Axe de recherche au Ceped : Axe 1 - Santé, vulnérabilités et relations de genre au Sud
- DEBEAUDRAP Pierre
- Estelle Pasquier (Epicentre/MSF)
- Tamara Fetters (Ipas)
Epicentre / Médecins Sans Frontières, France
Membres du Ceped participant au projet
- DEBEAUDRAP Pierre, (expert extérieur - analyses statistiques)
Abortion-related complications are one of the five main causes of maternal mortality worldwide ; almost all are related to unsafe abortion and nearly all (97%) occur in developing countries. Although unsafe abortion is the only cause of maternal mortality that is entirely preventable, it is also the most neglected cause of maternal mortality, showing the smallest decline in cause-specific maternal mortality between 1990 and 2013. It should be noted that complications of abortion increased as a proportion of maternal deaths from 13% to 18% during the same time period.
Previous work on abortion-related complications has excluded fragile and/or conflict affected contexts because of security concerns and other challenges associated with collecting data in fragile areas. Yet, fragile and conflict-affected settings increase the vulnerability of affected population to sexual violence. Disruption and dislocation from health and contraceptive services also increase the risk of unwanted pregnancy. These factors may result in more abortion-seeking behavior and early pregnancy complications, including abortion-related complications.
This research is expected to generate evidence highlighting the magnitude and severity of abortion related complications. In addition, it will provide information on women’s trajectories to experiencing near-miss complications, and identify the challenges and barriers to health care experienced by women seeking post-abortion care in African fragile and/or conflict-affected settings.
To describe and estimate the burden of abortion-related complications, particularly near-miss complications and deaths, and their associated factors among women presenting for abortion related complications in health facilities supported by Médecins Sans Frontières (MSF) in African fragile and/or conflict-affected settings.
Multi-sites mixed-methods study with 4 components :
1- A Quantitative observational descriptive study among women presenting for abortion related complications to determine the frequency and severity of abortion-related complications including near-miss cases and death. Data will be collected through a medical records review and a quantitative survey among women presenting for abortion related complications to determine the sociodemographic and clinical characteristics of the women with abortion-related complications, the type of abortion, the type and severity (near-miss) of complications (using the WHO criteria) and the clinical management received. It will also give insight into the characteristics of near-miss events following unsafe abortion.
2- A qualitative study about women’s experiences associated with a near-miss event (and life-threatening conditions) : their pathway of access to care including their decision making process, their own perceptions and opinions and other factors or conditions that might contribute to the near-miss event (in-depth face to face interviews).
3- A rapid health facility assessment with the health professional in charge of Post-Abortion Care will complement the assessment of the quality of management of complications
4- A Knowledge Attitudes, Practice and Behavior quantitative survey among health care providers involved in the management of abortion-related complications will identify provider-associated factors that may contribute to near-miss events.
Avortement, Santé sexuelle et reproductive, Conflits.
Bangui (Centrafrique), Masisi (DRC), Jahun (Nigeria).
Juillet 2018 - juillet 2022
courriel : Estelle.PASQUIER chez epicentre.msf.org