RESUMO
The purpose of this study is to describe the knowledge and attitudes regarding abortion of a sample of health professionals in Mexico. In particular, we aim to explore their association with the practice of abortion and the care of post-abortion complications, taking into consideration the present legal framework in Mexico. The data come from an anonymous and computerized survey applied to participants attending a national meeting of gynecology and obstetrics in Mexico in 2009 (n=418). The attitudes of health professionals in relation to abortion play a key role in promoting access to both medical and surgical abortion services. We did not find a statistical association between living in a largely restrictive federal entity and the practice of abortions, which may be explained by the lack of knowledge that these survey participants had about abortion laws in their federal entity. This lack of knowledge about abortion legislation can hinder a woman's access to these services even when the legal framework such access.
Assuntos
Aborto Induzido , Atitude do Pessoal de Saúde , Competência Clínica , Acessibilidade aos Serviços de Saúde , Padrões de Prática Médica/estatística & dados numéricos , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Modelos Logísticos , Masculino , México , Análise Multivariada , Complicações Pós-Operatórias/terapia , Gravidez , Inquéritos e QuestionáriosRESUMO
El objetivo de este estudio es describir los conocimientos y actitudes de una muestra de profesionales médicos en México con relación al aborto y su asociación con la práctica y la atención a complicaciones derivadas de abortos, tomando en cuenta el marco legal vigente. Los datos provienen de una encuesta anónima y computarizada a participantes que acudieron a una reunión de gineco-obstetricia en México en 2009 (n=418). Las actitudes de los profesionales de la salud juegan un papel determinante para favorecer el acceso a servicios de abortos tanto médicos como quirúrgicos. No se encontró asociación estadística entre vivir en una entidad federativa mayormente restrictiva y la práctica de abortos, lo cual se explica por el escaso conocimiento que los participantes de la encuesta tenían sobre las leyes de aborto vigentes en su entidad. Esta falta de conocimiento sobre la legislación del aborto puede obstaculizar que una mujer tenga este servicio aun cuando el marco legal lo permita.(AU)
The purpose of this study is to describe the knowledge and attitudes regarding abortion of a sample of health professionals in Mexico. In particular, we aim to explore their association with the practice of abortion and the care of post-abortion complications, taking into consideration the present legal framework in Mexico. The data come from an anonymous and computerized survey applied to participants attending a national meeting of gynecology and obstetrics in Mexico in 2009 (n=418). The attitudes of health professionals in relation to abortion play a key role in promoting access to both medical and surgical abortion services. We did not find a statistical association between living in a largely restrictive federal entity and the practice of abortions, which may be explained by the lack of knowledge that these survey participants had about abortion laws in their federal entity. This lack of knowledge about abortion legislation can hinder a womans access to these services even when the legal framework such access.(AU)
Assuntos
Adulto , Feminino , Humanos , Masculino , Gravidez , Aborto Induzido , Atitude do Pessoal de Saúde , Competência Clínica , Acessibilidade aos Serviços de Saúde , Padrões de Prática Médica/estatística & dados numéricos , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos , Estudos Transversais , Pesquisas sobre Atenção à Saúde , Modelos Logísticos , México , Análise Multivariada , Complicações Pós-Operatórias/terapia , Inquéritos e QuestionáriosRESUMO
El objetivo de este estudio es describir los conocimientos y actitudes de una muestra de profesionales médicos en México con relación al aborto y su asociación con la práctica y la atención a complicaciones derivadas de abortos, tomando en cuenta el marco legal vigente. Los datos provienen de una encuesta anónima y computarizada a participantes que acudieron a una reunión de gineco-obstetricia en México en 2009 (n=418). Las actitudes de los profesionales de la salud juegan un papel determinante para favorecer el acceso a servicios de abortos tanto médicos como quirúrgicos. No se encontró asociación estadística entre vivir en una entidad federativa mayormente restrictiva y la práctica de abortos, lo cual se explica por el escaso conocimiento que los participantes de la encuesta tenían sobre las leyes de aborto vigentes en su entidad. Esta falta de conocimiento sobre la legislación del aborto puede obstaculizar que una mujer tenga este servicio aun cuando el marco legal lo permita.
The purpose of this study is to describe the knowledge and attitudes regarding abortion of a sample of health professionals in Mexico. In particular, we aim to explore their association with the practice of abortion and the care of post-abortion complications, taking into consideration the present legal framework in Mexico. The data come from an anonymous and computerized survey applied to participants attending a national meeting of gynecology and obstetrics in Mexico in 2009 (n=418). The attitudes of health professionals in relation to abortion play a key role in promoting access to both medical and surgical abortion services. We did not find a statistical association between living in a largely restrictive federal entity and the practice of abortions, which may be explained by the lack of knowledge that these survey participants had about abortion laws in their federal entity. This lack of knowledge about abortion legislation can hinder a woman's access to these services even when the legal framework such access.
Assuntos
Adulto , Feminino , Humanos , Masculino , Gravidez , Aborto Induzido , Atitude do Pessoal de Saúde , Competência Clínica , Acessibilidade aos Serviços de Saúde , Padrões de Prática Médica/estatística & dados numéricos , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos , Estudos Transversais , Pesquisas sobre Atenção à Saúde , Modelos Logísticos , México , Análise Multivariada , Complicações Pós-Operatórias/terapia , Inquéritos e QuestionáriosRESUMO
The purpose of this study is to describe the knowledge and attitudes regarding abortion of a sample of health professionals in Mexico. In particular, we aim to explore their association with the practice of abortion and the care of post-abortion complications, taking into consideration the present legal framework in Mexico. The data come from an anonymous and computerized survey applied to participants attending a national meeting of gynecology and obstetrics in Mexico in 2009 (n=418). The attitudes of health professionals in relation to abortion play a key role in promoting access to both medical and surgical abortion services. We did not find a statistical association between living in a largely restrictive federal entity and the practice of abortions, which may be explained by the lack of knowledge that these survey participants had about abortion laws in their federal entity. This lack of knowledge about abortion legislation can hinder a womans access to these services even when the legal framework such access.
Assuntos
Aborto Induzido , Atitude do Pessoal de Saúde , Competência Clínica , Acessibilidade aos Serviços de Saúde , Padrões de Prática Médica/estatística & dados numéricos , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Modelos Logísticos , Masculino , México , Análise Multivariada , Complicações Pós-Operatórias/terapia , Gravidez , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Little is known about abortion practice in Mexico postlegalization of abortion in Mexico City in 2007. STUDY DESIGN: In 2009, we anonymously surveyed 418 Mexican health care providers at the Colegio Mexicano de Especialistas en Ginecologia y Obstetricia meeting using audio computer-assisted self-interview technology. RESULTS: The majority of respondents were obstetrician gynecologists (376, 90%), Catholic (341, 82%), 35-60 years old (332, 79%) and male (222, 53%) and worked with trainees (307, 74%). Prior to 2007, 11% (46) and 17% (71) provided medical and surgical abortions; now, 15% (62) and 21% (86) provide these services, respectively. Practitioners from Mexico City were more likely to provide services than those from other areas. Most medical abortion providers (50, 81%) used ineffective protocols. Surgical abortion providers mainly used either manual vacuum aspiration (39, 45%) or sharp curettage (27, 32%). Most abortion providers were trained in residency and wanted more training in medical (54, 87%) and surgical (59, 69%) abortion. Among nonproviders, 49% (175) and 27% (89) expressed interest in learning to perform medical and surgical abortion, respectively. CONCLUSION: Given the interest in learning to provide safe abortion services and the prevalent use of ineffective medical abortion regimens and sharp curettage, abortion training in Mexico should be strengthened.
Assuntos
Aborto Induzido/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Pharmacies are important sites for access to health information and medications in Mexico. Most workers are not trained in health issues and may provide inaccurate information to consumers. Misoprostol is used by women throughout Mexico for early abortion and often is purchased from pharmacies. This study aims to understand the practices of pharmacy workers when asked for advice about and medications for abortion, in particular misoprostol. STUDY DESIGN: A random sample of pharmacies in both urban and rural areas of one state of Mexico included both chain and independent pharmacies (n=169). Two mystery clients (MCs) visited the pharmacies, requesting medication for "bringing down the period" and then asking for misoprostol. MCs recorded information about the interactions following each visit in standardized formats. Bivariate comparisons were made between spontaneous and prompted discussions of misoprostol. Associations were considered statistically significant at alpha<.05. RESULTS: Ninety percent of pharmacy workers attending to the MCs discussed misoprostol as an abortifacient, either spontaneously or after being prompted by the MCs. Misoprostol was for sale in most (61%) of these pharmacies. The majority of pharmacy workers (75%) did not request a prescription. Over 75% of all pharmacy workers provided the MCs referral to trained medical providers with whom they could seek a follow-up visit. Sixteen percent of pharmacy workers suggested a regimen consistent with evidence and recommendations for using misoprostol for early abortion. Regimens that were underdosages were common, and few workers recommended a potentially harmful overdosage. Instructions about side effects and risks were rare. The price of misoprostol ranged from 900 to 1800 pesos (US$83-167) for a bottle of 28 tablets (200 mcg each) or US$4.07 per tablet, on average. CONCLUSIONS: Pharmacy workers in both urban and rural areas of Mexico are increasingly becoming aware of misoprostol as an effective abortifacient and are willing to provide the information to consumers. However, their information is limited and often inaccurate. Strategies need to be developed so that they receive timely and correct information, consistent with evidence-based recommendations. The legal context of abortion in Mexico (with restrictions in every state, except Mexico City), the restricted registration of misoprostol as a therapeutic agent only for gastric ulcers and the fact that the majority of pharmacy workers are not considered to be health workers are among the most important barriers to advances in training pharmacy workers in the correct application of misoprostol.