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肯尼亚通过“网络上的妇女”组织提供的远程医疗堕胎服务(2013 - 2019年):对寻求护理者的特征和动机的描述性分析

Telehealth abortion services via Women on Web in Kenya (2013-2019): a descriptive analysis of the characteristics and motivations of the care seekers.

作者信息

Ouma Mary Achieng, Alaze Anita, Juma Kenneth, Atay Hazal, Gomperts Rebecca, Miani Céline

机构信息

Doctoral student, Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.

Senior Research Officer, African Population and Health Research Center (APHRC), Nairobi, Kenya.

出版信息

Sex Reprod Health Matters. 2025 Dec;33(1):2500828. doi: 10.1080/26410397.2025.2500828. Epub 2025 Jun 4.

Abstract

In Kenya, access to abortion is legally restricted and allowed under a limited set of conditions. Teleabortion service providers, such as Women on Web (WoW), provide safe and effective abortion care outside the formal health sector. This study explores the characteristics and motivations of individuals in Kenya who completed an online consultation on the WoW website in 2013-2019. We used anonymised data provided by WoW to describe participants' characteristics ( = 857) and their motivations for accessing the WoW online consultation ( = 449, since this information was only available for those who filled out the questionnaire from December 2017). Participants' median age was 23; 65.0% did not have children, and 80.9% had not had a previous abortion. Pregnancies were caused by failure (43.6%) or absence of contraceptive method (49.0%), or rape (6.0%). The most frequently reported reasons for accessing the online consultation were legal restrictions and abortion costs. Those were selected by about half the participants (respectively 235 and 222/449). Next came the wish to keep the abortion private or secret, which was selected by 34.5% and 26.0% of participants. Among more positively framed reasons, home comfort came first (23.6%), followed by wanting to deal with the abortion oneself (20.7%) and finding an abortion through WoW empowering (17.4%). Abortion-seekers turning to teleabortion services usually do so following failing or absent contraception and to get access to safe abortions, avoid stigma, and keep their privacy. Expansion of teleabortion services, within or outside formal healthcare services, could strengthen abortion-seekers' autonomy and agency in Kenya.

摘要

在肯尼亚,堕胎在法律上受到限制,仅在有限的条件下被允许。远程堕胎服务提供者,如“网络上的女性”(WoW),在正规卫生部门之外提供安全有效的堕胎护理。本研究探讨了2013年至2019年在肯尼亚通过WoW网站完成在线咨询的个人的特征和动机。我们使用了WoW提供的匿名数据来描述参与者的特征(n = 857)以及他们进行WoW在线咨询的动机(n = 449,因为此信息仅适用于那些填写了2017年12月问卷的人)。参与者的年龄中位数为23岁;65.0%没有孩子,80.9%此前没有过堕胎经历。怀孕是由避孕失败(43.6%)或未采取避孕措施(49.0%),或强奸(6.0%)导致的。进行在线咨询最常报告的原因是法律限制和堕胎费用。约一半的参与者选择了这些原因(分别为235人和222人/449人)。其次是希望堕胎保持私密或保密,分别有34.5%和26.0%的参与者选择了这一原因。在更积极的原因中,在家舒适排在首位(23.6%),其次是希望自己处理堕胎事宜(20.7%)以及认为通过WoW进行堕胎能增强自主感(17.4%)。寻求堕胎者转向远程堕胎服务通常是在避孕失败或未采取避孕措施之后,目的是获得安全堕胎、避免污名化并保持隐私。在正规医疗服务内外扩大远程堕胎服务,可能会增强肯尼亚寻求堕胎者的自主权和行动能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7b6/12138938/e02f507ffd1f/ZRHM_A_2500828_F0001_OB.jpg

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