; Kristina Gemzell-Danielsson [Suède] ; Elisabeth Faxelid [Suède] ; Marie Klingberg-Allvin [Suède]Source :
- BMC Public Health [ 1471-2458 ] ; 2015.
Abstract
Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim of this study was to identify, summarise and synthesise available research addressing health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia.
A systematic literature search of three databases was conducted in November 2014, as well as a manual search of reference lists. The selection criteria included quantitative and qualitative research studies written in English, regardless of the year of publication, exploring health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. The quality of all articles that met the inclusion criteria was assessed. The studies were critically appraised, and thematic analysis was used to synthesise the data.
Thirty-six studies, published during 1977 and 2014, including data from 15 different countries, met the inclusion criteria. Nine key themes were identified as influencing the health care providers’ attitudes towards induced abortions: 1) human rights, 2) gender, 3) religion, 4) access, 5) unpreparedness, 6) quality of life, 7) ambivalence 8) quality of care and 9) stigma and victimisation.
Health care providers in sub-Saharan Africa and Southeast Asia have moral-, social- and gender-based reservations about induced abortion. These reservations influence attitudes towards induced abortions and subsequently affect the relationship between the health care provider and the pregnant woman who wishes to have an abortion. A values clarification exercise among abortion care providers is needed.
The online version of this article (doi:10.1186/s12889-015-1502-2) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12889-015-1502-2
PubMed: 25886459
PubMed Central: 4335425
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<author><name sortKey="Rehnstrom Loi, Ulrika" sort="Rehnstrom Loi, Ulrika" uniqKey="Rehnstrom Loi U" first="Ulrika" last="Rehnström Loi">Ulrika Rehnström Loi</name>
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<author><name sortKey="Faxelid, Elisabeth" sort="Faxelid, Elisabeth" uniqKey="Faxelid E" first="Elisabeth" last="Faxelid">Elisabeth Faxelid</name>
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<author><name sortKey="Klingberg Allvin, Marie" sort="Klingberg Allvin, Marie" uniqKey="Klingberg Allvin M" first="Marie" last="Klingberg-Allvin">Marie Klingberg-Allvin</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim of this study was to identify, summarise and synthesise available research addressing health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia.</p>
</sec>
<sec><title>Methods</title>
<p>A systematic literature search of three databases was conducted in November 2014, as well as a manual search of reference lists. The selection criteria included quantitative and qualitative research studies written in English, regardless of the year of publication, exploring health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. The quality of all articles that met the inclusion criteria was assessed. The studies were critically appraised, and thematic analysis was used to synthesise the data.</p>
</sec>
<sec><title>Results</title>
<p>Thirty-six studies, published during 1977 and 2014, including data from 15 different countries, met the inclusion criteria. Nine key themes were identified as influencing the health care providers’ attitudes towards induced abortions: 1) human rights, 2) gender, 3) religion, 4) access, 5) unpreparedness, 6) quality of life, 7) ambivalence 8) quality of care and 9) stigma and victimisation.</p>
</sec>
<sec><title>Conclusions</title>
<p>Health care providers in sub-Saharan Africa and Southeast Asia have moral-, social- and gender-based reservations about induced abortion. These reservations influence attitudes towards induced abortions and subsequently affect the relationship between the health care provider and the pregnant woman who wishes to have an abortion. A values clarification exercise among abortion care providers is needed.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12889-015-1502-2) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Public Health</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Public Health</journal-id>
<journal-title-group><journal-title>BMC Public Health</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2458</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25886459</article-id>
<article-id pub-id-type="pmc">4335425</article-id>
<article-id pub-id-type="publisher-id">1502</article-id>
<article-id pub-id-type="doi">10.1186/s12889-015-1502-2</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia: a systematic literature review of qualitative and quantitative data</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Rehnström Loi</surname>
<given-names>Ulrika</given-names>
</name>
<address><email>ulrika.rehnstrom@ki.se</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gemzell-Danielsson</surname>
<given-names>Kristina</given-names>
</name>
<address><email>Kristina.Gemzell@ki.se</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Faxelid</surname>
<given-names>Elisabeth</given-names>
</name>
<address><email>Elisabeth.Faxelid@ki.se</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Klingberg-Allvin</surname>
<given-names>Marie</given-names>
</name>
<address><email>mkl@du.se</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<aff id="Aff1"><label></label>
Department of Public Health Sciences/IHCAR, Karolinska Institutet, Stockholm, Sweden</aff>
<aff id="Aff2"><label></label>
Department of Women’s and Children’s Health, Karolinska Institutet/Karolinska University Hospital Stockholm, Stockholm, Sweden</aff>
<aff id="Aff3"><label></label>
School of Education, Health and Social studies, Dalarna University, Falun, Sweden</aff>
</contrib-group>
<pub-date pub-type="epub"><day>12</day>
<month>2</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>12</day>
<month>2</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>15</volume>
<elocation-id>139</elocation-id>
<history><date date-type="received"><day>20</day>
<month>5</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>3</day>
<month>2</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Rehnström Loi et al.; licensee BioMed Central. 2015</copyright-statement>
<license license-type="open-access"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim of this study was to identify, summarise and synthesise available research addressing health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia.</p>
</sec>
<sec><title>Methods</title>
<p>A systematic literature search of three databases was conducted in November 2014, as well as a manual search of reference lists. The selection criteria included quantitative and qualitative research studies written in English, regardless of the year of publication, exploring health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. The quality of all articles that met the inclusion criteria was assessed. The studies were critically appraised, and thematic analysis was used to synthesise the data.</p>
</sec>
<sec><title>Results</title>
<p>Thirty-six studies, published during 1977 and 2014, including data from 15 different countries, met the inclusion criteria. Nine key themes were identified as influencing the health care providers’ attitudes towards induced abortions: 1) human rights, 2) gender, 3) religion, 4) access, 5) unpreparedness, 6) quality of life, 7) ambivalence 8) quality of care and 9) stigma and victimisation.</p>
</sec>
<sec><title>Conclusions</title>
<p>Health care providers in sub-Saharan Africa and Southeast Asia have moral-, social- and gender-based reservations about induced abortion. These reservations influence attitudes towards induced abortions and subsequently affect the relationship between the health care provider and the pregnant woman who wishes to have an abortion. A values clarification exercise among abortion care providers is needed.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12889-015-1502-2) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Induced abortion</kwd>
<kwd>Providers’ attitudes</kwd>
<kwd>Sub-Saharan Africa</kwd>
<kwd>Southeast Asia</kwd>
<kwd>Systematic review</kwd>
<kwd>Thematic analysis</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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