Author:
Sorhaindo Annik,Sedgh Gilda
Abstract
BackgroundWe 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.MethodsWe searched five bibliographic databases for all articles published on MA between 2007 and July 2020 in LMICs. The search yielded 1294 articles. We identified 107 articles in which one or more of the three WHO-defined subtasks for MA was self-led outside of a clinic setting, and use of drugs that are part of safe, evidence-based regimens was related to the study exposure or outcome. We classified these studies by subject area, study design, country, legal context, gestational age and other categories.ResultsThe 107 studies covered research in 44 countries, of which 18 have liberal abortion laws. Seventy- four articles reported on quantitative research methods, of which 14 were randomised controlled trials. Fifty-two studies focused on MA in the first trimester. Sixty-two focused on WHO subtask two (drug administration) and 32 focused on subtask three (assessing and managing abortion completion). We found little research on self-management of the entire MA process, innovative approaches to supporting self-managed MA or the needs of underserved populations.ConclusionWe recommend syntheses of evidence on safety and efficacy of self-managed MA and preferences of people undergoing self-managed MA. We also encourage new research on topics including self-management of the entire process, the needs and experiences of underserved populations and innovative approaches to supporting people undertaking self-managed MA. The time is opportune for amplifying and expanding evidence to inform programmes and policies on self-care.
Subject
Public Health, Environmental and Occupational Health,Health Policy
Reference26 articles.
1. World Health Organization . Safe abortion: technical and policy guidance for health systems. second edition. Geneva: World Health Organization, 2012.
2. World Health Organization . Health worker roles in providing safe abortion care and post abortion contraception. Geneva: World Health Organization, 2015.
3. World Health Organization . Who recommendations on self-care interventions. self-management of medical abortion. WHO/SRH/20.11. Geneva: World Health Organization, 2020 WHO/SRH/20.11.
4. Self care interventions to advance health and wellbeing: a conceptual framework to inform normative guidance
5. Why self-managed abortion is so much more than a provisional solution for times of pandemic;Assis;Sex Reprod Health Matters,2020
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献