scholarly journals ‘I didn’t feel judged’: exploring women’s access to telemedicine abortion in rural Australia

2020 ◽  
Vol 12 (1) ◽  
pp. 49 ◽  
Author(s):  
Sarah Ireland ◽  
Suzanne Belton ◽  
Frances Doran
Keyword(s):  
Rural Communities ◽  
Reproductive Health ◽  
Rural Areas ◽  
Low Cost ◽  
Geographical Location ◽  
Medical Abortion ◽  
Reproductive Health Services ◽  
Framework Analysis ◽  
Situational Contexts ◽  
Personal Skills

ABSTRACT INTRODUCTIONRegardless of geographical location, safe and legal abortion is an essential reproductive health service. Accessing an abortion is problematic for women in rural areas. Although telemedicine is globally established as safe and effective for medical abortion in urban settings, there is a paucity of research exploring access to telemedicine abortion for women in rural locations. AIMThe aim of this qualitative research is to explore and better understand women’s access to telemedicine abortion in Australian rural areas. METHODSStructured interviews were conducted with women (n=11) living in rural areas who had experienced a telemedicine abortion within the last 6 months. Phone interviews were recorded and transcribed verbatim. Data underwent a Patient-Centred Access framework analysis and were coded according to the domain categories of approachability/ability to perceive, acceptability/ability to seek, availability/ability to reach, affordability/ability to pay, and appropriateness/ability to engage. RESULTSRural women had severely limited access to abortion care. The five domains of the Patient-Centred Access model demonstrated that when women with the prerequisite personal skills and circumstances are offered a low-cost service with compassionate staff and technical competence, telemedicine can innovate to ensure rural communities have access to essential reproductive health services. DISCUSSIONTelemedicine offers an innovative model for ensuring women’s access to medical abortion services in rural areas of Australia and likely has similar applicability to international non-urban contexts. Strategies are needed to ensure women with lower literacy and less favourable situational contexts, can equitably access abortion services through telemedicine.

scholarly journals Testing a community-based distribution approach to reproductive health service delivery in Senegal (a study of community agents in Kébémer)

2004 ◽  
Keyword(s):  
Rural Communities ◽  
Reproductive Health ◽  
Service Delivery ◽  
Social Action ◽  
Rural Areas ◽  
Cost Effective ◽  
Health Service Delivery ◽  
Reproductive Health Services ◽  
Community Based ◽  
Integrated Cost

The Division of Reproductive Health (DSR) of the Senegal Ministry of Health and Social Action, in partnership with the Population Council’s FRONTIERS in Reproductive Health program and Management Sciences for Health (MSH), conducted a study to test and compare three ways of providing reproductive health services to rural communities in the Kébémer district of Senegal in terms of their effectiveness, cost, and cost-effectiveness. FRONTIERS and MSH collaborated with the DSR to design the interventions, MSH supported the DSR in implementing the interventions, and FRONTIERS undertook the evaluation. This study, funded by USAID, responded to the recommendations of a 1999 workshop, organized by FRONTIERS and the DSR, on the community-based distribution (CBD) approach, which defined alternative CBD models appropriate for Senegal. The DSR sees the development of community-based service delivery models as essential for the future of health care in Senegal. As noted in this report, the general objective of the study was to contribute to the development of an integrated cost-effective program to increase the accessibility and availability of reproductive health information and services in rural areas of Senegal.

scholarly journals Quick and collaborative response to teenage pregnancies in a poor semi-rural area of Belgium

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Déom ◽  
L Ben Abdelhafidh ◽  
N Annez ◽  
C Glorie ◽  
M Roland
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Rural Areas ◽  
Sexual And Reproductive Health ◽  
Health Clinic ◽  
Local Health ◽  
Reproductive Health Services ◽  
Sexually Transmitted ◽  
Victims Of Violence ◽  
The City

Abstract Early pregnancies are often linked to precarious situations. Even if Belgium has seen a decrease in teenage pregnancies, in the former mining region of the Hainaut there are still twice as many births to young women under 20 compared to the national rate. Colfontaine is one of the poorest cities in Belgium. Last year, one of the local high schools counted 10 pregnant teenagers out of 450 students. Médecins du Monde was already present in the city at the time with a mobile health clinic called the Médibus. In response, we carried out a mapping of the local sexual and reproductive health actors. The lack of accessibility to social and health structures capable of welcoming teenagers anonymously and free of charge quickly emerged as a problem, the nearest family planning center being located 30 minutes away by bus. In September 2019, in partnership with 5 local health actors, we decided to reshape the Médibus into the Adobus in order to offer family planning consultations, health promotion and harm reduction activities at the high school once a week. In addition to offering health information services, we also aim to detect teenagers experiencing vulnerable situations such as addiction, violence, gender issues and refer them to appropriate services. Halfway through the project, we met 430 teenagers in 14 afternoons. The most common reasons for consultation (N = 310) were questions related to contraception for 29% and to sexually transmitted infections for 24,5%. 70,9% of teenagers received condoms and 13 girls were tested for pregnancy. One girl received a morning-after pill. 3 teenagers with addiction problems and 17 victims of violence were detected. The teams referred 18 teenagers to other services. The success of this outreach project confirms the need for information regarding sexual and reproductive health for teenagers living in precarious situations as well as the need to develop reachable and affordable sexual and reproductive health services in semi-rural areas. Key messages Outreach is an efficient approach to respond to teenagers’ needs in poor semi-rural areas. Outreach facilitated the detection of early pregnancies, addiction and violence issues among teenagers.

Development of an Intervention to Support Reproductive Health of Garment Factory Workers in Cambodia

2020 ◽  
Author(s):  
Chris Smith ◽  
Ly Sokhey ◽  
Camille Tijamo ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Rural Areas ◽  
Intervention Mapping ◽  
Intervention Development ◽  
Community Support ◽  
Medical Abortion ◽  
Structured Interviews ◽  
Factory Workers ◽  
Garment Factory ◽  
Garment Factory Workers

Abstract Background: Garment factory workers in Cambodia are potentially a vulnerable population in terms of support for reproductive health issues and access to services, as the majority are young women aged under 30 years who have migrated from rural areas away from their family and community support. The aim of this paper was to describe the development of an intervention to support the reproductive health of garment factory workers in Cambodia.Methods: The research was conducted by a multidisciplinary team with backgrounds in public health, linguistics, digital cultures and service delivery in a suburb of Phnom Penh where many garment factories cluster. Informed by intervention mapping approaches, we conducted a needs assessment with general and participant observation and semi-structured interviews, followed by intervention development activities including specifying possible behaviour change, designing the intervention and producing and refining intervention content.Results: Our research identified some challenges that Cambodian garment factory workers experience regarding contraception and abortion. Concerns or experience of side-effects were identified as an important determinant leading to non-use of effective contraception and subsequent unintended pregnancy. Financial constraints or a desire to space pregnancies were the main reported reasons to seek an abortion. Information about medical abortion given to women by private providers was often verbal, with packaging and the drug information leaflet withheld. Given the observed widespread use of social media among factory workers, we developed three short ‘edutainment’ videos about contraception which were evaluated after one month. In addition we adapted three informative videos made by Marie Stopes International (MSI) from English to the Khmer language, and also adapted the MSI medical abortion ‘Mariprist’ instruction leaflet to a simple video format.Conclusions: We describe the development of an intervention to support reproductive health among garment factory workers in Cambodia. These videos could be further improved and additional videos could be developed. More work is required to develop appropriate and effective interventions to support reproductive health of garment factory workers in Cambodia.

Challenges of Seeking Reproductive Health Care in People Experiencing Intimate Partner Violence

2020 ◽  
pp. 088626052095962
Author(s):  
Carly O’Connor-Terry ◽  
Danielle Burton ◽  
Tejasvi Gowda ◽  
Adrianne Laing ◽  
Judy C. Chang
Keyword(s):  
Health Care ◽  
Intimate Partner Violence ◽  
Reproductive Health ◽  
Partner Violence ◽  
Low Cost ◽  
Intimate Partner ◽  
Reproductive Health Services ◽  
Structured Interviews ◽  
Reproductive Health Care ◽  
Title X

Title X is a federally funded family planning initiative that provides low-cost and confidential reproductive health services to its clients. In recent years, Title X has been the subject of debate as its core tenants have been revised by the current administration. Though advocates have fought against these changes, the voices of survivors on intimate partner violence are absent from this conversation. This study was designed to elicit the opinions and experiences on survivors of intimate partner violence on reproductive decision-making, their access to care, and their opinions about political efforts to restrict this access. Twenty-six semi-structured interviews were conducted with women who were seeking services for intimate partner violence. These interviews were audio-recorded, transcribed, and coded. Codes were then organized into themes. Participants endorsed the need for confidential services due to experiences of coercion from their partners and the fear of retaliation against them. Participants largely supported accessible contraception but reported the need for contraception to be reliable. Participants addressed pregnancy and its many complexities and advocated for nondirective options-counseling. Overall, participants spoke about their challenges with reproductive health care and their opinions on how best to service survivors of intimate partner violence. This study asserts the need for advocates for survivors to advocate for the preservation of Title X and establishes the need for future studies on the prevalence of intimate partner violence in Title X clinics.

scholarly journals Geographic accessibility of healthcare services and health seeking behaviours of rural communities in Kudat and Pitas areas of Sabah

2020 ◽  
Vol 1 (1) ◽  
pp. 46-54
Author(s):  
Oo Tha Naing ◽  
Wendy Diana Shoesmith ◽  
Chrystalle B. Y. Tan ◽  
Mohd Yusof Ibrahim ◽  
Syed Shajee Hussein
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Geographical Location ◽  
Healthcare Services ◽  
Health Staff ◽  
Vision 2020 ◽  
Health Seeking ◽  
Cross Sectional ◽  
Geographic Accessibility ◽  
Health Clinics

  Introduction: One of the aims outlined in Malaysia’s Health Vision 2020 is to be a nation of healthy individuals, families, and communities through an equitable, affordable, efficient, environmentally adaptable, and consumer friendly healthcare system. Sabah faces tremendous challenges to provide the best care for patients. For example, Sabah's unique geographical location and landscape, such as steep hills and rivers, is one of the challenges that health staff faces. Objectives of this study aimed to examine the prevalence of geographical accessibility, types of healthcare services, and the types of health seeking behaviour in 2 northern rural areas of Sabah to assess the geographic accessibility and availability of healthcare services. Materials and Methods: A community-based cross-sectional study was conducted in two rural areas in Sabah—Kudat and Pitas. Data collection was done by using questionnaire and face–to-face interviews. Results: It was found that 48% of the study population sought healthcare and they mainly chose healthcare services from hospitals and health clinics. Conclusion: Half of the population in the areas studied used healthcare in the last year. The choice of using a public hospital or community health clinics was determined by distance from residence.

Accelerating rural sanitation coverage in Ghana: what are the speed bumps impeding progress?

2015 ◽  
Vol 5 (4) ◽  
pp. 531-543 ◽  
Author(s):  
Isaac Monney ◽  
Amos Baffoe-Kyeremeh ◽  
Papa Kofi Amissah-Reynolds
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Low Cost ◽  
Group Discussions ◽  
Human Resource Capacity ◽  
Household Level ◽  
Face To Face ◽  
Local Assembly ◽  
Improved Sanitation ◽  
Sanitation Promotion

Progress towards the Millennium Development Goal (MDG) sanitation target has generally been slow-paced in Ghana. This is particularly the case in rural areas where access to improved sanitation has increased by just 4% within two decades. This paper examines defecation practices as well as constraints and existing opportunities at both household and institutional levels in promoting in-house toilet construction. The study was conducted in three rural communities in the Tain district and drew on key informant interviews, focus group discussions, field observations and face-to-face interviews of 400 residents selected from 249 houses. The results showed the scarcity of in-house toilets, which means consequently open defecation and use of communal toilets are common practices. The need for in-house toilet facilities is high among property owners without them, mainly driven by the desire for comfort and safety. Barriers at the household level constraining latrine installation include ignorance of low-cost technologies, the perceived high cost of latrines and the low priority given to their ownership. Analysis of expenditure patterns at the local assembly shows low priority afforded to sanitation promotion, which is constrained by low donor support, lack of requisite logistics and poor human resource capacity. Existing opportunities for accelerating sanitation coverage in these study communities are examined both at the household and institutional levels, and best practices discussed.

Development of an Intervention to Support Reproductive Health of Garment Factory Workers in Cambodia

2020 ◽  
Author(s):  
Chris Smith ◽  
Ly Sokhey ◽  
Camille Tijamo ◽  
Megan McLaren ◽  
Caroline Free ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Rural Areas ◽  
Intervention Mapping ◽  
Intervention Development ◽  
Community Support ◽  
Medical Abortion ◽  
Structured Interviews ◽  
Factory Workers ◽  
Garment Factory ◽  
Garment Factory Workers

Abstract Background: Garment factory workers in Cambodia are potentially a vulnerable population in terms of support for reproductive health issues and access to services, as the majority are young women aged under 30 years who have migrated from rural areas away from their family and community support. The aim of this paper was to describe the development of an intervention to support the reproductive health of garment factory workers in Cambodia.Methods: The research was conducted by a multidisciplinary team with backgrounds in public health, linguistics, digital cultures and service delivery in a suburb of Phnom Penh where many garment factories cluster. Informed by intervention mapping approaches, we conducted a needs assessment with general and participant observation and semi-structured interviews, followed by intervention development activities including specifying possible behaviour change, designing the intervention and producing and refining intervention content.Results: Our research identified some challenges that Cambodian garment factory workers experience regarding contraception and abortion. Concerns or experience of side-effects were identified as an important determinant leading to non-use of effective contraception and subsequent unintended pregnancy. Financial constraints or a desire to space pregnancies were the main reported reasons to seek an abortion. Information about medical abortion given to women by private providers was often verbal, with packaging and the drug information leaflet withheld. Given the observed widespread use of social media among factory workers, we developed three short ‘edutainment’ videos about contraception which were evaluated after one month. In addition we adapted three informative videos made by Marie Stopes International (MSI) from English to the Khmer language, and also adapted the MSI medical abortion ‘Mariprist’ instruction leaflet to a simple video format.Conclusions: We describe the development of an intervention to support reproductive health among garment factory workers in Cambodia. These videos could be further improved and additional videos could be developed. More work is required to develop appropriate and effective interventions to support reproductive health of garment factory workers in Cambodia.Trial registration: N/A

scholarly journals Access to Reproductive Health Services and Maternal Perceptions on Family Planning in an Indigenous Guatemalan Valley

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Lauren Ashley Lambert ◽  
Jeremy Brittingham Hatcher ◽  
Xinyu Wang
Keyword(s):  
Family Planning ◽  
Rural Communities ◽  
Reproductive Health ◽  
Reproductive Health Services ◽  
Staff Members ◽  
Contraception Use ◽  
Planning Methods ◽  
Women And Children ◽  
Family Planning Methods ◽  
Structured Questionnaire

Objective. To identify reproductive health barriers and perceptions regarding family planning among mothers in ten rural communities of Guatemala. Methods. Data were collected from 85 women in a Nutrition Recuperation Project (NRP) conducted by a freestanding nonprofit clinic in Palajunoj Valley, Guatemala. All nonpregnant women participating in the NRP were eligible for enrollment in this study, and NRP staff members aided in their enrollment. Participants were interviewed and data were entered into a structured questionnaire. Data analysis was conducted using R version 1.1.456. Results. After asking participants if they believed fertility is higher on certain days, only 5 women (5.9%) correctly identified these days as occurring in the middle of the menstrual cycle. 35 women (41.2%) practiced some form of family planning, and 27 (31.8%) reported that they do not know of a place where they could obtain a contraceptive method. Conclusion. There is a lack of education regarding family planning methods in this valley, and the levels of contraception use are below average for rural Guatemala. These findings may implicate substantial health risks for women and children in the valley, and they support the pertinence of education-based interventions in the area of reproductive health behaviors.

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