"Es el derecho de la mujer" A Qualitative Review of Abortion Care Quality in Bogota, Colombia Open Access

Bougrab, Nassira Marissa (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/rv042t72k?locale=en


Background. Despite the decriminalization of abortion in Colombia, women continue to seek out abortions outside the law. The clandestine nature of these abortions has raised a serious public health concern because "illegal abortion" is often synonymous with "unsafe abortion". It is unclear why women continue to get illegal abortions years after the procedure had been decriminalized. In an effort to answer this question, a student research team from the Rollins School of Public Health at Emory University traveled to Bogotá, Colombia in the summer of 2015 to assess the quality of abortion care. Although there is a dearth of research on how quality of care standards are followed in medical practice, the literature suggests there is a need to improve the implementation of the law and the quality of abortion care.

Objectives. We conducted a qualitative study of physicians and medical school faculty to explore their experiences providing abortions or training others to provide abortions.

Methods. We conducted structured in depth interviews with nine physicians and 14 medical school faculty. We addressed these questions: 1) to explore the perceptions of doctors about the quality of abortion care currently provided; and, 2) to describe the current medical education curriculum on abortion care in medical schools.

Results. Overall, many participants agreed that the quality of legal abortion care in Bogotá is of good quality, but that there are problems with the application of the law and the structure of the health and education system. Most of these issues are present in the form of barriers to care for the patient.

Conclusions. In conjunction with the Socio Ecological Model and the Organizational Stage Theory of Change, our findings show that there is an interaction across various levels that can impact the quality of care for a patient seeking an elective abortion. These findings have implications for individual provider outcomes as well as for larger institutions of care.

Table of Contents

Chapter I. Introduction 1

Abortion in Colombia 1

The Problem 2

Purpose and Aims 3

Significance 4

Terms 5

Chapter II. Review of the Literature 5

Quality of Abortion Care 6

Curriculum and Medical Education 8

Organizational Theory 9

Chapter III. Methods 14

Interviews 14

Analysis 16

Chapter IV. Results 18

Physician Interviews 18

Medical Educator Interviews 23

Chapter V. Discussion 27

Findings and Conclusions 27

Data quality limitations 30

Implications 31

Future Research 31

Appendix A: Consent Form 36

Appendix B: Physician Interview Guide 38

Appendix C: Medical Educator Interview Guide 40

Table of Figures

Figure 1: Socio Ecological Model and Stage Theory of Organizational Change (Awareness Stage) 13

Figure 2: SEM and STOC Awareness stage with Themes 29

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