Ishola Foluso, Ukah U Vivian, Nandi Arijit
Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Purvis Hall 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada.
Syst Rev. 2021 Jun 28;10(1):192. doi: 10.1186/s13643-021-01739-w.
A country's abortion law is a key component in determining the enabling environment for safe abortion. While restrictive abortion laws still prevail in most low- and middle-income countries (LMICs), many countries have reformed their abortion laws, with the majority of them moving away from an absolute ban. However, the implications of these reforms on women's access to and use of health services, as well as their health outcomes, is uncertain. First, there are methodological challenges to the evaluation of abortion laws, since these changes are not exogenous. Second, extant evaluations may be limited in terms of their generalizability, given variation in reforms across the abortion legality spectrum and differences in levels of implementation and enforcement cross-nationally. This systematic review aims to address this gap. Our aim is to systematically collect, evaluate, and synthesize empirical research evidence concerning the impact of abortion law reforms on women's health services and outcomes in LMICs.
We will conduct a systematic review of the peer-reviewed literature on changes in abortion laws and women's health services and outcomes in LMICs. We will search Medline, Embase, CINAHL, and Web of Science databases, as well as grey literature and reference lists of included studies for further relevant literature. As our goal is to draw inference on the impact of abortion law reforms, we will include quasi-experimental studies examining the impact of change in abortion laws on at least one of our outcomes of interest. We will assess the methodological quality of studies using the quasi-experimental study designs series checklist. Due to anticipated heterogeneity in policy changes, outcomes, and study designs, we will synthesize results through a narrative description.
This review will systematically appraise and synthesize the research evidence on the impact of abortion law reforms on women's health services and outcomes in LMICs. We will examine the effect of legislative reforms and investigate the conditions that might contribute to heterogeneous effects, including whether specific groups of women are differentially affected by abortion law reforms. We will discuss gaps and future directions for research. Findings from this review could provide evidence on emerging strategies to influence policy reforms, implement abortion services and scale up accessibility.
PROSPERO CRD42019126927.
一个国家的堕胎法是决定安全堕胎有利环境的关键因素。虽然大多数低收入和中等收入国家（LMICs）仍然实行限制性堕胎法，但许多国家已经改革了其堕胎法，其中大多数国家不再实行绝对禁令。然而，这些改革对妇女获得和使用卫生服务以及她们的健康结果的影响尚不确定。首先，对堕胎法进行评估存在方法上的挑战，因为这些变化并非外生变量。其次，鉴于堕胎合法性范围内改革的差异以及各国实施和执行水平的不同，现有评估在普遍性方面可能存在局限性。本系统评价旨在填补这一空白。我们的目的是系统地收集、评估和综合关于堕胎法改革对低收入和中等收入国家妇女卫生服务及结果影响的实证研究证据。
我们将对关于低收入和中等收入国家堕胎法变化以及妇女卫生服务和结果的同行评审文献进行系统评价。我们将检索Medline、Embase、CINAHL和Web of Science数据库，以及灰色文献和纳入研究的参考文献列表以获取更多相关文献。由于我们的目标是推断堕胎法改革的影响，我们将纳入考察堕胎法变化对至少一项我们感兴趣的结果影响的准实验研究。我们将使用准实验研究设计系列清单评估研究的方法学质量。由于预计政策变化、结果和研究设计存在异质性，我们将通过叙述性描述来综合结果。
本综述将系统地评估和综合关于堕胎法改革对低收入和中等收入国家妇女卫生服务及结果影响的研究证据。我们将研究立法改革的效果，并调查可能导致异质性影响的条件，包括特定妇女群体是否受到堕胎法改革的不同影响。我们将讨论研究的差距和未来方向。本综述的结果可为影响政策改革、实施堕胎服务和扩大可及性的新策略提供证据。
PROSPERO CRD42019126927
