Healthcare students' knowledge and opinions about the Argentinean abortion law

Necessary but not sufficient: a scoping review of legal accountability for sexual and reproductive health in low-income and middle-income countries

BACKGROUND

This paper is a scoping review of the impact of legal accountability efforts for sexual and reproductive health and rights (SRHR), exploring the links between legal accountability strategies and changes in the desired SRHR outcomes.

METHODS

We defined legal accountability as use of the judicial system following state failure to respect, protect or fulfil SRHR as enshrined in national law, as well as individuals' or the state's use of criminal law mechanisms to prevent unwanted behaviour and to provide remedy. We undertook a keyword search in PubMed, Scopus and LexisNexis and then consulted a group of experts to provide guidance regarding further peer-reviewed and grey literature, yielding a total of 191 articles.

RESULTS

The majority of the empirical, peer-reviewed articles identified were regarding abortion law and abortion care availability, followed by violence against women. Most of these articles explore the gaps between law and practice. We identified seven key factors that shape the efficacy of legal accountability efforts, including the ways a law or court decision is formulated, access to courts, the (dis)advantages of criminal law in the given context, cultural norms, politics, state capacity and resources and the potential for further litigation. Many articles explained that use of the judiciary may be necessary to effect change and that the act of claiming rights can empower, but that legal avenues for change can be imperfect tools for justice.

CONCLUSIONS

Legal accountability can be effective as part of a broader, long-term strategy, with due attention to context.

Termination of pregnancy: Staff knowledge and training

OBJECTIVES

In January 2019, Termination of Pregnancy (TOP) services were introduced in Ireland allowing the termination of pregnancies < 12 weeks. This study aimed to investigate staff knowledge and training on early TOP and views regarding challenges to successful integration of the service within a large maternity hospital.

STUDY DESIGN

A questionnaire, modelled on interim clinical guidance and previous studies on the topic, was distributed to clinical staff in a large maternity hospital in 2019. Descriptive analysis and a hierarchical multiple regression were performed using SPSS.

MAIN OUTCOME MEASURES

Levels of knowledge on TOP among staff, training received and main challenges to the service.

RESULTS

Of the total of participants (n = 133), just one-quarter correctly answered all questions on the current legislation and 63.2% on complications. Male gender, education level (diploma/certificate), and age (<30 years) negatively contributed to overall knowledge. 'Medical' job position positively contributed to knowledge levels. Most respondents (88%) had not received training prior to introduction of TOP services. Of those who did, few (9%) believed it to be sufficient. The main identified challenges to the service were lack of training and education, staffing and resources.

CONCLUSIONS

Low levels of knowledge among staff suggests that training is required to ensure the provision of a safe and effective TOP service. Our findings indicate that updated and clearer clinical guidance on TOP services is also needed.

Pro-abortion attitude with context of traditional and professional identity dilemma

BACKGROUND

Nurses are in a key position for reproduction health service delivery. Therefore, it is thought that it would be important to inspect opinions of student nurses, who will be health employees in the future, about self-induced abortion to develop women health and public health.

OBJECTIVES

The goal of this study is to inspect opinions of nursing students with different sociocultural specialties, about self-induced abortions.

RESEARCH DESIGN

It is qualitative type and planned with ethnographic research pattern.

PARTICIPANTS AND RESEARCH CONTEXT

The study was conducted with 20 last-term students of Kırşehir Ahi Evran University, Faculty of Health Sciences, Department of Nursing, who were chosen by maximum diversity sampling technique. Interviews were made with semi-structured interview form and voice records during the study; data were analyzed with content analyzing method.

ETHICAL CONSIDERATIONS

Permission from the organization, university ethics committee, and personal approvals were taken from participants to conduct the research.

FINDINGS

Based on the analysis, two major themes on self-induced abortion in Turkish nursing students were found: dilemma of traditional perspective and professional identity and occupational awareness.

DISCUSSION AND CONCLUSION

It is seen that there is a dilemma between traditional point of view and professional identities about self-induced abortion for nursing students, but they had occupational awareness. It should be recommended to give information about national and international licit legislations for reproductive health, self-induced abortion, and setting up ethical discussion environments for nursing students.

Medical and midwifery student attitudes toward moral acceptability and legality of abortion, following decriminalization of abortion in Chile

OBJECTIVE

Soon after Chile decriminalized abortion under three limited circumstances in 2017, we assessed medical and midwifery students' attitudes about abortion morality and legality when compared to national opinions.

STUDY DESIGN

We administered an anonymous, online survey to medical and midwifery students from seven secular and religiously-affiliated universities in Santiago, Chile. We compared student responses to a nationally representative public opinion survey.

MAIN OUTCOME MEASURES

We examined three main outcomes related to abortion attitudes: (1) moral acceptability of abortion and legal support for abortion in (2) one or (3) all listed circumstances. We used general estimating equations to examine whether university type, field of study, and other student characteristics are associated with each outcome and compared student views toward abortion legality with those of the general public.

RESULTS

Among the 369 student respondents, most agreed that abortion can be a good thing for some women in some situations (82%). When compared to the general public, a larger proportion of students supported decriminalizing abortion in at least one (83% and 97%, respectively) or all (17% and 51%, respectively) seven listed circumstances. While secular university students held significantly more favorable views about abortion morality and legality than students from religiously-affiliated universities, the majority of students from both university types supported abortion in the three cases in which it was recently decriminalized.

CONCLUSIONS

Medical and midwifery students from not only secular but also religiously-affiliated universities are very supportive of the recent decriminalization of abortion, which presents training opportunities for both types of universities.

Perspectives of healthcare workers on the morality of abortion: a multicenter study in seven Brazilian public hospitals

We used the questionnaire "Mosaic of Opinions on Induced Abortion" to conduct a multi-centered study to evaluate the perspectives of physicians, nurses, social workers, psychologists and pharmacists on the morality of abortion. In all, 254 participants constituted the sample. The inadequate knowledge on Brazilian abortion laws was the only determinant negatively associated with the construct "Sexual and Reproductive Rights", corroborating the hypothesis that a better understanding of abortion legislation could mitigate the opposition of some professionals to the ethical perspective that access to safe abortion should be seen as a sexual and reproductive right.

What Do Married Couples Think About Induced Abortion?

This study examined the opinions of married couples concerning induced abortion in a sample of 674 married couples obtaining services at a large obstetrical/gynecological outpatient service. Although approximately half of the sample were not using birth control, a similar percentage felt that curettage (selective abortion) should never be performed. A larger percentage felt that selective abortion is a sin and should be banned. Sex differences in attitudes were minimal. Couples may benefit from a birth control education program in a hospital that is designed to cover abortion in order to provide accurate information in a more professional environment.

Health care students at an Argentinean school of medicine: are they well prepared to provide quality sexual and reproductive health services?

OBJECTIVES

The aim of our study was to assess what students of the University of Buenos Aires School of Medicine learn about sexual and reproductive health (SRH) and rights, focusing particularly on their knowledge of accessibility to contraception and abortion legislation.

METHODS

In this cross-sectional study, self-administered, anonymous questionnaires were administered to 760 first year students and to 695 final year students from different fields of study (medicine, midwifery, nursing, radiology, nutrition, speech therapy and physiotherapy) between 2011 and 2013. Students' knowledge of SRH was measured according to six variables: contraceptive methods, accessibility to contraception, emergency contraception, legislation on surgical contraception, legislation on voluntary interruption of pregnancy, and HIV transmission and prevention. Their level of knowledge was categorised as low, basic, medium or high, according to their responses.

RESULTS

We observed higher levels of knowledge in final year students compared with first year students. Those with basic level knowledge or higher were doubled in most of the variables. However, when analysed in detail per field of study, the differences were not so marked. It is important that medical, midwifery and nursing students receive formal education in SRH topics.

CONCLUSIONS

Our investigation revealed important deficiencies in knowledge in core topics of SRH care among soon-to-be health care providers that could represent serious barriers to health and rights for the Argentinean population in the near future. Thus, there is an urgent need to improve the teaching of SRH care.

Future healthcare professionals' knowledge about the Argentinean abortion law

OBJECTIVE

We assessed healthcare students' knowledge and opinions on Argentinian abortion law and identified differences between first- and final-year healthcare students.

METHODS

In this cross-sectional study, self-administered anonymous questionnaires were administered to 760 first- and 695 final-year students from different fields of study (medicine, midwifery, nursing, radiology, nutrition, speech therapy, and physiotherapy) of the School of Medicine at the University of Buenos Aires, in 2011-2013.

RESULTS

Compared to first-year students, a higher percentage of final-year students knew that abortion is legally restricted in Argentina (p < 0.001). A significantly higher percentage of final-year students could correctly identify the circumstances in which abortion is legal: woman's life risk (87.4% last vs. 79.1% first year), rape of a woman with developmental disability (66.2% first vs. 85.4% last-year; p < 0.001). More final-year students chose severe foetal malformations (37.3% first year vs. 57.3% final year) despite its being illegal.

CONCLUSIONS

Although most final-year students knew that abortion is legally restricted in Argentina, misconceptions regarding circumstances of legal abortion were observed; this may be due to the fact that abortion is inadequately covered in the medical curricula. Medical schools should ensure that sexual and reproductive health topics are an integral part of their curricula. Healthcare providers who are aware of the legality of abortion are more likely to provide the public with sound information and ensure abortions are appropriately performed.