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Acceptability of ho...
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Paul, Mandira,1985-Uppsala universitet,Institutionen för kvinnors och barns hälsa,Internationell kvinno- & mödrahälsovård och migration/Essén
(författare)
Acceptability of home-assessment post medical abortion and medical abortion in a low-resource setting in Rajasthan, India : Secondary outcome analysis of a non-inferiority randomized controlled trial
- Artikel/kapitelEngelska2015
Förlag, utgivningsår, omfång ...
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2015-09-01
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Public Library of Science (PLoS),2015
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:du-19527
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https://urn.kb.se/resolve?urn=urn:nbn:se:du-19527URI
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https://doi.org/10.1371/journal.pone.0133354DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:131937046URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-262580URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Background: Studies evaluating acceptability of simplified follow-up after medical abortion have focused on high-resource or urban settings where telephones, road connections, and modes of transport are available and where women have formal education.Objective: To investigate women's acceptability of home-assessment of abortion and whether acceptability of medical abortion differs by in-clinic or home-assessment of abortion outcome in a low-resource setting in India.Design: Secondary outcome of a randomised, controlled, non-inferiority trial. Setting Outpatient primary health care clinics in rural and urban Rajasthan, India.Population: Women were eligible if they sought abortion with a gestation up to 9 weeks, lived within defined study area and agreed to follow-up. Women were ineligible if they had known contraindications to medical abortion, haemoglobin < 85mg/l and were below 18 years.Methods: Abortion outcome assessment through routine clinic follow-up by a doctor was compared with home-assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet. A computerized random number generator generated the randomisation sequence (1: 1) in blocks of six. Research assistants randomly allocated eligible women who opted for medical abortion (mifepristone and misoprostol), using opaque sealed envelopes. Blinding during outcome assessment was not possible.Main outcome measures: Women's acceptability of home-assessment was measured as future preference of follow-up. Overall satisfaction, expectations, and comparison with previous abortion experiences were compared between study groups.Results: 731 women were randomized to the clinic follow-up group (n = 353) or home-assessment group (n = 378). 623 (85%) women were successfully followed up, of those 597 (96%) were satisfied and 592 (95%) found the abortion better or as expected, with no difference between study groups. The majority, 355 (57%) women, preferred home-assessment in the event of a future abortion. Significantly more women, 284 (82%), in the home-assessment group preferred home-assessment in the future, as compared with 188 (70%) of women in the clinic follow-up group, who preferred clinic follow-up in the future (p < 0.001).Conclusion: Home-assessment is highly acceptable among women in low-resource, and rural, settings. The choice to follow-up an early medical abortion according to women's preference should be offered to foster women's reproductive autonomy.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Iyengar, KirtiKarolinska Institutet,Karolinska institutet; ARTH, India,Karolinska University Hospital, Stockholm, Sweden
(författare)
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Essén, BirgittaKarolinska institutet,Karolinska University Hospital, Stockholm, Sweden(Swepub:uu)bires412
(författare)
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Gemzell-Danielsson, KristinaKarolinska Institutet,Karolinska institutet,Karolinska University Hospital, Stockholm, Sweden
(författare)
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Iyengar, Sharad D.Action Research & Training for Health (ARTH), Udaipur, Rajasthan, India
(författare)
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Bring, JohanStatisticon, Stockholm, Sweden.
(författare)
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Soni, SunitaAction Research & Training for Health (ARTH), Udaipur, Rajasthan, India
(författare)
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Klingberg-Allvin, MarieKarolinska Institutet,Högskolan Dalarna,Omvårdnad,Karolinska institutet,Karolinska University Hospital, Stockholm, Sweden(Swepub:du)mkl
(författare)
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Uppsala universitetInstitutionen för kvinnors och barns hälsa
(creator_code:org_t)
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Ingår i:PLOS ONE: Public Library of Science (PLoS)10:91932-6203
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