PDF(Pubmed)
Abstract：
Routine assessment of health facility capacity to provide abortion and post-abortion care can inform policy and programmes to expand access and improve quality. Since 2018, abortion and/or post-abortion care have been integrated into two WHO health facility assessment tools: the Service Availability and Readiness Assessment and the Harmonised Health Facility Assessment. We discuss lessons learnt through experiences integrating abortion into these standardised tools. Our experiences highlight the feasibility of including abortion in health facility assessments across a range of legal contexts. Factors facilitating the integration of abortion include cross-country collaboration and experience sharing, timely inputs into tool adaptations, clear leadership, close relationships among key stakeholders as in assessment coordination groups, use of locally appropriate terminology to refer to abortion and reference to national policies and guidelines. To facilitate high-quality data collection, we identify considerations around question sequencing in tool design, appropriate terminology and the need to balance the normalisation of abortion with adequate sensitisation and education of data collectors. To facilitate appropriate and consistent analysis, future work must ensure adequate disaggregation of recommended and non-recommended abortion methods, alignment with national guidelines and development of a standardised approach for measuring abortion service readiness. Measurement of abortion service availability and readiness should be a routine practice and a standardised component of health facility assessment tools. Evidence generated by health facility assessments that include abortion monitoring can guide efforts to expand access to timely and effective care and help normalise abortion as a core component of sexual and reproductive healthcare.
摘要：
对医疗机构提供堕胎和堕胎后护理的能力进行常规评估，可以为扩大准入和提高质量的政策和方案提供信息。自2018年以来，堕胎和/或堕胎后护理已被纳入两个世卫组织卫生机构评估工具：服务可用性和就绪性评估和协调卫生机构评估。我们讨论了通过将堕胎整合到这些标准化工具中的经验吸取的教训。我们的经验强调了在一系列法律背景下将堕胎纳入医疗机构评估的可行性。促进堕胎融合的因素包括跨国合作和经验分享，及时输入工具适应性，明确的领导,在评估协调小组中，关键利益相关者之间的密切关系，使用当地适当的术语来指代堕胎和参考国家政策和准则。为了促进高质量的数据收集，我们确定了在工具设计中围绕问题排序的考虑因素，适当的术语，以及平衡堕胎正常化与数据收集者足够的敏感性和教育的必要性。为了促进适当和一致的分析，未来的工作必须确保对推荐和不推荐的堕胎方法进行充分分类，与国家指导方针保持一致，并制定了衡量堕胎服务准备情况的标准化方法。测量堕胎服务的可用性和准备情况应成为常规做法，也是医疗机构评估工具的标准化组成部分。包括堕胎监测在内的卫生机构评估产生的证据可以指导努力扩大获得及时有效护理的机会，并帮助将堕胎作为性和生殖保健的核心组成部分正常化。
