Evidence map›Paper›PMID 38390351›Full record

ArticleHealth science reports2024

Striving toward safe abortion services in Nepal: A review of barriers and facilitators.

Alok Atreya, Kishor Adhikari, Samata Nepal, Milan Bhusal, Ritesh G Menezes, Dhan B Shrestha, Deepak Shrestha

Abstract read
In one paragraph

Article in Health science reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alok AtreyaDepartment of Forensic Medicine Lumbini Medical College Palpa Nepal.ORCID 0000-0001-6657-7871
Kishor AdhikariDepartment of Community Medicine, School of Public Health Chitwan Medical College Bharatpur Nepal.
Samata NepalDepartment of Community Medicine Lumbini Medical College Palpa Nepal.
Milan BhusalMedical Officer Gulmi Hospital Tamghas, Gulmi Nepal.
Ritesh G MenezesDepartment of Pathology, College of Medicine Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia.ORCID 0000-0002-2135-4161
Dhan B ShresthaDepartment of Internal Medicine Mount Sinai Hospital Chicago Illinois USA.ORCID 0000-0002-8121-083X
Deepak ShresthaDepartment of Obstetrics and Gynaecology Lumbini Medical College Palpa Nepal.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Despite the decriminalization of abortion in Nepal in 2002, unsafe abortion is still a significant contributor to maternal morbidity and mortality. Nepal has witnessed a significant drop in abortion-related severe complications and maternal deaths owing to the legalization of abortion laws, lowered financial costs, and wider accessibility of safe abortion services (SAS). However, various factors such as sociocultural beliefs, financial constraints, geographical difficulties, and stigma act as barriers to the liberal accessibility of SAS. This review aimed to determine key barriers obstructing women's access to lawful, safe abortion care and identify facilitators that have improved access to and quality of abortion services. Methods: A systematic search strategy utilizing the databases PubMed, CINAHL, Scopus, and Embase was used to include studies on the accessibility and safety of abortion services in Nepal. Data were extracted from included studies through close reading. Barriers and facilitators were then categorized into various themes and analyzed. Results: Of 223 studies, 112 were duplicates, 73 did not meet the inclusion criteria, and 18 did not align with the research question; thus, 20 studies were included in the review. Various barriers to SAS in Nepal were categorized as economic, geographic, societal, legal/policy, socio-cultural, health systems, and other factors. Facilitators improving access were categorized as economic/geographic/societal, legal/policy, socio-cultural, and health systems factors. The patterns and trends of barriers and facilitators were analyzed, grouping them under legal/policy, socio-cultural, geographic/accessibility, and health systems factors. Conclusion: The review identifies financial constraints, unfavorable geography, lack of infrastructure, and social stigmatization as major barriers to SAS. Economics and geography, legalization, improved access, reduced cost and active involvement of auxiliary nurse-midwives and community health volunteers are key facilitators.

Indexed as

family planning serviceshealth facilitiespregnancyrural population

Identifiers

PMID38390351
PMCPMC10883100

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.