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

描述（由申请人提供）：本研究的长期目标是调查塞内加尔卫生专业人员对堕胎后护理的看法和做法。流产后护理是指对因不安全终止妊娠而出现产科并发症的妇女提供的紧急医疗和咨询服务。尽管塞内加尔的公共和私人卫生系统都提供堕胎后护理，但由于与终止妊娠有关的污名化，获得这些服务可能会受到阻碍。这项研究表明，保健专业人员对堕胎后护理的态度、观念和做法可能成为妇女获得医疗的障碍。本研究的目的是调查卫生专业人员对堕胎后护理的看法和寻求这些服务的客户。具体而言，该研究将探讨各种权力轴，如性别、职业类型和实践的类型和地点，以及获得社会、专业和经济资源如何影响卫生专业人员对堕胎后护理的看法。该研究将在为期一年的时间内进行，对60名卫生专业人员（医生、护士和助产士）进行深入的半结构化访谈，并对塞内加尔城市和农村地区的10名关键信息提供者进行结构化访谈。来自哥伦比亚大学和塞内加尔Cheikh Antia Diop大学的机构审查委员会将审查研究方案。塞内加尔卫生部将在向卫生专业人员宣布这项研究方面发挥关键作用。受访者将通过概率抽样技术从政府的供应商名单中选择。鉴于研究课题的敏感性，还将采用受访者驱动的抽样技术来加强卫生专业人员的招聘。研究方案将保护受访者的机密性和匿名性。访谈数据将通过内容分析进行分析，并采取措施确保可靠性。在研究期结束时，将向卫生部和其他利益攸关方汇报情况。不安全终止妊娠引起的并发症是塞内加尔妇女发病和死亡的主要原因。公共卫生相关性：通过探索卫生专业人员对堕胎后护理的看法和做法，本研究希望提供有用的信息，以确定获得救生护理的障碍。最终，本研究希望有助于制定政策和干预措施，改善获得堕胎后护理的机会，以降低塞内加尔的孕产妇死亡率和发病率。

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.