Professional Dilemmas:Health Workers' Perceptions of Postabortion Care in Senegal

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DESCRIPTION (provided by applicant): The long-term objective of this study is to investigate health professionals' perceptions and practices regarding post abortion care in Senegal. Post abortion care refers to emergency medical treatment and counseling services for women experiencing obstetric complications due to unsafe pregnancy termination. Although post abortion care is available throughout the public and private health system in Senegal, access to these services may be hindered due to stigma related to termination of pregnancy. This study proposes that health professionals' attitudes, perceptions and practices regarding post abortion care may serve as barriers to women accessing medical treatment. The study aims to investigate health professionals' perceptions of post abortion care and the clients seeking these services. Specifically, the study will explore how various axes of power, such as gender, type of profession and type and location of practice, and access to social, professional and economic resources shape health professionals' perceptions of post abortion care. The study will be conducted over a 1-year period of in-depth, semi-structured interviews with 60 health professionals (doctors, nurses and midwives) and structured interviews with 10 key informants in urban and rural sites in Senegal. Institutional Review Boards from Columbia University and Cheikh Antia Diop University in Senegal will review the research protocol. The Senegalese Ministry of Health will play a key role in announcing the study to health professionals. Respondents will be selected through probabilistic sampling techniques from government lists of providers. Given the sensitive nature of the research topic, respondent-driven sampling techniques will also be used to enhance the recruitment of health professionals. The research protocol will protect confidentiality and anonymity of respondents. Interview data will be analyzed through content analysis with measures taken to ensure reliability. The Ministry of Health and other stakeholders will be debriefed at the end of the research period. Complications from unsafe pregnancy termination are a leading cause of morbidity and mortality for women in Senegal. PUBLIC HEALTH RELEVANCE: By exploring health professionals' perceptions and practices regarding post abortion care, this study hopes to provide information that is useful in identifying barriers to accessing life-saving care. Ultimately, this study hopes to contribute to the development of policies and interventions that improve access to post abortion care in order to reduce maternal mortality and morbidity in Senegal.