Identifying barriers to accessibility and availability of safe abortion services among young women in Makwanpur.
SUMMARY: Induced abortion is commonly experienced by reproductive aged women throughout the world because of an unintended pregnancy. Abortion is safe because of minimal risk of severe complications or death when they are done with a method recommended by the World Health Organizations. Nepal has...
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c2018.
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| Summary: | SUMMARY: Induced abortion is commonly experienced by reproductive aged women throughout the world because of an unintended pregnancy. Abortion is safe because of minimal risk of severe complications or death when they are done with a method recommended by the World Health Organizations. Nepal has come a long way from criminalization of the abortion to legalization of the abortion in 2002 and now to free safe abortion services from the government health facilities. The Constitution of Nepal has acknowledged sexual and reproductive health and rights as individual's human rights there by the abortion services have been expanded throughout Nepal. Despite of those progress, more than half (58%) of the total induced abortion were clandestine provided by untrained or unapproved providers or induced by the pregnant woman herself. Young women and adolescent girls, with unwanted pregnancies often resort to unsafe abortion when they cannot access safe abortion. Numerous factors such as abortion law and policies, socioeconomic conditions, poor quality and lack of availability of safe abortion services, abortion stigma, geographical distribution, confidentiality and privacy, and shortage of service providers leads to the choice of safe or unsafe abortion. The objective of this study was to assess the barriers to accessibility and availability of safe abortion services among young women of Makawanpur district. This was a mixed-method study, comprising both qualitative and quantitative methods. The qualitative information has been collected employing focus group discussion (FGD) among 26 and in-depth interviews (IDI) among 10 whereas quantitative information has been collected through surveying colleges. This study has been conducted in Makawanpur district. Three sites that include Hetauda Sub-metropolitan city, Thaha municipality and Manahari rural municipality were selected purposively for field work. . The study population for both type of study included young women aged between 18 and 34 years. Quantitative information was collected from college students using self-administrative questionnaire. IDIs and FGDs were conducted among the government listed abortion service providers from public as well as private health facilities and post abortive women. Simple random sampling had been used to select the high schools and colleges from the available sampling frame to collect the quantitative data and purposive sampling method was used to identify participants. Secondary data regarding the availability of the safe abortion was collected from district health office, Makawanpur using standard format developed by BBC. The tools were pre-tested with the similar study participants prior to carrying out actual data collection. Ethical approval was taken from Nepal Health Research Council (NHRC) reference number 514 prior to the study and formal permission from respective local government authorities and respective colleges. A written informed voluntary consent was taken with the study population before collecting the data. Overall, 71% of the respondents were aware that abortion is legal in Nepal and 11 % believed abortion is illegal in Nepal. Three-fourth of the respondents (75%) knew where the safe abortion service(SAS) site is available. The quantitative study showed that only 54% of the respondents had higher level of accessibility to safe abortion services while 46% of the respondents had less access to safe abortion service. The analysis showed that exposure to internet, contact with FCHV and abortion stigma were significantly associated with access to safe abortion services. The qualitative findings showed lack of knowledge on abortion, cost of the abortion service, abortion stigma, lack of availability of service at rural area, marital status and quality of the services and lack of resources and lack of training were found as barriers to safe abortion service. Adequate information dissemination on safe abortion services and the expansion of the services within the reach of the young women were suggested by research participants to increase accessibility to safe abortion services. The findings suggested that access to safe abortion services among young women can be increased by raising awareness on safe abortion service(SAS), reducing abortion stigma, expanding SAS, improving the quality of safe abortion service through Multi-sectoral Approach and strengthening evidence based advocacy. |
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| Item Description: | Research Report. |