Women's experiences of facility-based abortion care: A WHO qualitative evidence synthesis.

The World Health Organization's Abortion Care Guideline requires abortion care to be not only safe but also effective, efficient, accessible, equitable, acceptable, and person centered. We synthesized qualitative evidence from 111 papers from 42 countries selected from a systematic search of literature published between January 1996 and September 2023. We developed a typology of experiences experienced by abortion seekers engaging with facility-based abortion care services at any stage of the abortion care pathway; factors that modify the experience as well as the consequences of these experiences for the abortion seeker.

Landscape assessment of the availability of medical abortion medicines in India.

Background: Medical abortion with mifepristone and misoprostol can be provided up to 63 days' gestation in India. This accounts for 67.5 percent of all abortions in the country.

Strengthening regional commitment to ensuring access to medical abortion medicines in WHO's South-East Asia region: report of a participatory assessment and workshop.

Background: In 2019, the World Health Organization identified improving access to safe abortion as an important priority toward improving sexual and reproductive health and rights and achieving Sustainable Development Goals. One strategy for addressing this priority is strengthening access to medicines for medical abortion. All 11 countries in the South-East Asia Region have some indications for legal abortion and permit post-abortion care.

Description of the methodology for developing and validating the WHO's family planning and comprehensive abortion care competencies for the primary health care workforce.

A qualified health workforce is essential to receiving effective, timely, affordable, equitable and respectful family planning and comprehensive abortion care. However, in many countries, health workers lack the competencies required to deliver quality family planning and comprehensive abortion care services. Competency-based education and learning aims to train and assess competencies.

Adaptations to comprehensive abortion care during the COVID-19 pandemic: case studies of provision in Bolivia, Mali, Nepal, and the occupied Palestinian territory.

The COVID-19 pandemic impacted comprehensive abortion care provision. To maintain access to services while keeping individuals safe from infection, many organisations adapted their programmes. We conducted a programme evaluation to examine service adaptations implemented in Bolivia, Mali, Nepal, and the occupied Palestinian territory.

Identifying and prioritizing evidence needs in self-care interventions for sexual and reproductive health.

Background: Self-care as an extension of health care systems can increase access to care. The development of programs and generation of evidence to support self-care in sexual and reproductive health (SRH) is a relatively nascent field. We undertook a study to identify and prioritize evidence gaps for SRH self-care.

Interventions to reduce stigma related to contraception and abortion: a scoping review.

Objectives: We conducted a scoping review to identify the types, volume and characteristics of available evidence and analyse the gaps in the knowledge base for evaluated interventions to reduce contraception and abortion stigma.

Design: We conducted a search of five electronic databases to identify articles published between January 2000 and January 2022, and explored the websites of relevant organisations and grey literature databases for unpublished and non-commercial reports. Articles were assessed for eligibility, and data were extracted.

Why does abortion stigma matter? A scoping review and hybrid analysis of qualitative evidence illustrating the role of stigma in the quality of abortion care.

Abortion stigma shapes the environment in which abortion is delivered and received and can have important implications for quality in abortion care. However, this has not previously been clearly articulated and evidenced. We conducted a scoping review of existing qualitative evidence to characterize the relationship between abortion stigma and quality in abortion care.

Scoping review of research on self-managed medication abortion in low-income and middle-income countries.

Background: We undertook a scoping review of recent studies on self-managed medical abortion (MA) or abortion where some or all of the process is led independently by the person having the abortion, in low-income and middle-income countries (LMICs) to uncover evidence gaps and help stakeholders leverage existing evidence.

Methods: We searched five bibliographic databases for all articles published on MA between 2007 and July 2020 in LMICs. The search yielded 1294 articles.

Glancing at the past and course-setting for the future: lessons from the last decade of research on medication abortion in high-income countries.

Objective: Although medication abortion has become more common in high-income countries, the procedure has not yet met early expectations for widening access to abortion. High-quality evidence can serve as a catalyst for changes in policy and practice. To direct research priorities, it is important to understand where quality evidence is concentrated and where gaps remain.

Creativity, serendipity, and collaboration: Cross-cutting features of successful task-sharing in comprehensive safe abortion care.

Limited capacity to deliver comprehensive safe abortion care and shortages in trained healthcare providers contribute to a lack of access to safe services. The World Health Organization published guidelines and recommendations on expanding health worker roles through task-sharing as one way to address disparities. A multicountry case study was conducted in six diverse contexts (Bangladesh, Colombia, Ghana, Mexico City in Mexico, Sweden, and Tunisia) to determine the cross-cutting strategies that enabled inclusion of a broader range of healthcare workers in comprehensive safe abortion care.

WHO guidelines and the role of the physician in task sharing in safe abortion care.

Globally, many women undergo unsafe abortion, although abortion is extremely safe when done in accordance with recommended guidelines. Hence, many women suffer from abortion-related complications, and unsafe abortion remains a major cause of maternal mortality. The high percentage of unsafe abortion is attributed to the inability of women to access safe abortion services.

Story Circles and abortion stigma in Mexico: a mixed-methods evaluation of a new intervention for reducing individual level abortion stigma.

This study presents the results of an evaluation of a Story Circles intervention to reduce individual level abortion stigma among women who have experienced abortion in Mexico. Using a mixed-methods approach, the study explored whether participation in the intervention reduced 18 women's experience of stigma one month after having participated. The study used the Individual Level Abortion Stigma Scale (ILAS Scale), qualitative interviews and focus groups to gain an understanding of women's experiences of the intervention and any changes in stigmatising feelings.

Implementation considerations when expanding health worker roles to include safe abortion care: a five-country case study synthesis.

Background: Allowing a broader range of trained health workers to deliver services can be an important way of improving access to safe abortion care. However, the expansion of health worker roles may be challenging to implement. This study aimed to explore factors influencing the implementation of role expansion strategies for non-physician providers to include the delivery of abortion care.

A Qualitative Study of Participant Engagement With a Weight Loss Intervention.

Background: Overweight and obesity are major public health problems and an increasing global challenge. In lieu of wider policy changes to tackle the obesogenic environment in which we presently reside, improving the design of individual-level weight loss interventions is important.

Aim: To identify which aspects of the Camden Weight Loss randomized controlled trial weight loss intervention participants engaged with, with the aim of improving the design of future studies and maximizing retention.

Being targeted: Young women's experience of being identified for a teenage pregnancy prevention programme.

Research on the unintended consequences of targeting 'high-risk' young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust among some young women.

Exploring intergenerational changes in perceptions of gender roles and sexuality among Indigenous women in Oaxaca.

The south of Mexico has traditionally faced disproportionate social, health and economic disadvantage relative to the rest of the country, due in part to lower levels of economic and human development, and barriers faced by Indigenous populations. The state of Oaxaca, in particular, has one of the highest proportions of Indigenous people and consistently displays high rates of maternal mortality, sexually transmitted infections and teenage pregnancy. This study examines how social values and norms surrounding sexuality have changed between two generations of women living in Indigenous communities in Oaxaca.

Constructing a validated scale to measure community-level abortion stigma in Mexico.

Objective: In Mexico, abortion stigma in the general population is largely unexplored. We developed a scale to measure abortion stigma at the community level, examine its prevalence and explore factors associated with abortion stigma in a nationally representative sample.

Study Design: Following intensive qualitative work to identify dimensions of the stigma construct, we developed a comprehensive list of statements that were cognitively tested and reduced to 33 to form a scale.

Nurse versus physician-provision of early medical abortion in Mexico: a randomized controlled non-inferiority trial.

Objective: To examine the effectiveness, safety, and acceptability of nurse provision of early medical abortion compared to physicians at three facilities in Mexico City.

Methods: We conducted a randomized non-inferiority trial on the provision of medical abortion and contraceptive counselling by physicians or nurses. The participants were pregnant women seeking abortion at a gestational duration of 70 days or less.

Qualitative evidence on abortion stigma from Mexico City and five states in Mexico.

Social manifestations of abortion stigma depend upon cultural, legal, and religious context. Abortion stigma in Mexico is under-researched. This study explored the sources, experiences, and consequences of stigma from the perspectives of women who had had an abortion, male partners, and members of the general population in different regional and legal contexts.

Patient preferences and performance bias in a weight loss trial with a usual care arm.

Objectives: This qualitative study examines performance bias, i.e. unintended differences between groups, in the context of a weight loss trial in which a novel patient counseling program was compared to usual care in general practice.

Randomized controlled trial of 'teens and toddlers': a teenage pregnancy prevention intervention combining youth development and voluntary service in a nursery.

We conducted an independent evaluation of the "Teens and Toddlers" intervention. Our randomized trial examined effects on self-reported last sex without contraception, >1 episode of sex without contraception in previous 3 months, expectation of teenage parenthood and youth development score, plus secondary outcomes among 449 at-risk girls age 13/14 in England. The intervention involves 18-20 weekly sessions in pre-school nurseries.