Development of an Intervention to Support Reproductive Health of Women after Seeking Medical Abortion in Cambodia: Research Protocol

Background In Cambodia, abortion has been legally available on request during the first trimester of pregnancy since 1997, but while there has been an increase in the percentage of women having induced abortion and medical abortion (MA), there has also been a decrease in the percentage of women who say they received help from a health worker with their abortion. These data point towards the ‘demedicalisation’ of abortion, and although MA has been shown to be safe, there are concerns around safety, given the variety of available products and counseling provided. These concerns are particularly relevant for female factory workers, who typically come from rural areas where access to good healthcare and information to reproductive healthcare is limited. Objective This project aims at understanding Cambodian female garment factory workers reproductive health needs after MA from a multi-disciplinary and mixed methods perspective, focusing on how they seek and share MA and health-related information, how they use their mobile phones for this and other purposes, what cultural challenges exist around reproductive health and how they might be magnified or mitigated by mobile phones, linguistic challenges around healthcare and mobile phone use. The main purpose of the research is to combine multi-disciplinary methods, theories, and expertise to gain new, culturally-grounded insights into family planning and MA in Cambodia, but the findings could help inform the development of a relevant intervention to support comprehensive post-abortion care. Methods The methods proposed are interviews and participant observation among factory workers, health providers and mobile phone providers; linguistic analysis of relevant data (interview transcripts, online sources and other fieldwork material); digital methods to understand what kind of information about MA exists online in Cambodia, and how accessible/accessed it is by the targeted population. Results The data collection part of the project ended on 31/12/2020. The team conducted 67 semi-structured interviews with female factory workers, women who sought medical abortion, health providers, mobile phone providers; participant observation with factory workers and health providers; analysis of Youtube and Facebook to understand what kind of information is available, who creates it, and how it is used. The team is currently doing data analysis, and findings are clustered around 1. Use of mobile phones and digital resources for health-related and MA related information, 2. Experience of MA care and 3. Development of an intervention through edutainment videos. Conclusions The project highlighted both the widely untapped potential of using digital platforms (especially Youtube and Facebook) to distribute accurate information on MA, and the challenges in providing individual information via mobile phones while respecting individuals’ privacy.