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Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention

BACKGROUND: Abortion services were legalized in India in 1972, however, the access to safe abortion services is restricted, especially in rural areas. In 2002, medical abortion using mifepristone- misoprostol was approved for termination of pregnancy, however, its use has been limited in primary car...

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Autores principales: Iyengar, Kirti, Iyengar, Sharad D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863363/
https://www.ncbi.nlm.nih.gov/pubmed/27165519
http://dx.doi.org/10.1186/s12978-016-0157-5
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author Iyengar, Kirti
Iyengar, Sharad D.
author_facet Iyengar, Kirti
Iyengar, Sharad D.
author_sort Iyengar, Kirti
collection PubMed
description BACKGROUND: Abortion services were legalized in India in 1972, however, the access to safe abortion services is restricted, especially in rural areas. In 2002, medical abortion using mifepristone- misoprostol was approved for termination of pregnancy, however, its use has been limited in primary care settings. METHODS: This paper describes a service delivery intervention for women attending with unwanted pregnancies over 14 years in four primary care clinics of Rajasthan, India. Prospective data was collected to document the profile of women, method of abortion provided, contraceptive use and follow-up rates after abortion. This analysis includes data collected during August 2001-March 2015. RESULTS: A total of 9076 women with unwanted pregnancies sought care from these clinics, and abortion services were provided to 70 % of these. Most abortion seekers were married, had one or more children. After 2003, the use of medical abortion increased over the years and ultimately accounted for 99 % of all abortions in 2014. About half the women returned for a follow-up visit, while the proportion using contraceptives declined from 74 % to 52 % from 2001 to 2014. CONCLUSIONS: The results of our intervention indicate that integrating medical abortion into primary care settings is feasible and has a potential to improve access to safe abortion services in rural areas. Our experience can be used to guide program managers and service providers about reducing barriers and making abortion services more accessible to women.
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spelling pubmed-48633632016-05-12 Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention Iyengar, Kirti Iyengar, Sharad D. Reprod Health Research BACKGROUND: Abortion services were legalized in India in 1972, however, the access to safe abortion services is restricted, especially in rural areas. In 2002, medical abortion using mifepristone- misoprostol was approved for termination of pregnancy, however, its use has been limited in primary care settings. METHODS: This paper describes a service delivery intervention for women attending with unwanted pregnancies over 14 years in four primary care clinics of Rajasthan, India. Prospective data was collected to document the profile of women, method of abortion provided, contraceptive use and follow-up rates after abortion. This analysis includes data collected during August 2001-March 2015. RESULTS: A total of 9076 women with unwanted pregnancies sought care from these clinics, and abortion services were provided to 70 % of these. Most abortion seekers were married, had one or more children. After 2003, the use of medical abortion increased over the years and ultimately accounted for 99 % of all abortions in 2014. About half the women returned for a follow-up visit, while the proportion using contraceptives declined from 74 % to 52 % from 2001 to 2014. CONCLUSIONS: The results of our intervention indicate that integrating medical abortion into primary care settings is feasible and has a potential to improve access to safe abortion services in rural areas. Our experience can be used to guide program managers and service providers about reducing barriers and making abortion services more accessible to women. BioMed Central 2016-05-10 /pmc/articles/PMC4863363/ /pubmed/27165519 http://dx.doi.org/10.1186/s12978-016-0157-5 Text en © Iyengar and Iyengar. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Iyengar, Kirti
Iyengar, Sharad D.
Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention
title Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention
title_full Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention
title_fullStr Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention
title_full_unstemmed Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention
title_short Improving access to safe abortion in a rural primary care setting in India: experience of a service delivery intervention
title_sort improving access to safe abortion in a rural primary care setting in india: experience of a service delivery intervention
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863363/
https://www.ncbi.nlm.nih.gov/pubmed/27165519
http://dx.doi.org/10.1186/s12978-016-0157-5
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