Abortion as agentive action: reproductive agency among young women seeking post-abortion care in Uganda

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Study Justification:
– Unsafe abortion is a major contributor to global maternal mortality, particularly affecting young women in Africa.
– Uganda has legal restrictions and stigma surrounding abortion, leading to a significant public health issue.
– This study aims to explore reproductive agency among young women seeking post-abortion care in Uganda, providing unique insights into their experiences and needs.
Highlights:
– Through in-depth interviews, the study found that reproductive agency was constrained by gender norms, power imbalances, and stigma.
– Lack of resources and the need for secrecy resulted in harmful abortion practices and delayed care-seeking.
– Women did not claim ownership of the abortion decision, but viewed it as an agentive action to regain control over their bodies and futures.
– Women’s experiences shaped their contraceptive intentions and discourse, highlighting missed opportunities for comprehensive sexual and reproductive health care.
Recommendations:
– Health systems in Uganda should strengthen efforts to meet young women’s sexual and reproductive health needs and protect their rights.
– Access to safe abortion and contraception is paramount in enabling young women’s agency.
– Addressing gender norms, power imbalances, and stigma is crucial in promoting reproductive autonomy and reducing unsafe abortion.
Key Role Players:
– Ministry of Health: Responsible for policy development and implementation of sexual and reproductive health programs.
– Non-governmental organizations (NGOs): Involved in advocacy, service provision, and community education on sexual and reproductive health.
– Health care providers: Play a vital role in delivering comprehensive sexual and reproductive health care services.
– Community leaders and influencers: Can help challenge stigma and promote positive attitudes towards reproductive health.
Cost Items for Planning Recommendations:
– Training and capacity building for health care providers on safe abortion and contraception.
– Development and dissemination of educational materials on sexual and reproductive health.
– Implementation of community awareness campaigns to challenge stigma and promote reproductive rights.
– Provision of affordable and accessible contraceptive methods.
– Strengthening health systems to ensure availability of post-abortion care services.
– Monitoring and evaluation of program effectiveness and impact.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study conducted in-depth interviews to explore reproductive agency among young women seeking post-abortion care in Uganda. It identified constraints on reproductive agency, such as gender norms, power imbalances, and stigma. The study also highlighted the harmful abortion practices and delayed care-seeking resulting from lack of resources and the need for secrecy. The findings suggest that women view abortion as an agentive action to regain control over their bodies and future. The study provides unique insights into how young women negotiate and enact reproductive agency in Uganda. To improve the strength of the evidence, the study could have included a larger sample size and used a mixed-methods approach to complement the qualitative interviews with quantitative data. Additionally, conducting follow-up interviews or surveys to assess the long-term impact of reproductive agency on women’s health outcomes would provide further evidence.

Unsafe abortion in Africa continues to be a major contributor to the global maternal mortality which affects young women in particular. In Uganda, where abortion is legally restricted and stigmatised, unsafe abortion is a major public health issue. We explored reproductive agency in relation to unsafe abortion among young women seeking post-abortion care. Through in-depth interviews we found that reproductive agency was constrained by gender norms and power imbalances and strongly influenced by stigma. Lack of resources and the need for secrecy resulted in harmful abortion practices and delayed care-seeking. Women did not claim ownership of the abortion decision, but the underlying meaning in the narratives positioned abortion as an agentive action aiming to regain control over one′s body and future. Women′s experiences shaped contraceptive intentions and discourse, creating a window of opportunity that was often missed. This study provides unique insight into how young women negotiate and enact reproductive agency in Uganda. Health systems need to strengthen their efforts to meet young women’s sexual and reproductive health needs and protect their rights. Enabling young women’s agency through access to safe abortion and contraception is paramount.

Based on the publication “Abortion as agentive action: reproductive agency among young women seeking post-abortion care in Uganda,” the following recommendations can be developed into innovations to improve access to maternal health:

1. Strengthening Health Systems: Develop a mobile health application that provides information on safe abortion services and contraception options, as well as a directory of healthcare facilities that offer these services. This app can also include a feature for scheduling appointments and reminders for contraceptive use.

2. Addressing Gender Norms and Power Imbalances: Create a community-based program that educates both young women and men on gender equality and reproductive rights. This program can include workshops, peer support groups, and mentorship opportunities to challenge and change harmful gender norms and power imbalances.

3. Reducing Stigma: Launch a multimedia campaign that aims to destigmatize abortion and promote understanding and empathy towards young women seeking post-abortion care. This campaign can include TV and radio advertisements, social media campaigns, and community events featuring testimonials from women who have sought post-abortion care.

4. Providing Resources: Establish a fund that provides financial support to young women who cannot afford safe abortion services or contraception. This fund can also be used to provide transportation vouchers to healthcare facilities and distribute informational materials on reproductive health.

5. Empowering Young Women: Develop a comprehensive sexual and reproductive health education curriculum that is integrated into schools and community centers. This curriculum should focus on empowering young women to make informed decisions about their reproductive health, including information on safe abortion, contraception, and self-advocacy.

By implementing these innovations, access to maternal health can be improved in Uganda, particularly for young women seeking post-abortion care. These innovations aim to address the underlying factors that contribute to unsafe abortion practices and delayed care-seeking, while empowering young women to take control of their reproductive health.
AI Innovations Description
Based on the publication “Abortion as agentive action: reproductive agency among young women seeking post-abortion care in Uganda,” the following recommendation can be developed into an innovation to improve access to maternal health:

1. Strengthening Health Systems: Health systems in Uganda need to prioritize and invest in meeting the sexual and reproductive health needs of young women. This includes improving access to safe abortion services and contraception.

2. Addressing Gender Norms and Power Imbalances: Efforts should be made to challenge and change gender norms and power imbalances that constrain reproductive agency. This can be done through education, awareness campaigns, and community engagement.

3. Reducing Stigma: Stigma surrounding abortion needs to be addressed to create an environment where young women feel comfortable seeking post-abortion care. This can be achieved through public education, destigmatization campaigns, and involving community leaders and influencers.

4. Providing Resources: Lack of resources often leads to harmful abortion practices and delayed care-seeking. Health systems should ensure that young women have access to the necessary resources, including financial support, information, and healthcare facilities.

5. Empowering Young Women: Enabling young women’s agency is crucial in improving access to maternal health. This can be done by providing comprehensive sexual and reproductive health education, promoting self-advocacy, and ensuring their rights are protected.

By implementing these recommendations, an innovation can be developed to improve access to maternal health in Uganda, particularly for young women seeking post-abortion care. This innovation should focus on addressing the underlying factors that contribute to unsafe abortion practices and delayed care-seeking, while empowering young women to make informed decisions about their reproductive health.
AI Innovations Methodology
To simulate the impact of the main recommendations mentioned in the abstract on improving access to maternal health, a mixed-methods research methodology can be employed. Here is a brief description of the methodology:

1. Quantitative Data Collection: Conduct a survey or use existing data sources to gather quantitative data on the current state of maternal health access in Uganda, particularly among young women seeking post-abortion care. This data can include information on the availability and utilization of safe abortion services, contraception usage, gender norms, power imbalances, stigma, and resources.

2. Qualitative Data Collection: Conduct in-depth interviews or focus group discussions with young women who have sought post-abortion care in Uganda. Explore their experiences, challenges, and decision-making processes related to reproductive agency, access to maternal health services, and the impact of gender norms, power imbalances, and stigma. This qualitative data will provide rich insights into the lived experiences of young women and help understand the underlying factors influencing access to maternal health.

3. Data Analysis: Analyze the quantitative data using statistical methods to identify patterns, trends, and associations between variables related to maternal health access. Use qualitative data analysis techniques, such as thematic analysis, to identify key themes, barriers, and facilitators to accessing maternal health services among young women.

4. Simulation Modeling: Develop a simulation model that incorporates the findings from the quantitative and qualitative data analysis. This model can simulate the impact of implementing the main recommendations mentioned in the abstract on improving access to maternal health. The model can estimate the potential changes in access to safe abortion services, contraception usage, reduction in stigma, and improvement in resources based on different scenarios and interventions.

5. Impact Assessment: Evaluate the simulated impact of the recommendations by comparing the outcomes of the simulation model with the baseline data. Assess the potential improvements in access to maternal health services, reduction in unsafe abortion practices, and changes in reproductive agency among young women.

6. Policy and Program Recommendations: Based on the findings from the simulation model and impact assessment, develop policy and program recommendations to improve access to maternal health in Uganda. These recommendations should be informed by the evidence gathered from the quantitative and qualitative data analysis and the simulated impact of the main recommendations mentioned in the abstract.

By following this methodology, researchers can gain insights into the potential impact of implementing the recommendations mentioned in the abstract on improving access to maternal health in Uganda. This can inform evidence-based decision-making and guide the development of interventions and policies to address the barriers faced by young women seeking post-abortion care.

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