Rogers Claire, Sapkota Sabitri, Tako Anita, Dantas Jaya A R
International Health Programme, School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, 6102, Western Australia.
Marie Stopes International, London, UK.
BMC Womens Health. 2019 Feb 26;19(1):40. doi: 10.1186/s12905-019-0734-1.
Globally, women face many barriers in the attainment of sexual and reproductive health and rights (SRHR). Since 2002, the legalisation of abortion in Nepal has seen significant progress in the expansion of safe abortion and family planning services.
This qualitative, exploratory study was conducted in 2014 and uses nine in-depth, open-ended interviews with a cross-section of SRHR professionals, to explore their perspectives on abortion in Nepal. The study was underpinned by the Assets Focused Rapid Participatory Appraisal (AFRPA) research methodology and used the health information pyramid conceptual framework.
Thematic content analysis revealed emerging themes relating to barriers to access and uptake of skilled safe abortion services and post-abortion family planning. Findings also emphasised current practical and legal components relating to the provision of medical abortion through pharmacies and highlighted issues of sex-selective abortion within the predominantly patriarchal society.
Effective and ongoing sector-wide monitoring and evaluation of safe abortion services and their staff is essential for women in Nepal to have adequate access to effective and efficient safe abortion services, access to contraception and sexual and reproductive health (SRH) information post-abortion and to ensure adherence to current Safe Abortion Policy. It is critical that the unsafe (less and least safe) provision of medical abortion through pharmacies and sex-selective abortion continues to be investigated and that innovative strategies are formulated to ensure the cultural, reproductive and sexual health and rights of Nepali women are realised.
在全球范围内，女性在实现性健康和生殖健康及权利（SRHR）方面面临诸多障碍。自2002年以来，尼泊尔堕胎合法化在扩大安全堕胎和计划生育服务方面取得了显著进展。
这项定性探索性研究于2014年开展，对一系列性健康和生殖健康及权利专业人员进行了9次深入的开放式访谈，以探讨他们对尼泊尔堕胎问题的看法。该研究以资产聚焦快速参与式评估（AFRPA）研究方法为基础，并使用了健康信息金字塔概念框架。
主题内容分析揭示了与获得和接受熟练的安全堕胎服务及堕胎后计划生育的障碍相关的新出现主题。研究结果还强调了通过药店提供药物流产的当前实际和法律因素，并突出了在以父权制为主的社会中性别选择性堕胎问题。
对安全堕胎服务及其工作人员进行有效且持续的全部门监测和评估，对于尼泊尔女性能够充分获得有效且高效的安全堕胎服务、获得避孕措施以及堕胎后的性健康和生殖健康（SRH）信息，并确保遵守当前的安全堕胎政策至关重要。至关重要的是，继续调查通过药店不安全（较不安全和最不安全）地提供药物流产以及性别选择性堕胎的情况，并制定创新战略，以确保尼泊尔女性的文化、生殖、性健康及权利得以实现。
