Moore Ann M, Kibombo Richard, Cats-Baril Deva
Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038, USA, Development Research and Social Policy Analysis Centre (DRASPAC), Kampala, Uganda and University of Vermont, Post Baccalaureate Premedical Program 322 S Prospect St., Burlington, Vermont 05401.
Health Policy Plan. 2014 Oct;29(7):893-901. doi: 10.1093/heapol/czt070. Epub 2013 Sep 23.
While laws in Uganda surrounding abortion remain contradictory, a frequent interpretation of the law is that abortion is only allowed to save the woman's life. Nevertheless abortion occurs frequently under unsafe conditions at a rate of 54 abortions per 1000 women of reproductive age annually, taking a large toll on women's health. There are an estimated 148,500 women in Uganda who experience abortion complications annually. Understanding opinion leaders' knowledge and perceptions about unsafe abortion is critical to identifying ways to address this public health issue. We conducted in-depth, semi-structured interviews with 41 policy-makers, cultural leaders, local politicians and leaders within the health care sector in 2009-10 at the national as well as district (Bushenyi, Kamuli and Lira) level to explore their knowledge and perceptions of unsafe abortion and the potential for policy to address this issue. Only half of the sample knew the current law regulating abortion in Uganda. Respondents understood that the result of the current abortion restrictions included long-term health complications, unwanted children and maternal death. Perceived consequences of increasing access to safe abortion included improved health as well as overuse of abortion, marital conflict and less reliance on preventive behaviour. Opinion leaders expressed the most support for legalization of abortion in cases of rape when the perpetrator was unknown. Understanding opinion leaders' perspectives on this politically sensitive topic provides insight into the policy context of abortion laws, drivers behind maintaining the status quo, and ways to improve provision under the law: increase education among providers and opinion leaders.
虽然乌干达有关堕胎的法律仍然相互矛盾，但对该法律的一种常见解释是，只有在挽救妇女生命的情况下才允许堕胎。然而，堕胎在不安全的条件下频繁发生，每年每1000名育龄妇女中有54例堕胎，给妇女健康造成了巨大损失。据估计，乌干达每年有148,500名妇女经历堕胎并发症。了解意见领袖对不安全堕胎的认识和看法对于确定解决这一公共卫生问题的方法至关重要。2009年至2010年，我们在国家以及地区（布申尼、卡穆利和利拉）层面，对41名政策制定者、文化领袖、地方政客和医疗保健部门的领导人进行了深入的半结构化访谈，以探讨他们对不安全堕胎的认识和看法，以及政策解决这一问题的潜力。样本中只有一半的人知道乌干达目前管制堕胎的法律。受访者明白，目前堕胎限制的结果包括长期健康并发症、意外生育和孕产妇死亡。增加安全堕胎机会的预期后果包括健康改善以及堕胎的过度使用、婚姻冲突和对预防行为的依赖减少。意见领袖对强奸案中犯罪者身份不明时堕胎合法化表示最支持。了解意见领袖对这个政治敏感话题的看法，有助于深入了解堕胎法律的政策背景、维持现状背后的驱动因素，以及根据法律改进堕胎服务的方法：加强提供者和意见领袖之间的教育。
