Sarah Fried


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    Objective: About 26 million women refugees worldwide are affected by emergencies and face multiple sexual and reproductive health and rights (SRHR) risks, requiring access to key services. Women in humanitarian emergency settings face increased exposure to unintended pregnancies while lacking access to SRHR services, including safe abortion.

    An overall growth in institutional capacity in SRHR in humanitarian settings has been reported, however with an exception for abortion-related services. Suggested reasons for this are legal uncertainties, health care providers’ personal moral/attitudes, and lack of quality commodities. However, research confirming or rejecting these hypotheses is lacking.

    The aim of this study was to gain a better understanding of health care providers’ readiness to provide safe abortion services in humanitarian settings, and to identify obstacles and facilitators in service provision.
    Methods: Ten individual in-depth interviews were conducted with health care providers with experience in working in humanitarian settings in Nepal and Pakistan. An inductive qualitative approach was used for analysis. 

    Preliminary results: Induced abortion is rarely prioritized or discussed in medical training. Health care providers are willing to provide safe abortions, but often have inadequate knowledge, poor access to updated guidelines, and lack equipment and supplies. Despite being legal, access to abortion is limited. Stigma surrounding abortions consist a barrier both for patients and health care providers, since abortion services often are frowned upon by surrounding communities. Health care providers’ personal values, and involvement of influential people, such as religious leaders, were mentioned as both barriers and facilitating factors.  

    Conclusions: Further training addressing caregivers’ knowledge, attitudes and values is needed. Information on local legal situations, support to health care providers, in-service training and updated guidelines are lacking. As research on this topic is scarce, this study is of high importance for humanitarian actors with mandate and aim to provide safe abortion services.