Oreglia Elisa, Ly Sokhey, Tijamo Camille, Ou Amra, Free Caroline, Smith Chris
Kings College London, London, United Kingdom.
Marie Stopes International Cambodia, Phnom Penh, Cambodia.
JMIR Res Protoc. 2020 Jul 10;9(7):e17779. doi: 10.2196/17779.
In Cambodia, abortion has been legally permitted on request during the first trimester of pregnancy since 1997. However, although there has been an increase in the percentage of women having induced abortion and medical abortion, there has also been a decrease in the percentage of women who say they received help from a health worker with their abortion. These data point toward the demedicalization of abortion, and although medical abortion has been shown to be safe, there are concerns about safety, given the variety of available products and counseling provided. These concerns are particularly relevant for female factory workers, who typically come from rural areas where access to good health care and information about reproductive health care is limited.
This study aims to understand the reproductive health needs of female Cambodian garment factory workers after medical abortion from a multidisciplinary and mixed-methods perspective, focusing on how they seek and share medical abortion- and health-related information; how they use their mobile phones for this and other purposes; what cultural challenges exist around reproductive health; and how they might be magnified or mitigated by mobile phones, linguistic challenges around health care, and mobile phone use. The main purpose of this study is to combine multidisciplinary methods, theories, and expertise to gain new, culturally grounded insights into family planning and medical abortion in Cambodia, but the findings could help inform the development of a relevant intervention to support comprehensive postabortion care.
The methods proposed are interviews and participant observation among factory workers, health providers, and mobile phone providers; a linguistic analysis of relevant data (interview transcripts, web-based sources, and other fieldwork materials); and digital methods to understand what kind of information about medical abortion exists on the web in Cambodia and how it is accessed by the targeted population.
The data collection part of the project will end on December 31, 2020. The team conducted 67 semistructured interviews with female factory workers, women who sought a medical abortion, health providers, and mobile phone providers; participant observation with factory workers and health providers; and an analysis of YouTube and Facebook to understand what kind of information is available, who creates it, and how it is used. The team is currently performing data analysis, and the findings are clustered around (1) the use of mobile phones and digital resources for health-related and medical abortion-related information, (2) the experience of medical abortion care, and (3) the development of an intervention through edutainment videos.
The project highlights both the widely untapped potential of using digital platforms (especially YouTube and Facebook) to distribute accurate information on medical abortion and the challenges in providing individual information via mobile phones while respecting individuals' privacy.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17779.
自1997年以来，柬埔寨法律允许在怀孕头三个月内根据请求进行堕胎。然而，尽管人工流产和药物流产的女性比例有所上升，但称在堕胎过程中得到医护人员帮助的女性比例却有所下降。这些数据表明堕胎出现了非医学化趋势，尽管药物流产已被证明是安全的，但鉴于有多种可用产品和提供的咨询服务，人们对安全性仍存在担忧。这些担忧对于女性工厂工人尤为重要，她们通常来自农村地区，那里获得优质医疗保健和生殖健康保健信息的机会有限。
本研究旨在从多学科和混合方法的角度了解柬埔寨女性制衣厂工人药物流产后的生殖健康需求，重点关注她们如何寻求和分享与药物流产及健康相关的信息；她们如何使用手机来实现这一目的及其他目的；生殖健康方面存在哪些文化挑战；以及手机、医疗保健方面的语言挑战和手机使用如何放大或缓解这些挑战。本研究的主要目的是结合多学科方法、理论和专业知识，以获得关于柬埔寨计划生育和药物流产的新的、基于文化的见解，但研究结果可能有助于为制定相关干预措施提供信息，以支持全面的堕胎后护理。
提议的方法包括对工厂工人、医疗服务提供者和手机供应商进行访谈和参与观察；对相关数据（访谈记录、网络资源和其他实地调查材料）进行语言分析；以及采用数字方法来了解柬埔寨网络上存在哪些关于药物流产的信息以及目标人群如何获取这些信息。
该项目的数据收集部分将于2020年12月31日结束。研究团队对女性工厂工人、寻求药物流产的女性、医疗服务提供者和手机供应商进行了67次半结构化访谈；对工厂工人和医疗服务提供者进行了参与观察；并对YouTube和Facebook进行了分析，以了解有哪些可用信息、谁创建了这些信息以及如何使用这些信息。研究团队目前正在进行数据分析，研究结果主要集中在以下几个方面：（1）使用手机和数字资源获取与健康及药物流产相关的信息；（2）药物流产护理的经历；（3）通过寓教于乐视频开发干预措施。
该项目既凸显了利用数字平台（尤其是YouTube和Facebook）传播关于药物流产准确信息的巨大未开发潜力，也凸显了在尊重个人隐私的同时通过手机提供个人信息所面临的挑战。
国际注册报告识别码（IRRID）：DERR1-10.2196/17779
