Abstract：
We report on a comparative situational analysis of comprehensive abortion care (CAC) in Botswana, Eswatini, Lesotho and Namibia. We conducted systematic literature searches and country consultations and used a reparative health justice approach (with four dimensions) for the analysis. The following findings pertain to all four countries, except where indicated. Individual material dimension: pervasive gender-based violence (GBV); unmet need for contraception (15-17%); high HIV prevalence; poor abortion access for rape survivors; fees for sexual and reproductive health (SRH) services (Eswatini). Collective material dimension: no clear national budgeting for SRH; over-reliance on donor funding (Eswatini; Lesotho); no national CAC guidelines or guidance on legal abortion access; poor data collection and management systems; shortage and inequitable distribution of staff; few facilities providing abortion care. Individual symbolic dimension: gender norms justify GBV; stigma attached to both abortion and unwed or early pregnancies. Collective symbolic dimension: policy commitments to reducing unsafe abortion and to post-abortion care, but not to increasing access to legal abortion; inadequate research; contradictions in abortion legislation (Botswana); inadequate staff training in CAC. Political will to ensure CAC within the country\'s legislation is required. Reparative health justice comparisons provide a powerful tool for foregrounding necessary policy and practice change.
摘要：
我们报告了博茨瓦纳综合堕胎护理（CAC）的比较情况分析，埃斯瓦蒂尼,莱索托和纳米比亚。我们进行了系统的文献检索和国家咨询，并使用了恢复性健康正义方法（具有四个维度）进行了分析。以下调查结果涉及所有四个国家，除非另有说明。个人物质层面：普遍存在的基于性别的暴力（GBV）；未满足的避孕需求（15-17％）；艾滋病毒感染率高；强奸幸存者堕胎机会差；性健康和生殖健康（SRH）服务费（Eswatini）。集体物质层面:没有明确的生殖健康国家预算；过度依赖捐助者资金(埃斯瓦蒂尼；莱索托)；没有关于合法堕胎的国家CAC准则或指导；数据收集和管理系统差；工作人员短缺和分配不均；提供堕胎护理的设施很少。个人象征意义：性别规范为性别暴力辩护；堕胎和未婚或早孕都受到污名化。集体象征层面:减少不安全堕胎和堕胎后护理的政策承诺，但不增加获得合法堕胎的机会；研究不足；堕胎立法中的矛盾（博茨瓦纳）；CAC的人员培训不足。需要确保CAC在该国立法范围内的政治意愿。恢复性健康正义比较为必要的政策和实践变革提供了有力的工具。
