Marlow Heather M, Wamugi Sylvia, Yegon Erick, Fetters Tamara, Wanaswa Leah, Msipa-Ndebele Sinikiwe
Senior Associate, Research and Evaluation, Ipas, Chapel Hill, NC, USA.
Communications Associate, Programs, Africa Alliance Regional Policy, Ipas Africa Alliance, Nairobi, Kenya.
Reprod Health Matters. 2014 May;22(43):149-58. doi: 10.1016/S0968-8080(14)43758-3.
Unsafe abortion in Kenya is a leading cause of maternal morbidity and mortality. In October 2012, we sought to understand the methods married women aged 24-49 and young, unmarried women aged ≤ 20 used to induce abortion, the providers they utilized and the social, economic and cultural norms that influenced women's access to safe abortion services in Bungoma and Trans Nzoia counties in western Kenya. We conducted five focus groups with young women and five with married women in rural and urban communities in each county. We trained local facilitators to conduct the focus groups in Swahili or English. All focus groups were audiotaped, transcribed, translated, computerized, and coded for analysis. Abortion outside public health facilities was mentioned frequently. Because of the need for secrecy to avoid condemnation, uncertainty about the law, and perceived higher cost of safer abortion methods, women sought unsafe abortions from community midwives, drug sellers and/or untrained providers at lower cost. Many groups believed that abortion was safer at higher gestational ages, but that there was no such thing as a safe abortion method. Our aim was to inform the design of a community-based intervention on safe abortion for women. Barriers to seeking safe services such as high cost, perceived illegality, and fear of insults and abuse at public facilities among both age groups must be addressed.
在肯尼亚，不安全堕胎是孕产妇发病和死亡的主要原因。2012年10月，我们试图了解24至49岁的已婚妇女以及20岁及以下的年轻未婚女性用于堕胎的方法、她们所利用的医疗服务提供者，以及影响肯尼亚西部邦戈马县和特兰斯恩佐亚县妇女获得安全堕胎服务的社会、经济和文化规范。我们在每个县的农村和城市社区与年轻女性进行了5次焦点小组访谈，与已婚女性进行了5次焦点小组访谈。我们培训了当地主持人，让他们用斯瓦希里语或英语主持焦点小组访谈。所有焦点小组访谈都进行了录音、转录、翻译、电脑化处理并编码以便分析。公共卫生设施以外的堕胎情况被频繁提及。由于需要保密以避免遭到谴责、法律存在不确定性以及认为更安全的堕胎方法成本更高，女性会以较低成本从社区助产士、药品销售商和/或未经培训的医疗服务提供者那里寻求不安全堕胎服务。许多群体认为，怀孕孕周越大堕胎越安全，但不存在安全的堕胎方法。我们的目的是为基于社区的妇女安全堕胎干预措施的设计提供信息。必须解决两个年龄组寻求安全服务时面临的障碍，例如成本高、被认为非法以及担心在公共设施受到侮辱和虐待。
