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

我的研究表明，迫切需要考虑妇女的需求和印度堕胎护理提供的生活现实。虽然自1971年以来堕胎是合法的，但妇女在获得安全服务方面仍然遇到障碍；大多数堕胎发生在医疗机构之外。我记录了妇女的堕胎经历，说明了妇女与卫生工作者和卫生系统的互动如何涉及许多延误、谈判和争论，这些都是堕胎耻辱的基础。我的研究结果表明，非专业社区卫生中介机构（CHIs），如经认证的社会卫生活动家（ASHAs），在妇女堕胎经历中发挥着关键作用，能够或限制获得一系列与堕胎相关的服务，但缺乏准确的信息。我发现他们的培训没有充分涵盖与堕胎相关的信息或支持。此外，在培训材料和结构中，对堕胎采取高度医疗化的做法，忽视了妇女的社会和经济环境所形成的经验和需求。根据这些数据和叙述，我建议使用视觉方法为包括学术界，倡导和政策组织在内的一系列受众共同产生影响和学术产出。在现有关系的基础上，我将与一个培训asha堕胎相关护理的组织合作，设计和提供一个新颖的研讨会。在这个研讨会上，我将利用参与式的方法，与大约30-45名asha共同创造一套视觉资源（例如，使用图像、草图和叙述创建的杂志-小册子，用于创建实践社区）。我还将研究音频材料的制作，以产生更大的影响。为了促进知识交流，我将确保广泛提供这些材料，并使各种群体——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——能够随时获得这些材料。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（例如国家ASHA辅导小组或CHW中心）。我还将制作一份关于研讨会方法和流程的资源，以便它可以适应印度或其他环境中CHI培训的不同设置。我将对这些输出使用copyleft许可，允许针对特定的本地环境进行复制、修改或改编。我工作的核心要素之一是将学术界与政策或倡导干预联系起来。我渴望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——直接或间接地——为地方或社区层面的政策、倡导或竞选活动做出贡献。为了将这两种不同的受众聚集在一起，我将组织一次国际研讨会，讨论共同开展的SRHR研究和干预措施。我渴望建立我的学术和研究事业，渴望继续从事与SRHR和妇女健康有关的关键社会科学研究问题。为此，我将向研究资助者提交两项拨款。我也将专注于建立我的出版记录和传播我的学术工作。我将在asha研讨会的基础上，写一篇关于我开发和实现的方法的学术文章。我还将继续将我的博士研究改编成至少三篇以上的文章。我的目标是将这些文章提交给我所在领域的知名期刊，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.