IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v71y2010i1p62-70.html
   My bibliography  Save this article

Choosing early pregnancy termination methods in Urban Mozambique

Author

Listed:
  • Mitchell, Ellen M.H.
  • Kwizera, Amata
  • Usta, Momade
  • Gebreselassie, Hailemichael

Abstract

Little is known about who chooses medication abortion with misoprostol and why. Women seeking early abortion in 5 public hospitals in Maputo, Mozambique were recruited in 2005 and 2006 to explore decision-making strategies, method preferences and experiences with misoprostol and vacuum aspiration for early abortion. Client screenings (n = 1799), structured clinical surveys (n = 837), in-depth exit interviews (n = 70), and nurse focus groups (n = 2) were conducted. Triangulation of qualitative and quantative data revealed seemingly contradictory findings. Choice of method reflected women's heightened concerns about privacy, pain, quality of home support, HIV infection risk, sexuality, and safety of research participation. Urban Mozambican women are highly motivated to find early pregnancy termination techniques that they deem socially and clinically low-risk. Although 42% found vaginal misoprostol self-administration challenging and 25% delayed care for over a week to amass funds for user fees, almost all (96%) reported adequate preparation and comfort with home management. Women reported satisfaction with all methods and quality of care, even if the initial method failed or pain management or postabortion contraception were not offered. A more nuanced understanding of what women value most can yield service delivery models that are responsive and effective in reducing maternal death and disability from unsafe abortion.

Suggested Citation

  • Mitchell, Ellen M.H. & Kwizera, Amata & Usta, Momade & Gebreselassie, Hailemichael, 2010. "Choosing early pregnancy termination methods in Urban Mozambique," Social Science & Medicine, Elsevier, vol. 71(1), pages 62-70, July.
    • Handle: RePEc:eee:socmed:v:71:y:2010:i:1:p:62-70
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(10)00269-8
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Songane, Francisco Ferreira & Bergström, Staffan, 2002. "Quality of registration of maternal deaths in Mozambique: a community-based study in rural and urban areas," Social Science & Medicine, Elsevier, vol. 54(1), pages 23-31, January.
    2. Glick, Peter, 2009. "How reliable are surveys of client satisfaction with healthcare services? Evidence from matched facility and household data in Madagascar," Social Science & Medicine, Elsevier, vol. 68(2), pages 368-379, January.
    3. Machungo, Fernanda & Zanconato, Giovanni & Bergström, Staffan, 1997. "Reproductive characteristics and post-abortion health consequences in women undergoing illegal and legal abortion in Maputo," Social Science & Medicine, Elsevier, vol. 45(11), pages 1607-1613, December.
    4. Valentine, Nicole & Darby, Charles & Bonsel, Gouke J., 2008. "Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries," Social Science & Medicine, Elsevier, vol. 66(9), pages 1939-1950, May.
    5. Chapman, Rachel R., 2003. "Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk," Social Science & Medicine, Elsevier, vol. 57(2), pages 355-374, July.
    6. Mead, Nicola & Bower, Peter, 2000. "Patient-centredness: a conceptual framework and review of the empirical literature," Social Science & Medicine, Elsevier, vol. 51(7), pages 1087-1110, October.
    7. Kabakian-Khasholian, Tamar & Campbell, Oona & Shediac-Rizkallah, Mona & Ghorayeb, Françoise, 2000. "Women's experiences of maternity care: satisfaction or passivity?," Social Science & Medicine, Elsevier, vol. 51(1), pages 103-113, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Coast, Ernestina & Norris, Alison H. & Moore, Ann M. & Freeman, Emily, 2018. "Trajectories of women's abortion-related care: A conceptual framework," Social Science & Medicine, Elsevier, vol. 200(C), pages 199-210.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bromley, Elizabeth, 2012. "Building patient-centeredness: Hospital design as an interpretive act," Social Science & Medicine, Elsevier, vol. 75(6), pages 1057-1066.
    2. Siddiqui, Shayzal & Smith-Morris, Carolyn, 2022. "Professional competition amidst intractable maternal mortality: Midwifery in rural Pakistan during the COVID-19 pandemic," Social Science & Medicine, Elsevier, vol. 313(C).
    3. DeVolder, Russell & Serra-Sastre, Victoria & Zamora, Bernarda, 2020. "Examining the variation across acute trusts in patient delayed discharge," Health Policy, Elsevier, vol. 124(11), pages 1226-1232.
    4. Hyojung Tak & Gregory Ruhnke & Ya-Chen Shih, 2015. "The Association between Patient-Centered Attributes of Care and Patient Satisfaction," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 187-197, April.
    5. Rathert, Cheryl & Mittler, Jessica N. & Vogus, Timothy J. & Lee, Yuna S.H., 2023. "Better outcomes through patient – Provider therapeutic connections? An exploratory study of proposed mediating variables," Social Science & Medicine, Elsevier, vol. 338(C).
    6. Ashill, Nicholas J. & Rod, Michel, 2011. "Burnout processes in non-clinical health service encounters," Journal of Business Research, Elsevier, vol. 64(10), pages 1116-1127, October.
    7. Nor Azmaniza Azizam & Siti Noorsuriani Maon & Leny Suzana & Nor Intan Shamimi Abdul Aziz, 2018. "Factors Influencing Selected Health Outcome among Patients Attending Universiti Teknologi MARA Medical Centre," International Journal of Academic Research in Business and Social Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Business and Social Sciences, vol. 8(7), pages 500-511, July.
    8. Zainab Zahran & Marcelle Tauber & Holly Howe Watson & Phoebe Coghlan & Sarah White & Sue Procter & Gulen Addis & Christine Norton, 2016. "Systematic review: what interventions improve dignity for older patients in hospital?," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(3-4), pages 311-321, February.
    9. Valadez, Joseph J. & Hage, Jerald & Vargas, William, 2005. "Understanding the relationship of maternal health behavior change and intervention strategies in a Nicaraguan NGO network," Social Science & Medicine, Elsevier, vol. 61(6), pages 1356-1368, September.
    10. Eissens van der Laan, M.R. & van Offenbeek, M.A.G. & Broekhuis, H. & Slaets, J.P.J., 2014. "A person-centred segmentation study in elderly care: Towards efficient demand-driven care," Social Science & Medicine, Elsevier, vol. 113(C), pages 68-76.
    11. Catherine Fullwood & Anne Kennedy & Anne Rogers & Martin Eden & Caroline Gardner & Joanne Protheroe & David Reeves, 2013. "Patients’ Experiences of Shared Decision Making in Primary Care Practices in the United Kingdom," Medical Decision Making, , vol. 33(1), pages 26-36, January.
    12. Fiorentini, Gianluca & Ragazzi, Giovanni & Robone, Silvana, 2015. "Are bad health and pain making us grumpy? An empirical evaluation of reporting heterogeneity in rating health system responsiveness," Social Science & Medicine, Elsevier, vol. 144(C), pages 48-58.
    13. Reid, Alice & Garrett, Eilidh, 2018. "Medical provision and urban-rural differences in maternal mortality in late nineteenth century Scotland," Social Science & Medicine, Elsevier, vol. 201(C), pages 35-43.
    14. Kreuzer, Maria & Cado, Vesna & Raïes, Karine, 2020. "Moments of care: How interpersonal interactions contribute to luxury experiences of healthcare consumers," Journal of Business Research, Elsevier, vol. 116(C), pages 482-490.
    15. Janice Gandy & Erika Metzler Sawin & Sharon Zook & Lynne Eggert, 2019. "Improving Adherence to Mental Health Treatment in a Low-Income Clinic," SAGE Open, , vol. 9(2), pages 21582440198, May.
    16. Murdoch, Jamie & Salter, Charlotte & Ford, John & Lenaghan, Elizabeth & Shiner, Alice & Steel, Nicholas, 2020. "The “unknown territory” of goal-setting: Negotiating a novel interactional activity within primary care doctor-patient consultations for patients with multiple chronic conditions," Social Science & Medicine, Elsevier, vol. 256(C).
    17. Hardman, Doug & Ongaro, Giulio, 2020. "Subjunctive medicine: A manifesto," Social Science & Medicine, Elsevier, vol. 256(C).
    18. David K. Evans & Anna Welander Tärneberg, 2018. "Health‐care quality and information failure: Evidence from Nigeria," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 90-93, March.
    19. Gutin, Iliya, 2022. "Not ‘putting a name to it’: Managing uncertainty in the diagnosis of childhood obesity," Social Science & Medicine, Elsevier, vol. 294(C).
    20. Paulus, Trena M. & Grubbs, Heather & Rice-Moran, Renee & Lester, Jessica N., 2023. "How student healthcare providers in a communication skills course respond to standardized patient resistance," Social Science & Medicine, Elsevier, vol. 337(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:71:y:2010:i:1:p:62-70. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.