Guttmacher Institute , New York , NY , USA.
International Institute for Population Sciences , Mumbai , India.
Glob Public Health. 2019 Dec;14(12):1757-1769. doi: 10.1080/17441692.2019.1642365. Epub 2019 Jul 24.
Medical methods of abortion, MMA, has been legal in India since 2002. Guidelines stipulate that it should be administered by a provider or acquired via prescription. 1.2 million women having abortions in India use MMA acquired from health facilities [Singh, S., Shekhar, C., Acharya, R., Moore, A. M., Stillman, M., Pradhan, M. R., … Browne, A. (2018). The incidence of abortion and unintended pregnancy in India, 2015. , (1), e111-e120. doi: 10.1016/S2214-109X(17)30453-9 ]. We undertook a study of abortion in Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh in 2015 to better understand under what conditions and how MMA is being administered in facilities. The majority of facilities that provide MMA are in the private sector and located in urban areas. Most facilities offer MMA both at the facility and as a prescription, although some facilities only offer MMA as a prescription. A high proportion of facilities report that women typically take the medication at home. (Re)training providers in MMA protocols and counselling, increasing the number of facilities offering MMA, and stocking of the drugs would help improve women's access to MMA and the information they need to be able to use this method safely. In the six states in our sample, Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh, 8% of abortions in 2015 were done using medical methods of abortion (MMA) acquired from health facilities. The majority of facilities that provide MMA in the six states are in the private sector and are located in urban areas. Health facilities in Madhya Pradesh and Tamil Nadu are comparatively better in their provision of MMA with Assam, Bihar, Gujarat and Uttar Pradesh demonstrating poorer provision of MMA. There are many opportunities for improvement in the practices of MMA provision through improved training of providers, accessibility to the medications and better support of women using MMA.
自 2002 年以来，印度的医疗堕胎方法（MMA）一直合法。指南规定，应由提供者进行管理或通过处方获得。印度有 120 万妇女通过从卫生机构获得的 MMA 进行堕胎[Singh，S.，Shekhar，C.，Acharya，R.，Moore，A. M.，Stillman，M.，Pradhan，M. R.，…Browne，A.（2018）。2015 年印度堕胎和意外怀孕的发生率。，（1），e111-e120。doi：10.1016/S2214-109X（17）30453-9]。我们在 2015 年对印度的阿萨姆邦、比哈尔邦、古吉拉特邦、中央邦、泰米尔纳德邦和北方邦进行了堕胎研究，以更好地了解在什么条件下以及如何在设施中管理 MMA。提供 MMA 的大多数设施都在私营部门，位于城市地区。大多数设施既在设施内又提供 MMA 处方，但有些设施仅提供 MMA 处方。相当多的设施报告说，妇女通常在家中服药。（重新）培训提供者 MMA 协议和咨询，增加提供 MMA 的设施数量，并储备药物，将有助于改善妇女获得 MMA 的机会，并为她们提供使用这种方法的安全所需的信息。在我们抽样的六个州，即阿萨姆邦、比哈尔邦、古吉拉特邦、中央邦、泰米尔纳德邦和北方邦，2015 年有 8％的堕胎是使用从卫生机构获得的医疗堕胎方法（MMA）进行的。在这六个州中，提供 MMA 的大多数设施都在私营部门，位于城市地区。在 MMA 的提供方面，中央邦和泰米尔纳德邦的卫生机构相对较好，而阿萨姆邦、比哈尔邦、古吉拉特邦和北方邦的 MMA 提供情况较差。通过改进提供者的培训、获得药物的机会以及更好地支持使用 MMA 的妇女，可以在 MMA 提供方面有很多改进的机会。
