Abstract
Abortion complications are a major public health problem, and studies to assess the quality of abortion care require adequate measurement tools. This study is a continuation of such an instrument's refinement, the QualiAborto-Pt questionnaire. Using data from a survey of 2,336 women hospitalized for abortion complications in 19 hospitals in three state capitals in Northeast Brazil (Salvador - Bahia, Recife - Pernambuco, and São Luís - Maranhão), we implemented a series of exploratory and confirmatory factor analyses based on a 55-item prototype. The analyses indicate a structure with 17 items in five dimensions: reception, orientation, inputs/physical environment, technical quality, and continuity of care. All the items in the final model displayed acceptable reliability, absence of content redundancy, and factor specificity, as well as theoretical consistency with the respective dimensions. The solution also shows discriminant factor validity. Despite some persistent issues for further analysis and clarification, this version merits recommendation for use in Brazil.
Highlights
Every year there are approximately 22 million unsafe abortions in the world, 98% of which in low and middle-income countries 1
The sample excluded abortions permitted by Brazil’s legislation, resulting from ectopic pregnancy and hydatidiform mole, and those resulting from other abnormal products of conception whose clinical and legal justifications support uterine evacuation under safe conditions
We interviewed the women hospitalized from August 31 to December 30, 2010, for abortion complications in all the public hospitals providing this type of care until we reached the calculated sample size
Summary
Every year there are approximately 22 million unsafe abortions in the world, 98% of which in low and middle-income countries 1. According to the World Health Organization (WHO) 1, one-fourth of these abortions require timely medical care to avoid complications. In Brazil, abortion is only allowed when the pregnancy results from rape or involves risk to the woman’s life or fetal anencephaly. The legal prohibition does not prevent abortion in practice 2. According to a national survey in urban areas in 2016, 18% of Brazilian women 35 to 39 years of age reported having undergone an abortion 3. Illegality contributes to unsafe abortions, and the resulting complications lead to more than 200.000 hospitalizations per year 2. There are few Brazilian studies on quality of post-abortion care 6,7
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