O059 STATE OF SYSTEM PRODUCTION OF GROWTH AND APOPTOSIS FACTORS IN ADOLESCENT GIRLS WITH UTERINE BLEEDINGS

Abstract

Objectives: 1) Evaluate the acceptability, effectiveness, and safety of a harm-reduction model of service provision, designed to alleviate morbidity and mortality from unsafe abortion, for women with unintended pregnancies in Peru; 2) Assess the acceptability and effectiveness of a telephone follow-up visit as a less burdensome alternative to an in-person follow-up visit; 3) Understand the reasons why women do not return for follow-up visits, comparing reasons between women who receive telephone vs. in-person follow-up. Materials: This is a prospective cohort, mixed methods study, conducted with women with unintended pregnancies receiving harm-reduction services in 3 NGO clinics in Lima and Chimbote, Peru. It includes 400 questionnaires conducted via telephone, 25 indepth interviews with a subset of the participants, and collection of clinical data from clinic records. Data collection is currently under way. Methods: The clinical data will be merged with the questionnaire data, and univariate and multivariate analyses will be conducted. In-depth interviews will be coded and analyzed by key themes. The main quantitative outcomes that will be analyzed include: descriptive statistics of population accessing services (including gestational age); proportion that decide to take misoprostol and associated sociodemographic covariates; and proportion that choose to have telephone follow-up instead of in-person follow-up and associated sociodemographic covariates, among others. The following outcomes will be compared between those choosing telephone and in-person follow-up: satisfaction with service, effectiveness (not needing a surgical procedure to complete the abortion), safety (adverse events), and contraceptive use. The qualitative portion of the study will provide more in-depth details regarding satisfaction and acceptability of service; motivation for returning, or choosing not to return to clinic for follow-up; and decision-making process regarding decision to use misoprostol or not. Results: To date, 37 women have been enrolled in the study. Of the 5 telephone questionnaires that have been completed, 3 women reported choosing in-person follow-up, 1 reported choosing telephone follow-up, and 1 did not remember being offered a choice. Additional results will be available by October and presented at the Congress. Conclusions: The study findings will guide efforts to scale up the harm-reduction model and telephone follow-up in Peru and other settings.