Chaturvedi Sarika, Ali Sayyed, Randive Bharat, Sabde Yogesh, Diwan Vishal, De Costa Ayesha
Department of Public Health and Environment, R D Gardi Medical College, Ujjain, India.
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden;
Glob Health Action. 2015 Mar 20;8:26346. doi: 10.3402/gha.v8.26346. eCollection 2015.
Unsafe abortion contributes to a significant portion of maternal mortality in India. Access to safe abortion care is known to reduce maternal mortality. Availability and distribution of abortion care facilities can influence women's access to these services, especially in rural areas.
To assess the availability and distribution of abortion care at facilities providing childbirth care in three districts of Madhya Pradesh (MP) province of India.
Three socio demographically heterogeneous districts of MP were selected for this study. Facilities conducting at least 10 deliveries a month were surveyed to assess availability and provision of abortion services using UN signal functions for emergency obstetric care. Geographical Information System was used for visualisation of the distribution of facilities.
The three districts had 99 facilities that conducted >10 deliveries a month: 74 in public and 25 in private sector. Overall, 48% of facilities reported an ability to provide safe surgical abortion service. Of public centres, 32% reported the ability compared to 100% among private centres while 18% of public centres and 77% of private centres had performed an abortion in the last 3 months. The availability of abortion services was higher at higher facility levels with better equipped and skilled personnel availability, in urban areas and in private sector facilities.
Findings showed that availability of safe abortion care is limited especially in rural areas. More emphasis on providing safe abortion services, particularly at primary care level, is important to more significantly dent maternal mortality in India.
在印度，不安全堕胎导致了很大一部分孕产妇死亡。众所周知，获得安全堕胎护理可降低孕产妇死亡率。堕胎护理设施的可及性和分布情况会影响妇女获得这些服务的机会，尤其是在农村地区。
评估印度中央邦（MP）三个地区提供分娩护理的机构中堕胎护理的可及性和分布情况。
本研究选择了MP三个社会人口统计学特征各异的地区。对每月至少进行10次分娩的机构进行调查，使用联合国紧急产科护理信号功能评估堕胎服务的可及性和提供情况。利用地理信息系统对机构分布进行可视化展示。
这三个地区有99个每月分娩量超过10次的机构：74个公立机构和25个私立机构。总体而言，48%的机构报告有能力提供安全的手术堕胎服务。在公立机构中，32%报告有此能力，而私立机构中这一比例为100%，同时，18%的公立机构和77%的私立机构在过去3个月内进行过堕胎手术。在设施水平较高、人员配备更好且技术更熟练、位于城市地区以及私立机构中，堕胎服务的可及性更高。
研究结果表明，安全堕胎护理的可及性有限，尤其是在农村地区。更加强调提供安全堕胎服务，特别是在初级保健层面，对于大幅降低印度的孕产妇死亡率至关重要。
