Healthcare Providers’ Knowledge and Attitude Towards Abortions in Thailand: A Pre-Post Evaluation of Trainings on Safe Abortion
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Ethics Approval
2.3. Data Collection and Measures
2.4. Analysis
2.5. Descriptive Statistics
2.6. Bivariate Analysis
2.7. Multivariable Analysis
3. Results
3.1. Demographics Characteristics and Work Experience
3.2. Comparison of Pre-post Results on Attitudes towards Adolescents and Women Experiencing Unplanned Pregnancies and Unsafe Abortions
3.3. Comparison of Pre-post Results on Attitudes towards Various Scenarios for Abortions
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total (n = 247) |
---|---|
Sex (male/female) (%) | 15.4/84.6 |
Age (Year) (Mean ± SD) [Min–Max] | 35.9 ± 8.8 [23–58] |
Profession (%) | |
Doctor (n = 137) (% of total participants) | 43.7 |
General (% of doctors) | 52.8 |
Obstetrics and gynaecology (% of doctors) | 36.1 |
Family medicine (% of doctors) | 4.6 |
Preventative medicine (% of doctors) | 1.9 |
Others (% of doctors) | 4.6 |
Nurse (% of total participants) | 55.5 |
Pharmacist (% of total participants) | 0.4 |
Welfare workers (% of total participants) | 0.4 |
Prior experience counselling for unplanned pregnancies (% with experience) | 63.16 |
Prior experience treating for unplanned pregnancies (% with experience) | 80.57 |
Knowledge of regulations of the Medical Council on the Practices Regarding the Termination of Medical Pregnancies (% with knowledge) | 52.46 |
Manual vacuum aspirations (MVA) | |
Know of MVA (%) | 65.23 |
Knowledge of requirements for medical professionals for the use of MVA (%) | 64.00 |
Seen MVA (%) | 67.21 |
Used MVA (%) | 50.21 |
Questions | Pre-Test | Post-Test |
---|---|---|
Mean (SD), Median [IQR] | Mean (SD), Median [IQR] | |
1. At the present, unplanned pregnancies and unsafe abortions are a major public health problem that should be addressed. | 4.62 (0.50), | 4.76 (0.43), |
5 [1] | 5 [0] | |
2. In your area, unplanned pregnancies and unsafe abortions are a major public health problem, that should be addressed. | 4.10 (0.71), | 4.39 (0.68), |
4 [1] | 4 [1] | |
3. One reason for unsafe abortions is the limited options for pregnant women and the societal pressures pregnant women face. | 4.02 (0.78), | 4.64 (0.54), |
4 [1] | 5 [1] | |
4. Family and society should help unplanned pregnancies. | 4.50 (0.54), | 4.74 (0.46), |
5 [1] | 5 [1] | |
5. Women with unplanned pregnancies should have the right to decide and choose whether to continue or terminate the pregnancy. | 4.00 (0.82), | 4.61 (0.59), |
4 [1] | 5 [1] | |
6. Women that need to terminate their pregnancies, according to the criteria set by the Regulations of Medical Council of Thailand, should receive safe abortion, with the same level of services and benefits as other health problems. | 4.38 (0.59), | 4.72 (0.46), |
4 [1] | 5 [1] | |
7. Doctors and healthcare providers play a major role in addressing unplanned pregnancies and unsafe abortions. | 4.49 (0.54), | 4.72 (0.48), |
5 [1] | 5 [1] | |
8. You are happy to help, advise and provide consultations regarding abortions and places to obtain safe abortion services for those with unplanned pregnancies. | 4.05 (0.84), | 4.53 (0.58), |
4 [1] | 5 [1] | |
9. Thailand should allow the sale of medical abortion drugs as well as emergency contraceptives at pharmacies. | 2.38 (1.24), | 3.74 (1.20), |
2 [2] | 4 [2] | |
Average Score of all questions | 4.06 (0.42), | 4.54(0.41), |
4 [1.6] | 4.67 [0.6] |
Characteristics | Attitudes towards Adolescents and Women Experiencing Unplanned Pregnancies, and Unsafe Abortions | Change in Response to Examples of Scenarios on Abortions |
---|---|---|
Sex | p = 0.863 | p = 0.217 |
Female | 0.48 (0.43), 0.44 [0.55] | 0.75 (0.58), 0.71 [0.71] |
Male | 0.46 (0.38), 0.44 [0.55] | 0.61 (0.40), 0.64 [0.5] |
Age | p = 0.821 | p = 0.900 |
Less than 35 | 0.46 (0.44), 0.44 [0.55] | 0.71 (0.52), 0.71 [0.64] |
More than 35 | 0.49 (0.40), 0.44 [0.55] | 0.74 (0.60), 0.71 [0.64] |
Career | p = 0.013 * | p < 0.001 * |
OBGYN | 0.32 (0.38), 0.33 [0.44] | 0.54 (0.46), 0.42 [0.64] |
Other doctor | 0.46 (0.38), 0.44 [0.44] | 0.59 (0.44), 0.57 [0.57] |
Non-doctor | 0.53 (0.44), 0.55 [0.66] | 0.84 (0.61), 0.86 [0.71] |
Knowledge of MVA | p = 0.248 | p = 0.507 |
Knowledge of regulation | p = 0.004 * | p = 0.189 |
Prior knowledge | 0.55 (0.43), 0.55 [0.61] | |
No prior knowledge | 0.42 (0.39), 0.33 [0.55] | |
Experience in treating | p = 0.071 | p = 1.000 |
Experience in counselling | p = 0.087 | p = 0.157 |
Experience in using MVA | p = 0.846 | p = 0.698 |
(Reference: OBGYN) | Coef. (95% CI) | p-Value |
---|---|---|
Non-OBGYN doctor | 0.095 (−0.074, 0.264) | 0.269 |
Non-doctor | 0.165 (0.006, 0.323) | 0.041 |
Prior knowledge of regulation | −0.067 (−0.182, 0.047) | 0.247 |
Experience in treating | −0.102 (−0.236, 0.032) | 0.134 |
Experience in counselling | 0.002 (−0.002, 0.007) | 0.317 |
Constant | 0.475 (0.279, 0.671) | 0.000 |
Questions | Pre-Test | Post-Test |
---|---|---|
Mean (SD), Median [IQR] | Mean (SD), Median [IQR] | |
1. If the pregnant woman has underlying diseases and the pregnancy poses serious harm to their health or life. | 4.56 (0.59), 5 [1] | 4.85 (0.39), 5 [0] |
2. If the pregnant woman has physical or intellectual disabilities hindering their ability to care for themselves. | 4.45 (0.66), 5 [1] | 4.81 (0.49), 5 [0] |
3. If the pregnant woman has HIV/AID. | 3.40 (1.23), 3 [3] | 3.74 (1.25), 4 [2] |
4. If the pregnant woman has rubella. | 4.03 (0.89), 4 [1] | 4.50 (0.71), 5 [1] |
5. If the foetus has anomalies that can result in being physically or intellectually disabled. | 4.31 (0.81), 4 [1] | 4.74 (0.52), 5 [0] |
6. If the foetus has genetic disorders or serious diseases. | 4.38 (0.81), 4 [1] | 4.78 (0.49), 5 [0] |
7. If the pregnant woman’s mental health is at risk. | 3.71 (0.97), 4 [2] | 4.53 (0.65), 5 [1] |
8. If the pregnant woman is under the age of 15. | 3.33 (1.07), 3 [1] | 4.32 (0.83), 5 [1] |
9. If the pregnant woman is under the age of 20 and still in school. | 3.01 (1.04), 3 [2] | 3.97 (0.93), 4 [2] |
10. If the pregnancy is a result of rape. | 4.34 (0.76), 4 [1] | 4.78 (0.47), 5 [0] |
11. If the pregnancy is a result of incest. | 3.39 (1.03), 3 [1] | 4.24 (0.91), 5 [1] |
12. If the pregnancy is a result of contraceptive failure. | 2.97 (1.15), 3 [2] | 4.19 (0.87), 4 [1] |
13. If the pregnant woman is facing economic problems. | 2.76 (1.08), 3 [1] | 4.11 (0.93), 4 [1] |
14. If the pregnant woman is unmarried. | 2.67 (1.11), 3 [1] | 3.91 (0.99), 4 [2] |
Average Score of all questions | 3.67 (0.64), 3.64 [0.79] | 4.39 (0.53), 4.43 [0.86] |
(Reference: OBGYN) | Coef. (95% CI) | p-Value |
---|---|---|
Non-OBGYN doctor | 0.064 (−0.159, 0.288) | 0.573 |
Non-doctor | 0.323 (0.112, 0.534) | 0.003 * |
Prior knowledge of regulation | 0.041 (−0.109, 0.191) | 0.54 |
Experience in counselling | 0.003 (−0.004, 0.009) | 0.437 |
Constant | 0.489 (0.227, 0.751) | 0.000 |
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Sanitya, R.; Marshall, A.I.; Saengruang, N.; Julchoo, S.; Sinam, P.; Suphanchaimat, R.; Phaiyarom, M.; Tangcharoensathien, V.; Boonthai, N.; Chaturachinda, K. Healthcare Providers’ Knowledge and Attitude Towards Abortions in Thailand: A Pre-Post Evaluation of Trainings on Safe Abortion. Int. J. Environ. Res. Public Health 2020, 17, 3198. https://doi.org/10.3390/ijerph17093198
Sanitya R, Marshall AI, Saengruang N, Julchoo S, Sinam P, Suphanchaimat R, Phaiyarom M, Tangcharoensathien V, Boonthai N, Chaturachinda K. Healthcare Providers’ Knowledge and Attitude Towards Abortions in Thailand: A Pre-Post Evaluation of Trainings on Safe Abortion. International Journal of Environmental Research and Public Health. 2020; 17(9):3198. https://doi.org/10.3390/ijerph17093198
Chicago/Turabian StyleSanitya, Rugsapon, Aniqa Islam Marshall, Nithiwat Saengruang, Sataporn Julchoo, Pigunkaew Sinam, Rapeepong Suphanchaimat, Mathudara Phaiyarom, Viroj Tangcharoensathien, Nongluk Boonthai, and Kamheang Chaturachinda. 2020. "Healthcare Providers’ Knowledge and Attitude Towards Abortions in Thailand: A Pre-Post Evaluation of Trainings on Safe Abortion" International Journal of Environmental Research and Public Health 17, no. 9: 3198. https://doi.org/10.3390/ijerph17093198