London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK.
BMJ Glob Health. 2021 Jan;6(1). doi: 10.1136/bmjgh-2020-003813.
Consensus is lacking on the most appropriate indicators to document progress in safe abortion at programmatic and country level. We conducted a scoping review to provide an extensive summary of abortion indicators used over 10 years (2008-2018) to inform the debate on how progress in the provision and access to abortion care can be best captured. Documents were identified in PubMed and Popline and supplemented by materials identified on major non-governmental organisation websites. We screened 1999 abstracts and seven additional relevant documents. Ultimately, we extracted information on 792 indicators from 142 documents. Using a conceptual framework developed inductively, we grouped indicators into seven domains (social and policy context, abortion access and availability, abortion prevalence and incidence, abortion care, abortion outcomes, abortion impact and characteristics of women) and 40 subdomains. Indicators of access and availability and of the provision of abortion care were the most common. Indicators of outcomes were fewer and focused on physical health, with few measures of psychological well-being and no measures of quality of life or functioning. Similarly, there were few indicators attempting to measure the context, including beliefs and social attitudes at the population level. Most indicators used special studies either in facilities or at population level. The list of indicators (in online supplemental appendix) is an extensive resource for the design of monitoring and evaluation plans of abortion programmes. The large number indicators, many specific to one source only and with similar concepts measured in a multitude of ways, suggest the need for standardisation.
在以方案和国家为单位记录安全人工流产进展方面，用哪些最合适的指标仍存在争议。我们开展了一次范围界定综述，以广泛总结 10 年来（2008-2018 年）用于指导如何最佳捕捉提供和获取人工流产服务方面进展的人工流产指标。我们在 PubMed 和 Popline 上查找文献，并辅以主要非政府组织网站上确定的材料。我们筛选了 1999 篇摘要和另外 7 份相关文件。最终，我们从 142 份文件中提取了 792 项指标的信息。我们使用归纳法制定的概念框架，将指标分为 7 个领域（社会和政策背景、人工流产服务的可及性和可获得性、人工流产的流行率和发生率、人工流产护理、人工流产结局、人工流产影响以及妇女特征）和 40 个子领域。可及性和可获得性指标以及人工流产护理提供指标最为常见。结局指标较少，主要关注身体健康，很少有心理健康衡量标准，也没有衡量生活质量或功能的标准。同样，很少有指标试图衡量包括人群层面的信念和社会态度在内的背景情况。大多数指标使用了特定的研究，要么在医疗机构中进行，要么在人群层面进行。（在线补充附录中的）指标清单是人工流产方案监测和评估计划设计的丰富资源。大量的指标，许多仅特定于一个来源，且有许多类似的概念以多种方式进行衡量，这表明需要标准化。
