Developing and Testing Interventions to Address Conscientious Objection to Abortion Care in Mexico and South Africa

Ipas

Status: Terminated

Conditions: Abortion, Induced; Abortion, Incomplete

Treatments: Behavioral: CO Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT04290832

TIE_2020_01

Details and patient eligibility

About

The primary purpose of this research is to develop strategies and interventions to mitigate the impact of conscientious objection on women's access to safe abortion care in Mexico and South Africa using a user-centered design approach and test the feasibility and effectiveness of these interventions.

Full description

Conscientious objection (CO) is emerging as a growing barrier to abortion care, and evidence suggests that it is being incorrectly used as a justification for public sector medical providers and institutions to exempt themselves from their duties to provide essential reproductive health services for women. Given this, it is essential to better understand and address this misuse of CO and find ways to improve women's access to safe abortion services to prevent them from using unsafe methods which risk their health and lives.

This study will conduct formative research to more fully understand the problem of CO in Mexico and South Africa and use these findings to develop interventions and strategies to mitigate the impact of CO on women's access to safe abortion care using a user-centered design approach. Rapid randomized controlled trials will then be used to assess effectiveness of the interventions. The specific aims of this study are:

1. Improve our understanding of CO and its impact on access and quality of abortion care from providers' and facility mangers' perspectives in Mexico, and South Africa.
2. Develop strategies and interventions to mitigate the impact of CO on women's access to safe abortion care. Using the data collected, a multi-disciplinary Innovation Team will develop strategies and interventions to respond to the challenges posed by CO using a user-centered design approach.
3. Rapid-test intervention prototypes. We will test selected strategies (prototypes) in Mexico, and South Africa with assessments to determine successes, and the feasibility of scaling up these approaches.

Enrollment: 317 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

South Africa

Inclusion Criteria:

• All staff currently working in selected health facilities
• Able to provide informed consent

Exclusion Criteria:

• Unable to provide informed consent

Mexico

Inclusion Criteria:

• Doctors/anyone eligible to be an abortion provider working in selected health facilities
• Able to provide informed consent

Exclusion Criteria:

• Unable to provide informed consent

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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317 participants in 2 patient groups

CO intervention

Experimental group

Description:

South Africa: All health facility staff working in facilities assigned to the intervention arm receive standard Ipas support (including monitoring of abortion service provision and support to Ipas-trained abortion providers) plus the CO intervention. Mexico: Doctors/anyone eligible to be an abortion provider working in facilities assigned to the intervention arm receive the CO intervention.

Treatment:

Behavioral: CO Intervention

Control

No Intervention group

Description:

South Africa: All health facility staff working in facilities assigned to the control arm receive standard Ipas support (including monitoring of abortion service provision and support to Ipas-trained abortion providers). Mexico: No intervention