Maternal health in crisis: A scoping review of barriers and facilitators to safe abortion care in humanitarian crises

Dias Amaral, Bianca and Sakellariou, Dikaios ORCID: https://orcid.org/0000-0002-2668-2834 2021. Maternal health in crisis: A scoping review of barriers and facilitators to safe abortion care in humanitarian crises. Frontiers in Global Women's Health 2 , 699121. 10.3389/fgwh.2021.699121

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Abstract

During humanitarian crises, women are particularly vulnerable to unwanted pregnancy. Unsafe abortion is among the five leading causes of maternal mortality and it is the only one which is entirely preventable. This study aimed to identify the barriers and facilitators to the provision of safe abortion care by humanitarian organisations. We performed a scoping review of the literature in July 2020, covering the years 2010–2020, on the following databases: Medline, Global Health, CINAHL Plus and ReliefWeb. We critically appraised all included articles and we conducted a narrative synthesis of the findings. We retrieved 881 articles. After removing duplicates and excluding articles that did not meet the inclusion criteria, twenty-four articles published between 2015 and 2020 were included in the review. Nine of the included papers were non-research practise items. The findings revealed five main themes: legal environment; context;stigma; economic factors; and service delivery. Restrictive laws, stigma, and lack of funding were reported as the main barriers to safe abortion, while the main facilitators were the fact that abortion is permitted under some circumstances in most countries, humanitarian actors’ability to inform healthcare policies at the onset of a humanitarian crisis, and community engagement. The scoping review revealed a dearth of published research. Increased dissemination of studies on Termination of Pregnancy (ToP) could increase the visibility of unsafe abortion and the need to provide ToP in humanitarian settings. Moreover,humanitarian organisations need to have a clear protocol on safe abortion and an in-depth understanding of relevant legislation, including the International Humanitarian Law, in order to provide this service to the full extent of the law.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Additional Information:	This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
Publisher:	Frontiers Media
ISSN:	2673-5059
Date of First Compliant Deposit:	4 September 2021
Date of Acceptance:	25 August 2021
Last Modified:	02 May 2023 18:34
URI:	https://orca.cardiff.ac.uk/id/eprint/143879

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