<p>In the Democratic Republic of Congo (DRC) unsafe abortion claims thousands of lives every year. Under the 2018 Maputo protocol ratification, officials are implementing abortion services, yet abortion stigma contributes to delays in access to care. A recognized approach, person-centred care, can improve the quality and access to care in DRC. The aim of this study was to understand the experiences of women who received an abortion with midwives, nurses or physicians recently trained in comprehensive abortion care (CAC) using person-centred approaches in the capital city of Kinshasa. A qualitative design with semi-structured interviews captured the complexity and richness of twenty-five women who accessed CAC with trained healthcare providers. Participants were interviewed two weeks post-abortion. The analysis was thematic and applied person-centred abortion care frameworks. Participants emphasized the importance of emotional and psychological support from healthcare providers, and care that was empathetic, informative, reassuring and rapport building over time. They valued services tailored to their needs including care delivered virtually or outside of traditional clinical settings before, during, and after the abortion process. Relational continuity across the care journey, was central to their experiences and helped reduce feelings of isolation and stigma. Person-centred abortion care approaches can be expanded to explore how the care process, particularly the nexus between healthcare provider and client, shapes the overall experience. In DRC this includes prioritizing programs to support continuity of healthcare provider, and community-based care including the option for abortion self-management.</p>

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Experiences of Person-Centred Comprehensive Abortion Care: A Qualitative Study Among Women in Kinshasa, Democratic Republic of Congo

  • Kirsty M. Bourret,
  • Marie Chantal Kankolongo,
  • Nadia Lobo,
  • Jean-Claude Mulunda,
  • Eva Åkerman,
  • Elisa M Maffioli,
  • Marie Klingberg-Allvin

摘要

In the Democratic Republic of Congo (DRC) unsafe abortion claims thousands of lives every year. Under the 2018 Maputo protocol ratification, officials are implementing abortion services, yet abortion stigma contributes to delays in access to care. A recognized approach, person-centred care, can improve the quality and access to care in DRC. The aim of this study was to understand the experiences of women who received an abortion with midwives, nurses or physicians recently trained in comprehensive abortion care (CAC) using person-centred approaches in the capital city of Kinshasa. A qualitative design with semi-structured interviews captured the complexity and richness of twenty-five women who accessed CAC with trained healthcare providers. Participants were interviewed two weeks post-abortion. The analysis was thematic and applied person-centred abortion care frameworks. Participants emphasized the importance of emotional and psychological support from healthcare providers, and care that was empathetic, informative, reassuring and rapport building over time. They valued services tailored to their needs including care delivered virtually or outside of traditional clinical settings before, during, and after the abortion process. Relational continuity across the care journey, was central to their experiences and helped reduce feelings of isolation and stigma. Person-centred abortion care approaches can be expanded to explore how the care process, particularly the nexus between healthcare provider and client, shapes the overall experience. In DRC this includes prioritizing programs to support continuity of healthcare provider, and community-based care including the option for abortion self-management.