Induced abortion in Papua-New Guinea: Experience and opinions of health professionals

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Study Justification:
– Papua-New Guinea (PNG) has one of the highest maternal mortality rates in the world, with complications from unsafe abortion being a significant contributor.
– Abortion laws in PNG are restrictive, making safe, induced abortions inaccessible to most women.
– Unsafe abortions are prevalent throughout the country.
– The topic of abortion is stigmatized for women and health professionals.
Study Highlights:
– The study aimed to investigate the experiences and opinions of PNG health professionals regarding induced abortion and the provision of safe, accessible abortion services for women in PNG.
– Questionnaires were distributed to doctors working in provincial hospitals, doctors and nursing staff in Port Moresby General Hospital, and medical, nursing, and health sciences students at the University of Papua-New Guinea.
– Results revealed that a significant number of senior medical officers and nurses had encountered women seeking care after unsafe induced abortions.
– There was a wide variation in knowledge of PNG’s abortion laws and views on the provision of safe, accessible abortion services among respondents.
Study Recommendations:
– Abortion training should be provided to healthcare service providers to ensure they have the necessary skills and knowledge to offer safe abortion care.
– Primary care services should be expanded to include abortion care, ensuring equitable access for PNG women and reducing the need for untrained providers or self-abortion attempts.
– Innovative approaches should be adopted to complement existing family planning efforts in PNG.
Key Role Players:
– Healthcare service providers (doctors, nurses, midwives) for training and provision of abortion care.
– Government officials and policymakers for policy changes and allocation of resources.
– NGOs and international organizations for support, funding, and technical assistance.
– Community leaders and advocates for raising awareness and reducing stigma.
Cost Items for Planning Recommendations:
– Training programs for healthcare service providers on abortion care.
– Development and implementation of guidelines and protocols for safe abortion services.
– Equipment and supplies for providing abortion care.
– Capacity building and infrastructure development for primary care services.
– Awareness campaigns and educational materials to reduce stigma and increase knowledge about abortion.
– Monitoring and evaluation systems to assess the impact of the recommendations.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study conducted a questionnaire among health professionals in Papua-New Guinea to gather their experience and opinions on induced abortion and the provision of safe abortion services. The results indicate that significant numbers of medical officers and nurses have encountered women seeking care after unsafe induced abortions. However, the abstract does not provide specific details about the sample size, response rate, or statistical analysis conducted. To improve the strength of the evidence, the study could include a larger and more diverse sample, provide more information about the methodology, and conduct statistical analysis to support the reported findings.

Background: Papua-New Guinea (PNG) has one of the highest maternal mortality rates in the world; complications due to unsafe abortion are an important cause. Abortion laws are restrictive, and safe, induced abortions are unavailable to the majority of women, while unsafe abortions are known to be practised throughout the country. The topic of abortion is stigmatised, for women and health professionals. Aim: To conduct a study of PNG health professionals’ experience of induced abortion and their views on the provision of safe, accessible abortion services for PNG women. Materials and Methods: A questionnaire developed from similar surveys conducted in Australia and New Zealand was distributed in 2017 to doctors working in provincial hospitals of the public health system; in 2020, the questionnaire was distributed to doctors and nursing staff in Port Moresby General Hospital, and to medical, nursing and health sciences students in the University of Papua-New Guinea. Results: Significant numbers of senior medical officers and nurses reported experience of women presenting following unsafe induced abortion. There was wide variation across all respondents with regard to accurate knowledge of PNG’s abortion laws, and to views on the provision of safe accessible abortion services in the country’s public health system. Conclusions: Abortion training for service providers and provision of primary care services are necessary to ensure that PNG women have equitable access to abortion care instead of seeking out untrained providers or attempting self-abortion. Innovative approaches also need to be adopted to complement family planning efforts in PNG.

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Title: Implementing Comprehensive Abortion Care Services in Papua-New Guinea

Recommendation: To address the high maternal mortality rates and unsafe abortion practices in Papua-New Guinea, it is crucial to develop and implement comprehensive abortion care services. This recommendation involves the following steps:

1. Training for healthcare providers: Provide specialized training for doctors, nurses, and other healthcare professionals on safe abortion procedures, counseling, and post-abortion care. This training should focus on ensuring that healthcare providers have accurate knowledge of Papua-New Guinea’s abortion laws and are equipped to provide safe and accessible abortion services.

2. Integration of abortion services into the public health system: Establish safe abortion services within the existing public health system, particularly in provincial hospitals and the Port Moresby General Hospital. This integration will ensure that women have access to safe and legal abortion services, reducing the need for them to seek out untrained providers or resort to unsafe methods.

3. Primary care services: Strengthen primary care services to provide comprehensive reproductive healthcare, including family planning and contraceptive services. By promoting effective family planning methods, unintended pregnancies can be reduced, thereby decreasing the demand for unsafe abortions.

4. Addressing stigma and raising awareness: Develop public awareness campaigns to challenge the stigma surrounding abortion in Papua-New Guinea. These campaigns should aim to educate the public, including health professionals, about the importance of safe abortion services for women’s health and well-being.

5. Research and innovation: Encourage research and innovation in the field of maternal health to identify new approaches and technologies that can further improve access to safe abortion services. This may involve exploring telemedicine options, mobile health applications, or other innovative solutions that can reach women in remote areas.

By implementing these recommendations, Papua-New Guinea can work towards reducing maternal mortality rates and ensuring that women have equitable access to safe and legal abortion care.
AI Innovations Description
Based on the information provided, here is a recommendation that can be developed into an innovation to improve access to maternal health in Papua-New Guinea:

Title: Implementing Comprehensive Abortion Care Services in Papua-New Guinea

Recommendation: To address the high maternal mortality rates and unsafe abortion practices in Papua-New Guinea, it is crucial to develop and implement comprehensive abortion care services. This recommendation involves the following steps:

1. Training for healthcare providers: Provide specialized training for doctors, nurses, and other healthcare professionals on safe abortion procedures, counseling, and post-abortion care. This training should focus on ensuring that healthcare providers have accurate knowledge of Papua-New Guinea’s abortion laws and are equipped to provide safe and accessible abortion services.

2. Integration of abortion services into the public health system: Establish safe abortion services within the existing public health system, particularly in provincial hospitals and the Port Moresby General Hospital. This integration will ensure that women have access to safe and legal abortion services, reducing the need for them to seek out untrained providers or resort to unsafe methods.

3. Primary care services: Strengthen primary care services to provide comprehensive reproductive healthcare, including family planning and contraceptive services. By promoting effective family planning methods, unintended pregnancies can be reduced, thereby decreasing the demand for unsafe abortions.

4. Addressing stigma and raising awareness: Develop public awareness campaigns to challenge the stigma surrounding abortion in Papua-New Guinea. These campaigns should aim to educate the public, including health professionals, about the importance of safe abortion services for women’s health and well-being.

5. Research and innovation: Encourage research and innovation in the field of maternal health to identify new approaches and technologies that can further improve access to safe abortion services. This may involve exploring telemedicine options, mobile health applications, or other innovative solutions that can reach women in remote areas.

By implementing these recommendations, Papua-New Guinea can work towards reducing maternal mortality rates and ensuring that women have equitable access to safe and legal abortion care.
AI Innovations Methodology
Methodology to Simulate the Impact of Recommendations:

1. Study Design: Conduct a mixed-methods study involving qualitative and quantitative data collection methods to gather comprehensive information on the impact of the recommendations. This can include surveys, interviews, and focus group discussions.

2. Sampling: Randomly select a representative sample of healthcare professionals, including doctors, nurses, and other relevant staff, from provincial hospitals, Port Moresby General Hospital, and the University of Papua-New Guinea. Ensure that the sample size is statistically significant to provide reliable results.

3. Data Collection: Administer the questionnaire developed from similar surveys conducted in Australia and New Zealand to the selected participants. The questionnaire should include questions related to their experience with induced abortion cases, knowledge of abortion laws, views on safe abortion services, and the impact of training and primary care services on access to abortion care.

4. Data Analysis: Analyze the quantitative data using statistical methods to identify patterns, trends, and associations. Use qualitative data analysis techniques, such as thematic analysis, to identify key themes and insights from the interviews and focus group discussions.

5. Results: Present the findings in a comprehensive report, highlighting the experiences and opinions of health professionals regarding induced abortion and the provision of safe, accessible abortion services. Include quantitative data on the variation in knowledge and views among respondents. Use quotes and narratives from qualitative data to provide a deeper understanding of the issues.

6. Recommendations: Based on the study findings, provide recommendations for implementing the proposed recommendations. These recommendations should address the gaps identified in healthcare professionals’ knowledge, attitudes, and practices related to induced abortion and safe abortion services.

7. Implementation and Evaluation: Implement the recommended interventions, such as training programs for healthcare providers and strengthening primary care services. Monitor and evaluate the impact of these interventions on improving access to safe abortion services. This can be done through follow-up surveys and interviews with healthcare professionals and tracking relevant maternal health indicators.

By following this methodology, researchers can gain insights into the experiences and opinions of health professionals regarding induced abortion and the provision of safe, accessible abortion services. This information can guide the implementation of the recommendations and contribute to improving access to maternal health in Papua-New Guinea.

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