Towards comprehensive early abortion service delivery in high income countries: Insights for improving universal access to abortion in Australia

Dawson, A; Bateson, D; Estoesta, J; Sullivan, E

Towards comprehensive early abortion service delivery in high income countries: Insights for improving universal access to abortion in Australia

Dawson, A

Bateson, D Estoesta, J Sullivan, E

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Publication Type:: Journal Article
Citation:: BMC Health Services Research, 2016, 16 (1)
Issue Date:: 2016-10-22

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Field	Value	Language
dc.contributor.author	Dawson, A https://orcid.org/0000-0003-0926-2202	en_US
dc.contributor.author	Bateson, D	en_US
dc.contributor.author	Estoesta, J	en_US
dc.contributor.author	Sullivan, E https://orcid.org/0000-0002-8718-2753	en_US
dc.date.available	2016-10-12	en_US
dc.date.issued	2016-10-22	en_US
dc.identifier.citation	BMC Health Services Research, 2016, 16 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/57346
dc.description.abstract	© 2016 The Author(s). Background: Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. Methods: We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. Results: This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Conclusions: Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical abortion. However, to implement such directives leadership is required from Australian medical, nursing, midwifery and pharmacy practitioners, academic faculties and their associated professional associations. In addition, political will is needed to nationally decriminalise abortion and ensure dedicated public provision that is based on comprehensive models tailored for all populations.	en_US
dc.relation.ispartof	BMC Health Services Research	en_US
dc.relation.isbasedon	10.1186/s12913-016-1846-z	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Abortion, Induced	en_US
dc.subject.mesh	Leadership	en_US
dc.subject.mesh	Telemedicine	en_US
dc.subject.mesh	Midwifery	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Developed Countries	en_US
dc.subject.mesh	Income	en_US
dc.subject.mesh	Ambulatory Care Facilities	en_US
dc.subject.mesh	Universal Coverage	en_US
dc.subject.mesh	Patient Satisfaction	en_US
dc.subject.mesh	Delivery of Health Care	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Canada	en_US
dc.subject.mesh	United States	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Russia	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Young Adult	en_US
dc.subject.mesh	United Kingdom	en_US
dc.subject.mesh	Universal Health Insurance	en_US
dc.title	Towards comprehensive early abortion service delivery in high income countries: Insights for improving universal access to abortion in Australia	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	16	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	0807 Library and Information Studies	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	16	en_US

Abstract:

© 2016 The Author(s). Background: Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. Methods: We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. Results: This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Conclusions: Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical abortion. However, to implement such directives leadership is required from Australian medical, nursing, midwifery and pharmacy practitioners, academic faculties and their associated professional associations. In addition, political will is needed to nationally decriminalise abortion and ensure dedicated public provision that is based on comprehensive models tailored for all populations.

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http://hdl.handle.net/10453/57346