Ramón Michel Agustina, Ariza Navarrete Sonia, Chávez Susana
Centro de Estudios de Estado y Sociedad, Health Area, Latin American Consortium Against Unsafe Abortion, Palermo University, Buenos Aires, Argentina.
Centro de Estudios de Estado y Sociedad, Latin American Consortium Against Unsafe Abortion, Lisboa, Portugal.
Front Glob Womens Health. 2022 Aug 1;3:898754. doi: 10.3389/fgwh.2022.898754. eCollection 2022.
The rapid increase in demand for health services as a result of the COVID-19 outbreak has created significant challenges for health systems. National and international health authorities have declared reproductive health services as essential, particularly those related to prevention, care during pregnancy, delivery and postpartum, as well as abortion services. This research was conducted by a regional team in cooperation with nine local organizations that are members of the Latin American Consortium against Unsafe Abortion (, CLACAI).
Our research aimed to examine the provision of reproductive healthcare services, with a focus on abortion, in nine countries during the first few months of the pandemic (March to September 2020).
Our research design developed a set of quantitative and qualitative indicators to monitor the availability and accessibility of abortion services during the COVID-19 pandemic. Researchers collected the quantitative data by reviewing regulations and other documents, government and civil society reports, and official statistics; the qualitative data was acquired through interviews with key actors, and non-representative surveys completed by healthcare professional and end users of reproductive services.
Although six of the nine countries we researched deemed reproductive health services essential, only two of these six countries considered abortion services to be essential, and all nine countries reported difficulties in accessing abortion services. Restrictive abortion laws remained in place in the majority of countries (seven), and as a result access to abortion services became even more limited than it had been before the pandemic. At the same time, good practices to facilitate access to abortion services in healthcare facilities, updated regulatory frameworks, and collaboration between civil society and government agencies were identified and should continue to be promoted even after the pandemic crisis has subsided.
The pandemic catalyzed what was already happening in each country, and as such abortion services have become more accessible in countries like Argentina, where the so-called green wave has been generating social, legal and policy changes, whereas in countries such as Ecuador, where abortion is legally restricted and opposed to by the government, access to safe abortion became even more difficult than it was before the pandemic. However, the general trend has been a lack of adequate adaptation in order to guarantee quality in abortion care. That said, there have also been some interesting and positive service provision initiatives, such as telemedicine, implemented in at least two countries, which, if maintained long-term, could improve access to safe abortion.
由于新冠疫情爆发，对卫生服务的需求迅速增加，给卫生系统带来了重大挑战。国家和国际卫生当局已宣布生殖健康服务为基本服务，特别是那些与预防、孕期护理、分娩和产后护理以及堕胎服务相关的服务。这项研究是由一个区域团队与拉丁美洲反对不安全堕胎联盟（CLACAI）的九个当地成员组织合作开展的。
我们的研究旨在调查疫情头几个月（2020年3月至9月）九个国家的生殖健康护理服务情况，重点是堕胎服务。
我们的研究设计制定了一套定量和定性指标，以监测新冠疫情期间堕胎服务的可获得性和可及性。研究人员通过审查法规和其他文件、政府和民间社会报告以及官方统计数据来收集定量数据；定性数据则通过与关键行为者进行访谈以及由生殖服务的医疗专业人员和最终用户完成的非代表性调查获得。
尽管我们研究的九个国家中有六个将生殖健康服务视为基本服务，但这六个国家中只有两个将堕胎服务视为基本服务，而且所有九个国家都报告了获取堕胎服务存在困难。大多数国家（七个）仍然保留严格的堕胎法律，因此获得堕胎服务的机会比疫情前更加有限。与此同时，我们还发现了一些便利在医疗机构获取堕胎服务的良好做法、更新的监管框架以及民间社会与政府机构之间的合作，即使在疫情危机消退后也应继续推广。
疫情催化了每个国家已有的情况，因此在阿根廷等国家，堕胎服务变得更容易获得，在那里所谓的“绿色浪潮”一直在引发社会、法律和政策变革，而在厄瓜多尔等国家，堕胎在法律上受到限制且遭到政府反对，获得安全堕胎服务比疫情前更加困难。然而，总体趋势是缺乏足够的调整以保证堕胎护理的质量。话虽如此，至少在两个国家也有一些有趣且积极的服务提供举措，比如远程医疗，如果长期维持下去，可能会改善安全堕胎服务的可及性。
