Sexual and Reproductive Health Matters最新文献

{"title":"Autonomy in labour and delivery in a Latin American urban centre: a qualitative phenomenological analysis.","authors":"Maribel Mella-Guzmán, Lorena Binfa, Fiona Weeks","doi":"10.1080/26410397.2024.2310889","DOIUrl":"10.1080/26410397.2024.2310889","url":null,"abstract":"<p><p>The medicalisation of childbirth has diminished the role of labouring people. We conducted an exploratory phenomenological qualitative study, using purposive sampling, and then conducted 17 semi-structured interviews between December 2016 and October 2017 with people who had recently given birth in a public hospital in the Northern Metropolitan area of Santiago, Chile. The sufficiency of the study group was determined according to saturation criteria. Triangulated content analysis was applied to explore the clinical relationship and processes of autonomy and decision-making. The predominant clinical relationship observed was paternalism. The participation of labouring people in decision-making is scarce, with no evidence of ethically valid processes of informed consent.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for onward health data use in the electronic age among maternity patients and providers in South Africa: a qualitative study.","authors":"Amnesty LeFevre, Olivia Welte, Kearabetswe Moopelo, Nicki Tiffin, Gaolatlhe Mothoagae, Nobukhosi Ncube, Nasiphi Gwiji, Manape Shogole, Amy L Slogrove, Nomakhawuta Moshani, Andrew Boulle, Jane Goudge, Frances Griffiths, Lee Fairlie, Ushma Mehta, Kerry Scott, Nirvana Pillay","doi":"10.1080/26410397.2023.2274667","DOIUrl":"10.1080/26410397.2023.2274667","url":null,"abstract":"<p><p>Despite the expanding digitisation of individual health data, informed consent for the collection and use of health data is seldom explicitly sought in public sector clinics in South Africa. This study aims to identify perceptions of informed consent practices for health data capture, access, and use in Gauteng and the Western Cape provinces of South Africa. Data collection from September to December 2021 included in-depth interviews with healthcare providers (<i>n</i> = 12) and women (<i>n</i> = 62) attending maternity services. Study findings suggest that most patients were not aware that their data were being used for purposes beyond the individualised provision of medical care. Understanding the concept of anonymised use of electronic health data was at times challenging for patients who understood their data in the limited context of paper-based folders and booklets. When asked about preferences for electronic data, patients overwhelmingly were in favour of digitisation. They viewed electronic access to their health data as facilitating rapid and continuous access to health information. Patients were additionally asked about preferences, including delivery of health information, onward health data use, and recontacting. Understanding of these use cases varied and was often challenging to convey to participants who understood their health data in the context of information inputted into their paper folders. Future systems need to be established to collect informed consent for onward health data use. In light of perceived ties to the care received, these systems need to ensure that patient preferences do not impede the content nor quality of care received.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11001361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>\"It's not safe for me and what would it achieve?\"</i> Acceptability of patient-referral partner notification for sexually transmitted infections to young people, a mixed methods study from Zimbabwe.","authors":"Joni Lariat, Chido Dziva Chikwari, Ethel Dauya, Valentine T Baumu, Victor Kaisi, Laura Kafata, Esnath Meza, Victoria Simms, Constance Mackworth-Young, Helena Rochford, Anna Machiha, Tsitsi Bandason, Suzanna C Francis, Rashida A Ferrand, Sarah Bernays","doi":"10.1080/26410397.2023.2220188","DOIUrl":"10.1080/26410397.2023.2220188","url":null,"abstract":"<p><p>Partner notification (PN) is considered integral to the management of sexually transmitted infections (STI). Patient-referral is a common PN strategy and relies on index cases notifying and encouraging their partners to access treatment; however, it has shown limited efficacy. We conducted a mixed methods study to understand young people's experiences of PN, particularly the risks and challenges encountered during patient-referral. All young people (16-24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. PN slip uptake and partner treatment were recorded. Among 1807 young people (85.0% female) offered PN slips, 745 (41.2%) took up ≥1 PN slip and 103 partners (5.7%) returned for treatment. Most participants described feeling ill-equipped to counsel and persuade their partners to seek treatment. Between June and August 2021, youth researchers conducted in-depth interviews with 41 purposively selected young people diagnosed with an STI to explore their experiences of PN. PN posed considerable social risks, threatening their emotional and physical safety. Except for a minority in long-term, publicly acknowledged relationships, participants did not expect PN would achieve successful outcomes. Public health discourse, which constructs PN as \"the right thing to do\", influenced participants to adopt narratives that concealed the difficulties of PN and their unmet needs. Urgent interrogation is needed of whether PN is a suitable or constructive strategy to continue pursuing with young people. To improve the outcomes of preventing reinfection and onward transmission of STIs, we must consider developing alternative strategies that better align with young people's lived experiences.<b>Plain language summary</b> Partner notification is a public health strategy used to trace the sexual partners of people who have received a sexually transmitted infection (STI) diagnosis. It aims to interrupt the chains of STI transmission and prevent reinfection by treating both the person diagnosed and their sexual partners. The least effective but most common partner notification strategy used in many resource-limited settings is called \"patient referral\". This involves a sexual healthcare provider encouraging the person diagnosed to give a \"partner notification slip\" to their potentially exposed sexual partner/s and persuading them to access treatment. This research sought to better understand young people's experiences of partner notification, particularly the risks and challenges they faced during patient-referral.All young people (16-24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. Young people trained as researchers ","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/e6/ZRHM_31_2220188.PMC10424614.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10005445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of combined approaches towards improving utilisation of adolescent sexual and reproductive health services in Kenya: a quasi-experimental evaluation.","authors":"Lilian Mutea,&nbsp;Justinah Maluni,&nbsp;Mark Kabue,&nbsp;Vincent Were,&nbsp;Susan Ontiri,&nbsp;Kristien Michielsen,&nbsp;Peter Gichangi","doi":"10.1080/26410397.2023.2257073","DOIUrl":"10.1080/26410397.2023.2257073","url":null,"abstract":"<p><p>Adolescent sexual and reproductive health (ASRH) services are key to improving the health of adolescents. This study aimed to establish the effectiveness of an intervention that combined activities in health facilities and communities in Kenya to increase utilisation of ASRH services. A quasi-experimental evaluation design was used to assess the effectiveness of the intervention. Using a stratified cluster sampling approach, two cross-sectional household surveys targeting girls aged 15-19 were conducted at baseline (September 2019) and endline (December 2020) in intervention and comparison. We combined the difference-in-difference approach to analyse the net change in outcomes between intervention and comparison arms of the study at baseline and endline and coarsened exact matching for variables that were significantly different to address the imbalance. There were a total of 1011 participants in the intervention arm and 880 in the comparison arm. Descriptive results showed a net increase of 12.7% in intervention sites in the knowledge of misconceptions about sex, pregnancy, and contraception, compared to 10.4% in the control site. In the multivariate regression analysis, two outcomes remained significant: decreases in adolescents' discomfort when seeking ASRH services because of either fear of parents (aPR = 0.58, 95% CI = 0.42-0.79, <i>P</i> = 0.001) or a lack of support from their partner (aPR = 0.25, 95% CI = 0.08-0.82, <i>P</i> = 0.023). The intervention combining a facility and community approach was not effective in increasing the use of ASRH information and services. Possible reasons for this are explored.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/ef/ZRHM_31_2257073.PMC10552573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41158344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting to a global pandemic: a qualitative assessment of programmatic responses to COVID-19 in the multi-country Women's Integrated Sexual Health (WISH) programme.","authors":"Katy Footman,&nbsp;Pippa Page,&nbsp;Victoria Boydell,&nbsp;Megan McLaren,&nbsp;Sandra Mudhune","doi":"10.1080/26410397.2023.2260174","DOIUrl":"10.1080/26410397.2023.2260174","url":null,"abstract":"<p><p>The COVID-19 pandemic caused significant disruption to sexual and reproductive health and rights (SRHR) globally but there is little published evidence on the COVID-19 response of SRHR programmes, or lessons learned through their adaptations. To document the COVID-19 response of a global SRHR programme (the Women's Integrated Sexual Health programme), in-depth interviews were conducted between April and July 2021 with 22 key informants from implementing partners in Sierra Leone, Ethiopia and central or regional offices, the UK Foreign, Commonwealth and Development Office and the third-party monitoring partner. Framework analysis methods were used. Several rapid COVID-19 adaptations were identified: the development of crisis management and communication teams; increased partnership and engagement with government; reduced contact and risk in service delivery; reformulated community mobilisation; flexible performance management and remote methods of quality assurance; and sharing of learnings alongside the development of new guidance and tools. Throughout the pandemic, the programme was able to continue high-quality service delivery, though equity goals proved more difficult to reach. Challenges included the continually changing environment, competing pressures on governments, burdensome reporting, and staff burnout. The pandemic response was facilitated by prior experience of health emergencies, strong government relationships, a supportive workforce and some pre-existing approaches, tools, and systems. This study has identified important lessons that can inform programming in future crises, including the need for immediate recognition of SRHR as essential, sustained support for staff, use of multiple mechanisms to reach marginalised groups, adequate funding for equity goals, and a better balance between the burden of reporting and accountability needs.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Setting research priorities for prevention and response to child marriage in communities in the Arab region: findings from a multi-stage Delphi study involving practitioners across the region.","authors":"Janna Metzler, Aisha Hutchinson, Katrina Kiss","doi":"10.1080/26410397.2023.2275840","DOIUrl":"10.1080/26410397.2023.2275840","url":null,"abstract":"<p><p>Globally, more than 12 million girls under the age of 18 are forced to marry every year. Progress on ending child marriage in the Arab region is slowing, and risks being reversed, due to an increase in conflict-affected populations and widespread economic crisis. The aim of this paper is to consider the research priorities across the region to inform effective and accelerated child marriage prevention and response programming within the Arab region. Seventy-three specialists supporting child marriage prevention and response programming in the Arab region engaged with up to three phases of an online Delphi consultation process on research gaps and the research environment between July 2019 and December 2021. Proposals of research gaps were elicited, reviewed, and rated by participants to confirm a shared learning agenda. Participants identified 50 different research gaps across 7 main areas, reaching a high level of consensus support for 23 of 50 statements. Clear consensus was reached in relation to an increased need to produce and use evidence to support programme development, and further research on specific drivers and consequences of child marriage. The least consensus was found in relation to how research can inform prevention and response efforts within the law and legal system. The results provide the foundation of a child marriage research agenda for the Arab region which takes into account regional distinctiveness and builds on the global momentum for child marriage research. Mechanisms are in place to do this through the Regional Action Forum, and other networks across the region.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donors: curious connections in donor conception","authors":"Jung Chen","doi":"10.1080/26410397.2023.2245617","DOIUrl":"https://doi.org/10.1080/26410397.2023.2245617","url":null,"abstract":"This is an important book in the field of studying reproduction and health, and a timely response to the social changes following the policy shift that abolished the anonymity of gamete donors. Many scholars have been looking at relevant issues, mostly in relation to donor-recipient people, yet less attention has been paid to donors and their families. Petra Nordqvist and Leah Gilman examine gamete donors’ experiences from a relational perspective. Donors: Curious Connections in Donor Conception aims to explore the effects of changes in the legal, social, cultural, and technological context at this specific historical moment on people who have been or are considering becoming gamete (sperm or ovum) donors and how they make sense of the connections with the donorconceived children and the families. The shift from donor anonymity to traceability in the UK, which began in 2005, signifies a great transition from secrecy to openness in terms of the identity of people who donate sperm and ova. This regulatory change is the response to donorconceived people’s campaign for openness and the right for them to contact donors after they reach the age of 18 (p. 16). It has resulted in a new protocol for clinical practice in reproductive medicine and reflects wider sociocultural changes. By depicting donors’ lived experiences, Donors explains “the broader shift in donor conception practices and cultures” as the consent donor policy enacted and, at the same time, the emerging use of the Internet and social media to perform informal donation (p. 211). Thus, Donors examins both people who participate in donations in clinics, and those who donate informally, who are already acquainted with recipient parents. By looking at various donations, Donors captures how people perceive donation differently through investigating donors’ experiences as well as their relationships and their personal lives. With the expansion of reproductive gamete donation in the UK and worldwide, increasing research interests have been addressed around recipients, including recipient parents and donor-conceived children. However, there is a shortage of scholarly literature on the donor families and their relationships, especially research conducted via qualitative approaches, which can give a more in-depth understanding of how donation decisions shape donors’ lives and those with whom they share connections. Methodologically, Petra Nordqvist and Leah Gilman explore gamete donors’ experiences from a relational perspective and employ the personal life approach in sociology, to explore how social policies impact on people’s perceptions of connectedness. Donors sees gamete donation as a reflection of practices and relatedness negotiations, as well as a response to shifting social and political agendas. In the Introduction, the authors begin with the story of a sperm donor, Zak, to bring out the pressing questions: What does it mean to be a donor? (p. 1) How does that affect the donor, and their f","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46003655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlling reproduction: women, society, and state power","authors":"S. Rowlands","doi":"10.1080/26410397.2023.2186028","DOIUrl":"https://doi.org/10.1080/26410397.2023.2186028","url":null,"abstract":"I found this a fascinating book – written by a sociologist and an anthropologist, covering their disciplines and a fair amount of politics too. It should be accessible to the general SRHM journal readership. I felt I got a much richer insight into the subject than I would have done from a more demography-dominant perspective. Perhaps, a little more analysis of ethical aspects would have made it even more comprehensive. The book provides a wide-ranging analysis of the situation vis-à-vis restrictions to reproductive autonomy around the world with in-depth assessments of many countries and regimes. It is up to date, taking into account the overturning of Roe v. Wade. The scope is mainly fertility control but there are sections on assisted reproductive technology, surrogacy and adoption too. The book concentrates on the macro level and does not cover coercive control at the micro level. It includes forms of resistance to interference with reproduction. Covert contraceptive use is described, without explicitly defining it as such. There is an emphasis on how individuals and their bodies are harmed by undue control and by what mechanism. Religion, state governments and families are presented as major sources of interference with and constraint of an individual’s reproductive wishes/goals. Of course, patriarchy underlies all of this. So too does the prominence given to global capitalism/neoliberalism at the expense of the people; the pervasive adverse effect of neoliberalism runs as a thread throughout the book. There are interesting insights into the part NGOs and corporations play in programmes that purportedly empower women; however philanthro-capitalism is not mentioned. The frequent imposition of Global North values on the Global South is clearly stated. There are repeated references to the part played by colonialism, racism and gender inequality. However, the flaws in the universally used driver of the “unmet need for contraception indicator” are not mentioned. I also felt that more was needed to unpick the voluntariness of programmes and in defining reproductive autonomy. The particular plight of Filipinas is given as a detailed example: forced by lack of state services and ensuing poverty to migrate and send remittances back to their family – with the resultant loss of personal control over their reproductive goals. Financial aid from the US has dominated programmes such as those in India, Peru, the Philippines and Egypt. This from a country that does not recognise poverty as structural violence. Unfortunately, real choice is only available to those who have genuine options. Aid supplied is often matched to data from surveys that measure a Western view of individuals, ignoring the structural context. Often, “structural adjustment programmes” impose conditions for external funding: specific fertility reduction goals, reduction of state subsidies, increased prices of goods and services – which all shape individual behaviour toward a market orient","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46704566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>« Éloigne cette honte de moi! »</i>: une étude qualitative des normes sociales entourant les expériences d’avortement chez les adolescentes et jeunes femmes au Bénin.","authors":"Déo-Gracias Vanessa Dossi Sekpon, Jonna Both, Ramatou Ouedraogo, Isabelle L Lange","doi":"10.1080/26410397.2023.2294793","DOIUrl":"10.1080/26410397.2023.2294793","url":null,"abstract":"<p><p>In Africa, the rights of adolescent girls and young women in terms of sexual and reproductive health are strongly influenced by social norms. This article delves into the pivotal role these norms play in the abortion decisions and experiences of young women aged 15-24 in Benin. An ethnographic approach was adopted for data collection among young women who have undergone abortion, their confidants, and other community members. The findings reveal that these young women face a threefold normative burden in their social environment. They juggle contradictory norms that simultaneously stigmatise early pregnancies, hinder proper sexual education, and strongly condemn abortion. These normative pressures often drive their resort to abortions, typically carried out under unsafe conditions. The study also highlights the significant role parents play in the abortion decisions and processes of teenagers under 20. When men are involved in seeking care for abortion, adolescents and young women usually access safer procedures. However, their access to aftercare and contraception following an abortion is hindered by the social norms of healthcare professionals. In addition to broadening the conditions of access to abortion in Benin in October 2021, it is imperative to implement interventions centred on value clarification, raising awareness of adolescents' rights, combating obstetric violence, and social stigmatisation. These measures are crucial to alleviate the weight of social norms bearing down on these young women. DOI: 10.1080/26410397.2023.2294793.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avortement au Maroc et virage au drame : femmes et professionnels de santé en parlent ! Une étude transversale mixte à Agadir.","authors":"Sanae Elomrani, Bettina Utz, Vincent De Brouwere, Imane Kajjoune, Bouchra Assarag","doi":"10.1080/26410397.2023.2279371","DOIUrl":"10.1080/26410397.2023.2279371","url":null,"abstract":"<p><p>RésuméLes avortements à risque constituent une problématique majeure de santé publique, responsable de la mortalité et de la morbidité maternelles et absorbant les ressources des systèmes de santé publique à l'échelle mondiale. Malgré l'ampleur très probable du problème de l'avortement non sécurisé au Maroc, peu de données sont accessibles sur cette question. Cette recherche vise à analyser la situation de l'avortement du point de vue des femmes et des professionnels de santé dans la préfecture d'Agadir Idaoutanane au Sud du Maroc. Nous avons conduit une étude transversale mixte. De janvier à septembre 2018, 266 femmes ont été recrutées pour répondre à un questionnaire, et 45 entretiens avec les femmes et les professionnels de la santé impliqués dans la santé sexuelle et reproductive (SSR) ont été menés. Nous avons procédé à une analyse descriptive des données quantitatives et à une analyse de contenu thématique des données recueillies par les entretiens individuels. Les résultats de l'étude révèlent que les avortements sont la conjugaison de plusieurs facteurs multidimensionnels. Le manque d'informations en SSR et l'échec de la contraception sont les facteurs majeurs de grossesses non désirées. L'avortement provoqué est un sujet tabou, fortement stigmatisant, portant à l'image sociale de la personne. L'accessibilité aux services d'avortement est marquée de grandes disparités et de trajectoires différentes. Cette étude apporte une contribution à l'analyse du phénomène de l'avortement au Maroc et appelle à une action politique urgente sur plusieurs niveaux: l'accès aux programmes d'éducation sexuelle et à la contraception appropriée, l'élargissement des indications d'avortement préconisées dans le projet de loi, la mise en place des stratégies de lutte contre la stigmatisation de l'avortement par les professionnels de santé et l'accès à des soins post-avortement de haute qualité.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10860688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}