Physicians’ and non-physicians’ views about provision of medical abortion by nurses and AYUSH physicians in Maharashtra and Bihar, India
2014
Abstract There is only limited evidence on whether
certified and uncertified health care providers in India support reforming
the Medical Termination of Pregnancy (MTP) Act to expand the abortion
provider base to allow trained nurses and AYUSH physicians (who are
trained in Indian systems of medicine) to provide medical abortion. To
explore their views, we conducted a survey of 1,200 physicians and other
health care providers in Maharashtra and Bihar states and in-depth
interviews with 34 of them who had used medical abortion in their
practices. Findings indicate that obstetrician-gynaecologists and other
allopathic physicians were less supportive than non-physicians of nurses
and AYUSH physicians providing early medical abortion. The physicians did
not think that these providers would be able to assess women’s eligibility
for medical abortion correctly. In contrast, the majority of
non-physicians found task shifting of medical abortion provision to
trained nurses and AYUSH physicians acceptable, and they were confident
that these providers would be able to provide medical abortion as safely
and effectively as trained physicians. Assuming the reforms are passed,
efforts will need to be made by government and medical professional bodies
to train these new providers to undertake this role, prepare the health
infrastructure to include them, and create an environment, including among
physicians, that is conducive to enabling non-physicians to provide
medical abortion.
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