Suchergebnisse

Objective: To investigate factors associated with women's choice of medical abortion (MA) or manual vacuum aspiration (MVA) in Nepal, where the government recently began offering MA services. Methods: Structured exit interviews were conducted between January 19 and May 21, 2010, with women with a pregnancy of 63 days or less who underwent abortions at 7 clinics in 3 districts of Nepal. All those who accepted MA, and 1 in each 4 or 5 of those who underwent MVA, were invited for an interview. Of those interviewed, 499 chose MA and 542 underwent MVA. Results: Many women were not aware of both abortion methods before they came to the clinic. The odds of choosing MA were more than 3 times as high among those who knew about both methods as among those who did not. Of those who had decided on MVA prior to receiving information at the clinic, 29% chose MA. In contrast, only 10% of those who intended to accept MA opted for MVA after receiving information and counseling. Women who had more education, were of the upper Hindu caste, or resided in urban areas were more likely to choose MA. Conclusion: Information and counseling have a large impact on the women's choice of an abortion method. To expand access to MA and to ensure that women can make an informed choice, it is essential that the government of Nepal create positions for trained counselors at all public abortion clinics.

Objective: To investigate factors associated with women's choice of medical abortion (MA) or manual vacuum aspiration (MVA) in Nepal, where the government recently began offering MA services. Methods: Structured exit interviews were conducted between January 19 and May 21, 2010, with women with a pregnancy of 63 days or less who underwent abortions at 7 clinics in 3 districts of Nepal. All those who accepted MA, and 1 in each 4 or 5 of those who underwent MVA, were invited for an interview. Of those interviewed, 499 chose MA and 542 underwent MVA. Results: Many women were not aware of both abortion methods before they came to the clinic. The odds of choosing MA were more than 3 times as high among those who knew about both methods as among those who did not. Of those who had decided on MVA prior to receiving information at the clinic, 29% chose MA. In contrast, only 10% of those who intended to accept MA opted for MVA after receiving information and counseling. Women who had more education, were of the upper Hindu caste, or resided in urban areas were more likely to choose MA. Conclusion: Information and counseling have a large impact on the women's choice of an abortion method. To expand access to MA and to ensure that women can make an informed choice, it is essential that the government of Nepal create positions for trained counselors at all public abortion clinics.

Abstract Background The challenge of delivering multiple, complex messages to promote maternal and newborn health in the terai region of Nepal was addressed through training Female Community Health Volunteers (FCHVs) to counsel pregnant women and their families using a flipchart and a pictorial booklet that was distributed to clients. The booklet consists of illustrated messages presented on postcard-sized laminated cards that are joined by a ring. Pregnant women were encouraged to discuss booklet content with their families. Methods We examined use of the booklet and factors affecting adoption of practices through semi-structured interviews with district and community-level government health personnel, staff from the Nepal Family Health Program, FCHVs, recently delivered women and their husbands and mothers-in-law. Results The booklet is shared among household members, promotes discussion, and is referred to when questions arise or during emergencies. Booklet cards on danger signs and nutritious foods are particularly well-received. Cards on family planning and certain aspects of birth preparedness generate less interest. Husbands and mothers-in-law control decision-making for maternal and newborn care-seeking and related household-level behaviors. Conclusions Interpersonal peer communication through trusted community-level volunteers is an acceptable primary strategy in Nepal for promotion of household-level behaviors. The content and number of messages should be simplified or streamlined before being scaled-up to minimize intervention complexity and redundant communication.