加拿大的堕胎健康服务：2012年全国调查结果
Abortion health services in Canada: Results of a 2012 national survey.
作者信息
Norman Wendy V, Guilbert Edith R, Okpaleke Christopher, Hayden Althea S, Steven Lichtenberg E, Paul Maureen, White Katharine O'Connell, Jones Heidi E
机构信息
Assistant Professor and Canadian Institutes of Health Research Chair of Family Planning Public Health Research in the Department of Family Practice at the University of British Columbia in Vancouver.
Senior Medical Advisor in the Institut national de santé publique du Québec in Quebec city.
出版信息
Can Fam Physician. 2016 Apr;62(4):e209-e217.
OBJECTIVE
To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers.
DESIGN
An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distributed by mail and e-mail from July to November 2013.
SETTING
Canada.
PARTICIPANTS
A total of 94 abortion facilities were identified.
MAIN OUTCOME MEASURES
The number and location of services were compared with the distribution of reproductive-age women by location of residence.
RESULTS
We identified 94 Canadian facilities providing abortion in 2012, with 48.9% in Quebec. The response rate was 83.0% (78 of 94). Facilities in every jurisdiction with services responded. In Quebec and British Columbia abortion services are nearly equally present in large urban centres and rural locations throughout the provinces; in other Canadian provinces services are chiefly located in large urban areas. No abortion services were identified in Prince Edward Island. Respondents reported provision of 75 650 abortions in 2012 (including 4.0% by medical abortion). Canadian facilities reported minimal or no harassment, in stark contrast to American facilities that responded to the same survey.
CONCLUSION
Access to abortion services varies by region across Canada. Services are not equitably distributed in relation to the regions where reproductive-age women reside. British Columbia and Quebec have demonstrated effective strategies to address disparities. Health policy and service improvements have the potential to address current abortion access inequity in Canada. These measures include improved access to mifepristone for medical abortion; provincial policies to support abortion services; routine abortion training within family medicine residency programs; and increasing the scope of practice for nurses and midwives to include abortion provision.
目的
确定加拿大堕胎服务机构相对于育龄女性居住地的位置，以及堕胎机构和提供者的特征。
设计
对一项国际调查进行了调整以使其与加拿大相关情况相适应。利用公共资源和专业网络来识别机构。2013年7月至11月通过邮件和电子邮件分发了双语调查问卷。
地点
加拿大。
参与者
共识别出94家堕胎机构。
主要观察指标
将服务的数量和位置与按居住地点划分的育龄女性分布情况进行比较。
结果
我们识别出2012年在加拿大提供堕胎服务的94家机构，其中48.9%位于魁北克。回复率为83.0%（94家中的78家）。提供服务的每个司法管辖区的机构都做出了回复。在魁北克和不列颠哥伦比亚，堕胎服务在全省的大城市中心和农村地区分布几乎均等；在加拿大其他省份，服务主要位于大城市地区。在爱德华王子岛未识别出堕胎服务机构。受访者报告2012年进行了75650例堕胎（包括4.0%的药物流产）。与对同一调查做出回复的美国机构形成鲜明对比的是，加拿大机构报告极少或没有受到骚扰。
结论
加拿大各地获得堕胎服务的情况因地区而异。服务在与育龄女性居住地区的关系上分布不均。不列颠哥伦比亚和魁北克已展示出解决差异的有效策略。卫生政策和服务改进有可能解决加拿大目前堕胎服务获取不平等的问题。这些措施包括改善获取米非司酮进行药物流产的机会；支持堕胎服务的省级政策；家庭医学住院医师培训项目中的常规堕胎培训；以及扩大护士和助产士的执业范围以包括提供堕胎服务。
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