Stigmatized by association: challenges for abortion service providers in Ghana
Identifieur interne : 000140 ( Main/Exploration ); précédent : 000139; suivant : 000141Stigmatized by association: challenges for abortion service providers in Ghana
Auteurs : Patience Aniteye [Ghana] ; Beverley O Rien ; Susannah H. MayhewSource :
- BMC Health Services Research [ 1472-6963 ] ; 2016.
Abstract
Unsafe abortion is an issue of public health concern and contributes significantly to maternal morbidity and mortality globally. Abortion evokes religious, moral, ethical, socio-cultural and medical concerns which mean it is highly stigmatized and this poses a threat to both providers and researchers. This study sought to explore challenges to providing safe abortion services from the perspective of health providers in Ghana.
A descriptive qualitative study using in-depth interviews was conducted. The study was conducted in three (3) hospitals and five (5) health centres in the capital city in Ghana. Participants (
Stigma affects provision of safe-abortion services in Ghana in a number of ways. The ambiguities in Ghanaian abortion law and lack of overt institutional support for practitioners increased reluctance to openly provide for fear of stigmatisation and legal threat. Negative provider attitudes that stigmatised women seeking abortion care were frequently driven by socio-cultural and religious norms that highly stigmatise abortion practice. Exposure to higher levels of education, including training overseas, seemed to result in more positive, less stigmatising views towards the need for safe abortion services. Nevertheless, physicians open to practicing abortion were still very concerned about stigma by association.
Stigma constitutes an overarching impediment for abortion service provision. It affects health providers providing such services and even researchers who study the subject. Exposure to wider debate and education seem to influence attitudes and values clarification training may prove useful. Proper dissemination of existing guidelines and overt institutional support for provision of safe services also needs to be rolled out.
Url:
DOI: 10.1186/s12913-016-1733-7
PubMed: 27612453
PubMed Central: 5018197
Affiliations:
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Mayhew</name><affiliation><nlm:aff id="Aff3">Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, WC1H 9SH UK</nlm:aff><wicri:noCountry code="subfield">WC1H 9SH UK</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27612453</idno><idno type="pmc">5018197</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018197</idno><idno type="RBID">PMC:5018197</idno><idno type="doi">10.1186/s12913-016-1733-7</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000077</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000077</idno><idno type="wicri:Area/Pmc/Curation">000076</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000076</idno><idno type="wicri:Area/Pmc/Checkpoint">000062</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000062</idno><idno type="wicri:Area/Ncbi/Merge">000A30</idno><idno type="wicri:Area/Ncbi/Curation">000A30</idno><idno type="wicri:Area/Ncbi/Checkpoint">000A30</idno><idno type="wicri:Area/Main/Merge">000140</idno><idno type="wicri:Area/Main/Curation">000140</idno><idno type="wicri:Area/Main/Exploration">000140</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Stigmatized by association: challenges for abortion service providers in Ghana</title><author><name sortKey="Aniteye, Patience" sort="Aniteye, Patience" uniqKey="Aniteye P" first="Patience" last="Aniteye">Patience Aniteye</name><affiliation wicri:level="4"><nlm:aff id="Aff1">School of Nursing, College of Health Sciences, University of Ghana, P.O.BOX LG 43, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Nursing, College of Health Sciences, University of Ghana, P.O.BOX LG 43, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="O Rien, Beverley" sort="O Rien, Beverley" uniqKey="O Rien B" first="Beverley" last="O Rien">Beverley O Rien</name><affiliation><nlm:aff id="Aff2">Edmonton Clinic Health Academy (ECHA), Faculty of Nursing, 11405-87 Ave, 3rd Fl, Edmonton, Alberta T6G1C9 Canada</nlm:aff><wicri:noCountry code="subfield">Alberta T6G1C9 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Mayhew, Susannah H" sort="Mayhew, Susannah H" uniqKey="Mayhew S" first="Susannah H." last="Mayhew">Susannah H. Mayhew</name><affiliation><nlm:aff id="Aff3">Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, WC1H 9SH UK</nlm:aff><wicri:noCountry code="subfield">WC1H 9SH UK</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Health Services Research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Unsafe abortion is an issue of public health concern and contributes significantly to maternal morbidity and mortality globally. Abortion evokes religious, moral, ethical, socio-cultural and medical concerns which mean it is highly stigmatized and this poses a threat to both providers and researchers. This study sought to explore challenges to providing safe abortion services from the perspective of health providers in Ghana.</p></sec><sec><title>Methods</title><p>A descriptive qualitative study using in-depth interviews was conducted. The study was conducted in three (3) hospitals and five (5) health centres in the capital city in Ghana. Participants (<italic>n</italic> = 36) consisted of obstetrician/gynaecologists, nurse-midwives and pharmacists.</p></sec><sec><title>Results</title><p>Stigma affects provision of safe-abortion services in Ghana in a number of ways. The ambiguities in Ghanaian abortion law and lack of overt institutional support for practitioners increased reluctance to openly provide for fear of stigmatisation and legal threat. Negative provider attitudes that stigmatised women seeking abortion care were frequently driven by socio-cultural and religious norms that highly stigmatise abortion practice. Exposure to higher levels of education, including training overseas, seemed to result in more positive, less stigmatising views towards the need for safe abortion services. Nevertheless, physicians open to practicing abortion were still very concerned about stigma by association.</p></sec><sec><title>Conclusions</title><p>Stigma constitutes an overarching impediment for abortion service provision. It affects health providers providing such services and even researchers who study the subject. Exposure to wider debate and education seem to influence attitudes and values clarification training may prove useful. Proper dissemination of existing guidelines and overt institutional support for provision of safe services also needs to be rolled out.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Lithur, No" uniqKey="Lithur N">NO Lithur</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singh, S" uniqKey="Singh S">S Singh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Levandowski, Ba" uniqKey="Levandowski B">BA Levandowski</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cockrill, K" uniqKey="Cockrill K">K Cockrill</name></author><author><name sortKey="Nack, A" uniqKey="Nack A">A 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Gabreil</name></author><author><name sortKey="Bickers Bock, Lb" uniqKey="Bickers Bock L">LB Bickers Bock</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ghana</li></country><region><li>Région du Grand Accra</li></region><settlement><li>Accra</li><li>Legon (Ghana)</li></settlement><orgName><li>Université du Ghana</li></orgName></list><tree><noCountry><name sortKey="Mayhew, Susannah H" sort="Mayhew, Susannah H" uniqKey="Mayhew S" first="Susannah H." last="Mayhew">Susannah H. Mayhew</name><name sortKey="O Rien, Beverley" sort="O Rien, Beverley" uniqKey="O Rien B" first="Beverley" last="O Rien">Beverley O Rien</name></noCountry><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Aniteye, Patience" sort="Aniteye, Patience" uniqKey="Aniteye P" first="Patience" last="Aniteye">Patience Aniteye</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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