Asha: Co-producing abortion knowledge & impact outputs with lay community health intermediaries in India

我的研究表明，迫切需要考虑到妇女的需求和生活的现实，在堕胎护理提供在印度。虽然自1971年以来堕胎是法律的，但妇女在获得安全服务方面继续遇到障碍;大多数堕胎是在保健设施之外进行的。我记录了妇女的堕胎经历，说明妇女与卫生工作者和卫生系统的互动如何涉及无数的拖延、谈判和抗议，而这些都是以堕胎的耻辱为基础的。我的研究结果表明，像认可的社会健康活动家（ASHA）这样的非专业社区健康中介机构（CHIs）在妇女的堕胎经历中发挥着关键作用，使或限制获得一系列堕胎相关服务，但缺乏准确的信息。我发现他们的培训没有充分涵盖堕胎相关的信息或支持。此外，在培训材料和结构中仍然存在高度医学化的堕胎方法，忽视了妇女的经验和由其社会和经济环境形成的需求。利用这些数据和叙述，我建议使用视觉方法来共同制作的影响和学术成果的一系列观众，包括学术界，倡导和政策organizations. Building现有的关系，我将与组织，培训堕胎相关的护理提供ASHA设计和提供一个新颖的研讨会。在这次研讨会中，我将利用参与式方法与大约30 - 45名ASHA共同创建一套视觉资源（例如，zines-使用图像，草图和叙述创建的小册子，用于创建实践社区）。我还将调查音频材料的制作，以产生更大的影响，为了促进知识交流，我将确保这些材料广泛提供，并使各种群体都能获得，例如从事性健康和生殖健康及权利工作的组织、政策行为者或培训卫生工作者的机构。我将创建和维护一个项目网站，以确保资源的可用性，并确定现有的传播渠道（如国家ASHA指导小组或CHW中心）。我还将制作关于研讨会方法和过程的资源，因此它可以适用于印度或其他环境中CHI培训的不同设置。我将使用copyleft许可证对这些成果进行复制、修改或改编，以适应当地的具体情况。我工作的核心要素之一是将学术界与政策或宣传干预联系起来。我热衷于继续与民间社会组织建立强有力的伙伴关系，以确保我的研究有助于-直接或间接-在地方或社区层面的政策，宣传或运动的努力。为了将这两个不同的受众聚集在一起，我将组织一个国际研讨会，讨论在性健康和生殖健康权利方面共同制作的研究和干预措施。我热衷于建立我的学术和研究生涯，渴望继续致力于与性健康和生殖健康权利和妇女健康有关的关键社会科学研究问题。为此，我将开发两个赠款提交给研究资助者。我还将专注于建立我的出版记录和传播我的学术工作。我将根据与ASHA的研讨会，写一篇关于我开发和实现的方法的学术文章。我也将继续把我的博士研究改编成至少三篇文章。我的目标是将这些文章提交给我所在领域的知名期刊，并以我之前发表高影响力文章的经验为基础。

My research demonstrates the urgent need to account for women's needs and lived realities in abortion care-provision in India. While abortion has been legal since 1971, women continue to encounter barriers to safe services; with the majority of abortions occurring outside of health facilities. I documented women's abortion experiences, illustrating how women's interactions with health workers and the health system involved numerous delays, negotiations and contestations that were underpinned by abortion stigma. My findings demonstrate that lay community health intermediaries (CHIs) like Accredited Social Health Activists (ASHAs) play pivotal roles in women's abortion experiences, enabling or restricting access to a range of abortion-related services, but lack accurate information. I found that their training does not adequately cover abortion-related information or support. Additionally, a highly medicalised approach to abortion persists in training materials and structures, overlooking women's experiences and needs that are shaped by their social and economic environments. Drawing on these data and narratives, I propose using visual methodologies to co-produce impact and scholarly outputs for a range of audiences including academia, and advocacy and policy organisations.Building on existing relationships, I will work with an organisation that trains ASHAs on abortion-related care provision to design and deliver a novel workshop. In this workshop, I will utilise participatory methods to co-create, with approximately 30-45 ASHAs, a set of visual resources (e.g. zines- booklets created using images, sketches & narratives, used to create communities of practice). I will also investigate the production of audio materials for greater impact.In order to enable knowledge exchange, I will ensure that these materials are made widely available and remain accessible to a range of groups- e.g. organisations working on sexual and reproductive health and rights (SRHR), policy actors, or institutions that train health workers. I will create and maintain a project website to ensure availability of resources and identify existing channels for dissemination (e.g. National ASHA Mentoring Group or CHW Central). I will also produce a resource on the workshop methodology and process, so it can be adapted for different settings for CHI trainings in India or other contexts. I will use a copyleft licence for these outputs, allowing copying, modification or adaptation for specific local contexts.One of the core elements of my work is linking academia with policy or advocacy interventions. I am keen to continue building strong partnerships with civil society organisations to ensure my research contributes- directly or indirectly- to policy, advocacy or campaigning efforts at local or community levels. To bring these two different audiences together, I will organise an international workshop to discuss co-produced research and interventions in SRHR.I am keen to build my academic and research career, aspiring to continue working on crucial social science research questions relating to SRHR and women's health. Towards that, I will be developing two grants for submission to research funders. I will also focus on building my publication record and disseminating my scholarly work. I will, based on the workshop with ASHAs, write one academic article on the methodology I developed and implemented. I will also continue to adapt my PhD research into at least three more articles. I aim to submit these to prestigious journals in my field, building on my previous experience of publishing high-impact articles.