Developing and Testing Interventions to Address Use of Conscientious Objection to Deny Women's Access to Abortion Care in Mexico and South Africa
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Abortion, Induced
- Sponsor
- Ipas
- Enrollment
- 317
- Locations
- 2
- Primary Endpoint
- Intention to provide abortion service, referral, or information
- Status
- Terminated
- Last Updated
- 5 years ago
Overview
Brief Summary
The primary purpose of this research is to develop strategies and interventions to mitigate the impact of conscientious objection on women's access to safe abortion care in Mexico and South Africa using a user-centered design approach and test the feasibility and effectiveness of these interventions.
Detailed Description
Conscientious objection (CO) is emerging as a growing barrier to abortion care, and evidence suggests that it is being incorrectly used as a justification for public sector medical providers and institutions to exempt themselves from their duties to provide essential reproductive health services for women. Given this, it is essential to better understand and address this misuse of CO and find ways to improve women's access to safe abortion services to prevent them from using unsafe methods which risk their health and lives. This study will conduct formative research to more fully understand the problem of CO in Mexico and South Africa and use these findings to develop interventions and strategies to mitigate the impact of CO on women's access to safe abortion care using a user-centered design approach. Rapid randomized controlled trials will then be used to assess effectiveness of the interventions. The specific aims of this study are: 1. Improve our understanding of CO and its impact on access and quality of abortion care from providers' and facility mangers' perspectives in Mexico, and South Africa. 2. Develop strategies and interventions to mitigate the impact of CO on women's access to safe abortion care. Using the data collected, a multi-disciplinary Innovation Team will develop strategies and interventions to respond to the challenges posed by CO using a user-centered design approach. 3. Rapid-test intervention prototypes. We will test selected strategies (prototypes) in Mexico, and South Africa with assessments to determine successes, and the feasibility of scaling up these approaches.
Investigators
Eligibility Criteria
Inclusion Criteria
- •All staff currently working in selected health facilities
- •Able to provide informed consent
Exclusion Criteria
- •Unable to provide informed consent
- •Inclusion Criteria:
- •Doctors/anyone eligible to be an abortion provider working in selected health facilities
- •Able to provide informed consent
- •Exclusion Criteria:
- •Unable to provide informed consent
Outcomes
Primary Outcomes
Intention to provide abortion service, referral, or information
Time Frame: Next few days
Proportion of health facility staff reporting they would provide abortion service, referral or information to women seeking abortion care in their health unit in the next few days if needed.
Behavior making it easier for women to access abortion care
Time Frame: Past 30 days
Proportion of health facility staff exhibiting at least one behavior to make it easier for women to access abortion care (e.g. helped a woman find the abortion care unit, provided positive support to a woman seeking abortion care, gave accurate information to a woman seeking abortion care, etc.).
Behavior making it more difficult for women to access abortion care
Time Frame: Past 30 days
Proportion of health facility staff exhibiting at least one behavior to make it more difficult for women to access abortion care (e.g. gave incorrect directions to a woman seeking abortion care, told a woman abortion services were not available at the facility, tried to convince a woman that she should not have an abortion, etc.).
Secondary Outcomes
- Stigmatizing Attitudes Beliefs and Actions Scale (SABAS) score(Assessed at baseline and at 30-day follow-up)
- Interest in attending an abortion care training(Assessed at baseline and at 30-day follow-up)