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Cited by 39Reproductive Health and ContraceptionInternational Human Rights and Reproductive LawGlobal Maternal and Child Health

Implementing and expanding safe abortion care: An international comparative case study of six countries

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Chavkin, Wendy, Stifani, Bianca M., Bridgman‐Packer, David, Greenberg, Jamie M.S., Favier, Mary·2018·International Journal of Gynecology & Obstetrics
DOI 10.1002/ijgo.12671
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Abstract

We conducted a comparative case study‐based investigation of health sector strategies that were useful in expanding or establishing new abortion services. We selected geographically diverse countries from across the human development index if they had implemented new abortion laws, or changed interpretations of existing laws or policies, within the past 15 years (Colombia, Ethiopia, Ghana, Portugal, South Africa, and Uruguay). Factors facilitating the expansion of services include use of a public health frame, situating abortion as one component of a comprehensive reproductive health package, and including country‐based health and women's rights organizations, medical and other professional societies, and international agencies and nongovernment organizations in the design and rollout of services. Task sharing and the use of techniques that do not require much infrastructure, such as manual vacuum aspiration and medical abortion, are important for rapid establishment of services, especially in low‐resource settings. Political will emerged as the key factor in establishing or expanding access to safe abortion services.

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  • Advocacy strategies for safe abortion that seem to work are context specific, but often based on deep and well-informed understanding of abortion, a public health approach synthesized with human rights, and strategic involvement of multiple stakeholders.

    “Advocacy strategies for safe abortion that seem to work are context specific, but often based on deep and well‐informed understanding of abortion, a public health approach synthesized with the articulation of human rights, and the strategic involvement of multiple stakeholders.16, 17, 18”

    From Advocating safe abortion: outcomes of a multi‐country needs assessment on the potential role of national societies of obstetrics and gynecology (2020) · cites this paper as [18]

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  • Factors that facilitated reform in these countries were organizational commitments to reduce maternal mortality and a vocal public health sector, in addition to an active civil society movement, favorable public opinion, and the right political momentum.

    “Factors that facilitated reform in these countries were organizational commitments to reduce maternal mortality and a vocal public health sector, in addition to an active civil society movement, favorable public opinion, and the right political momentum.18, 24, 28, 32”

    From Advocating safe abortion: outcomes of a multi‐country needs assessment on the potential role of national societies of obstetrics and gynecology (2020) · cites this paper as [18]

    The Context and Lessons Learned sections link reform to concern about maternal mortality, health-sector participation, civil society advocacy, and political will. But the Context section says health sectors were less involved in advocacy in South Africa and Colombia, and our copy does not establish favorable public opinion as a facilitator across the six countries. Page numbers are unavailable in our copy. (LLM, conf=0.85)

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Research works printed but not linked: 63

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Authors
Chavkin, W., Stifani, B. M., Bridgman‐Packer, D., Greenberg, J. M. S., & Favier, M.
Affiliations
  • Columbia University Irving Medical Center (US)
  • Albert Einstein College of Medicine (US)
  • Parklands Surgery Parklands Cork Ireland
Corresponding author
Chavkin, Wendy
ORCID
Venue
International Journal of Gynecology & Obstetrics
Publisher
Wiley
Published
2018-10
Volume
143
Issue
S4
Pages
3-11
ISSN
  • 0020-6695 (ISSN-L)
  • 0020-7292
  • 1879-3479
DOI
10.1002/ijgo.12671
OpenAlex
W2899205423
Cited by
39
References
70
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 3 · 2019: 4 · 2018: 7
FWCI
5.48
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Gynecology & Obstetrics (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
UNDP-UNFPA-UNICEF-WHO-World Bank
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Social Sciences › Political Science and International Relations › International Human Rights and Reproductive Law
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
safe abortion care, abortion policy, reproductive health services, task sharing, manual vacuum aspiration, abortion pills, political will, women's rights organizations, resource-limited settings, Colombia, Ethiopia, Ghana, Portugal, South Africa, Uruguay
MeSH terms
Abortion, Induced, Colombia, Delivery of Health Care, Developing Countries, Ethiopia, Female, Ghana, Humans, Portugal, Pregnancy, South Africa, Uruguay, Women's Health, Patient Safety

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