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Research Article: Quality of care from the perspective of people obtaining abortion: a qualitative study in four countries

Date Published: 2023-09-19

Abstract:
Objective This qualitative study aimed to identify person-centred domains that would contribute to the definition and measurement of abortion quality of care based on the perceptions, experiences and priorities of people seeking abortion. Methods We conducted interviews with people seeking abortion aged 15–41 who obtained care in Argentina, Bangladesh, Ethiopia or Nigeria. Participants were recruited from hospitals, clinics, pharmacies, call centres and accompaniment models. We conducted thematic analysis and quantified key domains of quality identified by the participants. Results We identified six themes that contributed to high-quality abortion care from the clients’ perspective, with particular focus on interpersonal dynamics. These themes emerged as participants described their abortion experience, reflected on their interactions with providers and defined good and bad care. The six themes included (1) kindness and respect, (2) information exchange, (3) emotional support, (4) attentive care throughout the process, (5) privacy and confidentiality and (6) prepared for and able to cope with pain. Conclusions People seeking abortion across multiple country contexts and among various care models have confirmed the importance of interpersonal care in quality. These findings provide guidance on six priority areas which could be used to sharpen the definition of abortion quality, improve measurement, and design interventions to improve quality.

Introduction:
Abortion care is an essential component of comprehensive sexual and reproductive healthcare and access to abortion is considered a human right. 1 Globally, there are an estimated 39 induced abortions per 1000 women of reproductive age which are obtained in facility and out-of-facility settings. 2 The safety and availability of abortion has improved, especially in high-income countries, 2 yet the quality of abortion services varies widely. 3 4 Given the potential implications of poor quality on health outcomes such…

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