Ramachandar Lakshmi, Pelto Pertti J
Key Centre for Women's Health in Society, University of Melbourne, Melbourne, Australia.
Reprod Health Matters. 2002 May;10(19):64-75. doi: 10.1016/s0968-8080(02)00022-8.
This paper reports on qualitative research on abortion services in the Coimbatore district of Tamil Nadu in south India, and the role of government village health nurses (VHNs) in assisting women to obtain abortions. The aim of the research, carried out in 1997, was to document the process married women go through to obtain abortions in both the public and private sectors, particularly women in rural areas, and why they preferred private clinics. The research consisted of direct observation of "sterilization/medical termination of pregnancy camps" at rural primary health centres and in hospital settings, plus informal and in-depth, open-ended interviews with medical officers, gynaecologists, government medical administrators, VHNs and other health care personnel. It found that VHNs were not only helping their clients to obtain abortions in government facilities but also and more often with qualified private providers. Unmarried girls were excluded from this process by the need for secrecy, however, and were perceived to still be going to unqualified providers. Government records show that there were clear reductions in the availability of public abortion services in the rural areas throughout the 1990s. The widespread perception that private services were safer and treated women better, the increased availability of qualified private abortion providers and the help of VHNs to access private services all encouraged married women to use the private sector.
本文报道了对印度南部泰米尔纳德邦哥印拜陀地区堕胎服务的定性研究，以及政府乡村保健护士（VHNs）在协助妇女获得堕胎服务方面所起的作用。1997年开展的这项研究旨在记录已婚妇女在公共和私营部门获取堕胎服务的过程，尤其是农村地区的妇女，以及她们为何更倾向于选择私人诊所。该研究包括对农村初级保健中心和医院环境中“绝育/终止妊娠营”的直接观察，以及对医务人员、妇科医生、政府医疗管理人员、乡村保健护士和其他医护人员进行的非正式、深入的开放式访谈。研究发现，乡村保健护士不仅帮助她们的客户在政府机构获得堕胎服务，而且更经常地是帮助她们联系合格的私人提供者。然而，由于需要保密，未婚女孩被排除在这一过程之外，人们认为她们仍然会去找不合格的提供者。政府记录显示，整个20世纪90年代，农村地区公共堕胎服务的可及性明显下降。人们普遍认为私营服务更安全，对妇女的待遇更好，合格的私人堕胎提供者数量增加，以及乡村保健护士帮助获取私营服务，所有这些都促使已婚妇女选择私营部门。
