Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluation

In 2018, Ipas Bolivia launched an abortion self-care (ASC) community intervention with the goal of increasing access to supportive, well-informed abortion support provided by community agents (CAs). Between September 2019 and July 2020, Ipas conducted a mixed-methods evaluation to assess the reach,...

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Main Authors: Valerie N. Acre, Stephanie Andrea Küng, Christiam Arce, Adela Yapu, Delmy Iriondo, Malena Morales
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Sexual and Reproductive Health Matters
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Online Access:https://www.tandfonline.com/doi/10.1080/26410397.2022.2139888
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author Valerie N. Acre
Stephanie Andrea Küng
Christiam Arce
Adela Yapu
Delmy Iriondo
Malena Morales
author_facet Valerie N. Acre
Stephanie Andrea Küng
Christiam Arce
Adela Yapu
Delmy Iriondo
Malena Morales
author_sort Valerie N. Acre
collection DOAJ
description In 2018, Ipas Bolivia launched an abortion self-care (ASC) community intervention with the goal of increasing access to supportive, well-informed abortion support provided by community agents (CAs). Between September 2019 and July 2020, Ipas conducted a mixed-methods evaluation to assess the reach, outcomes, and acceptability of the intervention. We used logbook data maintained by CAs to capture demographic characteristics and ASC outcomes of people supported. We also conducted in-depth interviews with 25 women who had received support and 22 CAs who had provided support. 530 people accessed ASC support through the intervention, most of whom were young, single, educated women accessing abortion in the first trimester. Among the 302 people who self-managed their abortions, 99% reported having a successful abortion. No women reported adverse events. All women interviewed expressed satisfaction with the support provided by the CA and, in particular, with the information, lack of judgement, and respect they felt from CAs. CAs spoke highly about their experience and viewed their participation as a way to increase people’s ability to exercise their reproductive rights. Obstacles included experiences of stigma, fears of legal repercussions, and difficulties dispelling misconceptions around abortion. Legal restrictions and abortion stigma continue to complicate access to safe abortion, and findings from this evaluation highlight important avenues for the effectiveness and expansion of ASC interventions, including legal support to people who have abortions and those who provide abortion support, building capacity of people as informed buyers, and ensuring that interventions reach rural and other often under-served people.
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spelling doaj-art-ad3bbf3ae2d24142b10e4744a6caeeb12025-08-20T03:31:49ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972023-12-0131110.1080/26410397.2022.2139888Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluationValerie N. Acre0Stephanie Andrea Küng1Christiam Arce2Adela Yapu3Delmy Iriondo4Malena Morales5Senior Research, Monitoring and Evaluation Advisor, Ipas, Chapel Hill, NC, USA. Correspondence:Research Consultant, Ipas, Chapel Hill, NC, USAResearch Consultant, Ipas Bolivia, La Paz, BoliviaProgram Manager, Ipas Bolivia, La Paz, BoliviaAssociate, Ipas Bolivia, La Paz, BoliviaCountry Director, Ipas Bolivia, La Paz, BoliviaIn 2018, Ipas Bolivia launched an abortion self-care (ASC) community intervention with the goal of increasing access to supportive, well-informed abortion support provided by community agents (CAs). Between September 2019 and July 2020, Ipas conducted a mixed-methods evaluation to assess the reach, outcomes, and acceptability of the intervention. We used logbook data maintained by CAs to capture demographic characteristics and ASC outcomes of people supported. We also conducted in-depth interviews with 25 women who had received support and 22 CAs who had provided support. 530 people accessed ASC support through the intervention, most of whom were young, single, educated women accessing abortion in the first trimester. Among the 302 people who self-managed their abortions, 99% reported having a successful abortion. No women reported adverse events. All women interviewed expressed satisfaction with the support provided by the CA and, in particular, with the information, lack of judgement, and respect they felt from CAs. CAs spoke highly about their experience and viewed their participation as a way to increase people’s ability to exercise their reproductive rights. Obstacles included experiences of stigma, fears of legal repercussions, and difficulties dispelling misconceptions around abortion. Legal restrictions and abortion stigma continue to complicate access to safe abortion, and findings from this evaluation highlight important avenues for the effectiveness and expansion of ASC interventions, including legal support to people who have abortions and those who provide abortion support, building capacity of people as informed buyers, and ensuring that interventions reach rural and other often under-served people.https://www.tandfonline.com/doi/10.1080/26410397.2022.2139888abortionLatin America and the CaribbeanBoliviaabortion self-careself-managed abortionmedical abortion
spellingShingle Valerie N. Acre
Stephanie Andrea Küng
Christiam Arce
Adela Yapu
Delmy Iriondo
Malena Morales
Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluation
Sexual and Reproductive Health Matters
abortion
Latin America and the Caribbean
Bolivia
abortion self-care
self-managed abortion
medical abortion
title Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluation
title_full Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluation
title_fullStr Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluation
title_full_unstemmed Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluation
title_short Reach, experience, and acceptability of an abortion self-care intervention in Bolivia: a mixed-methods evaluation
title_sort reach experience and acceptability of an abortion self care intervention in bolivia a mixed methods evaluation
topic abortion
Latin America and the Caribbean
Bolivia
abortion self-care
self-managed abortion
medical abortion
url https://www.tandfonline.com/doi/10.1080/26410397.2022.2139888
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