PDF(Pubmed)
Abstract：
Post-abortion care (PAC) counselling and the provision of contraceptive methods are core components of PAC services. Nevertheless, this service is not uniformly provided to PAC patients. This paper explores the factors contributing to young women leaving health facilities without counselling and contraceptive methods. The paper draws from an ethnographic study conducted in Kilifi County, Kenya, in 2021. We conducted participant observation in health facilities and neighbouring communities, and held in-depth interviews with 21 young women aged 15-24 who received PAC. In addition, we interviewed 11 healthcare providers recruited from the public and private health facilities observed. Findings revealed that post-abortion contraceptive counselling and methods were not always offered to patients as part of PAC as prescribed in the PAC guidelines. When PAC contraceptive counselling was offered, certain barriers affected uptake of the methods, including inadequate information, coercion by providers and partners, and fears of side effects. Together, these factors contributed to repeat unintended pregnancies and repeat abortions. The absence of quality contraceptive counselling therefore infringes on the right to health of girls and young women. Findings underscore the need to strengthen the capacities of health providers on PAC contraceptive counselling and address their attitudes towards young female PAC patients.
摘要：
堕胎后护理（PAC）咨询和提供避孕方法是PAC服务的核心组成部分。然而，这项服务并非统一提供给PAC患者。本文探讨了导致年轻妇女离开医疗机构而没有咨询和避孕方法的因素。本文来自在基利菲县进行的人种学研究，肯尼亚,2021年。我们在医疗机构和邻近社区进行了参与者观察，并对21名接受PAC的15-24岁年轻女性进行了深入采访。此外,我们采访了从所观察的公立和私立医疗机构招募的11名医疗服务提供者.研究结果表明，并不总是按照PAC指南的规定，将堕胎后避孕咨询和方法作为PAC的一部分提供给患者。当提供PAC避孕咨询时，某些障碍影响了方法的吸收，包括不充分的信息，供应商和合作伙伴的胁迫，和对副作用的恐惧。一起,这些因素导致反复意外妊娠和反复流产.因此，缺乏高质量的避孕咨询侵犯了女孩和年轻妇女的健康权。调查结果强调，需要加强卫生提供者在PAC避孕咨询方面的能力，并解决他们对年轻女性PAC患者的态度。
