Provision of harm-reduction services to limit unsafe abortion in Tanzania
Provision of harm-reduction services to limit unsafe abortion in Tanzania
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DOI：
10.1002/ijgo.12035
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发表时间：
2017-02-01
影响因子：
3.8
通讯作者：
Meglioli, Alejandra
中科院分区：
文献类型：
--
作者：
Kahabuka, Catherine;Pembe, Andrea;Meglioli, Alejandra
目的：探讨在坦桑尼亚提供减少危害服务以减少不安全堕胎的可行性。方法：对2014年2月10日至10月10日期间在达累斯萨拉姆一家公共卫生中心接受减害咨询的110名妇女进行横断面研究。收集所有妇女的背景和临床资料；一个亚组（n=50）进行了一项半结构化调查，测量了妇女接受的服务类型、妇女对服务的看法和怀孕结果。主要研究结果包括随访的出席率、两次随访中妇女获得的信息的类型和质量，以及米索前列醇用于终止妊娠的使用。结果：总体而言，55名（50.0%）妇女参加了随访服务。应用米索前列醇人工流产54例（98.2%）；38名（70.4%）妇女在随访时获得了避孕措施。年龄大于34岁的女性（比值比[OR] 2.2, 95%可信区间[CI] 0.1-35.8）、已婚（比值比2.1,95% CI 0.8-5.7）和小学后教育水平（比值比2.0,95% CI 0.8-5.3）参加随访的可能性增加。平均而言，44名（87.0%）妇女在最初的咨询会议上获得了所有所需的信息，没有人报告需要住院治疗的主要并发症。结论：为不安全堕胎提供减少伤害的服务是可行和可接受的，并且可以为坦桑尼亚减少与堕胎有关的发病率和死亡率提供一个极好的机会。
Objective: To investigate the feasibility of providing harm-reduction services to reduce unsafe abortion in Tanzania.Methods: A cross-sectional study was conducted among 110 women who received harm-reduction counseling at a public health center in Dar es Salaam between February 10 and October 10, 2014. Background and clinical information was collected for all women; a subgroup (n=50) undertook a semi-structured survey that measured the type of services women received, women's perception of the services, and pregnancy outcome. The main study outcomes were attendance at the follow-up visit, type and quality of information women received on both visits, and misoprostol use for pregnancy termination.Results: Overall, 55 (50.0%) women attended follow-up services. Misoprostol was used for induced abortion among 54 (98.2%); 38 (70.4%) of these women had obtained contraception at the follow-up visit. Likelihood of attendance for follow-up was increased among women who were older than 34 years (odds ratio [ OR] 2.2, 95% confidence interval [ CI] 0.1-35.8), were married (OR 2.1, 95% CI 0.8-5.7), and had a post--primary education level (OR 2.0, 95% CI 0.8-5.3). On average, 44 (87.0%) women received all required information at the initial counseling session and none reported major complications that required hospitalization.Conclusion: Harm-reduction services for unsafe abortion are feasible and acceptable, and could provide an excellent opportunity to fight abortion--related morbidity and mortality in Tanzania.