Ibis Reproductive Health, 1736 Franklin Street, Suite 600, Oakland, CA 94612, USA.
International Planned Parenthood Federation, 4 Newhams Row, London SE1 3UZ, UK.
Health Policy Plan. 2021 Oct 12;36(9):1362-1370. doi: 10.1093/heapol/czab065.
Quality healthcare is a key part of people's right to health and dignity, yet access to high-quality care can be limited by legal, social and economic contexts. There is limited consensus on what domains constitute quality in abortion care and the opinions of people seeking abortion have little representation in current abortion quality measures. In this qualitative study, we conducted 45 interviews with abortion clients in Mumbai, India, and in Eldoret and Thika, Kenya, to assess experiences with abortion care, definitions of quality and priorities for high-quality abortion care. Among the many aspects of care that mattered to clients, the client-provider relationships emerged as essential. Clients prioritized being treated with kindness, respect and dignity; receiving information and counselling that was personalized to their individual situation and reassurance and support from their provider throughout the entire abortion process, including follow-up after the abortion. Many clients also noted the importance of skilled providers and appropriate care. There were similarities across the two country contexts, yet there were some differences in how clients defined high-quality care; therefore, specific political and cultural influences must be considered when implementing measurement and improving person-centred quality of care. These domains, particularly interpersonal interactions, should be prioritized in India and Kenya when health systems, facilities and providers design person-centred measures for quality in abortion care.
优质的医疗保健是人们健康和尊严权利的关键组成部分，但获得高质量的医疗保健可能受到法律、社会和经济背景的限制。对于堕胎护理质量的构成领域，目前尚未达成共识，而且寻求堕胎的人的意见在当前的堕胎质量措施中代表性不足。在这项定性研究中，我们在印度孟买、肯尼亚埃尔多雷特和锡卡进行了 45 次与堕胎客户的访谈，以评估他们对堕胎护理的体验、对质量的定义以及对高质量堕胎护理的优先事项。在客户认为重要的许多护理方面，客户与提供者的关系至关重要。客户希望得到友善、尊重和尊严的对待；获得个性化的信息和咨询，以适应他们的个人情况，并在整个堕胎过程中得到提供者的保证和支持，包括堕胎后的随访。许多客户还指出了有经验的提供者和适当护理的重要性。这两个国家的情况有一些相似之处，但客户对高质量护理的定义也存在一些差异；因此，在实施衡量标准和改善以人为主的护理质量时，必须考虑特定的政治和文化影响。在印度和肯尼亚，当卫生系统、设施和提供者设计以人为中心的堕胎护理质量衡量标准时，这些领域，特别是人际互动，应被优先考虑。
