Speaker
Description
Background
Maternal morbidity and mortality are major concerns for Zambia mainly due to complications of unsafe abortion which are preventable by providing safe abortion services. Students are the future providers of safe abortion care and are expected to understand and demonstrate appropriate knowledge, skills and attitudes in relation to comprehensive abortion care (CAC). Graduating students’ willingness to provide safe abortion services is an important influence on their intention and capacity to provide the service during their future careers. However, graduating students have moral, social and gender-based reservations that might affect their willingness towards providing safe abortion services. Many studies in Zambia have been conducted on factors influencing provision of safe abortion services among health workers. However, gap still exists on whether graduating students in Zambia are willing to provide the safe abortion care services in their future practice. Therefore, the study aimed to assess the willingness to provide to provide safe abortion services and associated factors among graduating midwifery, nursing and medical students at University of Zambia.
METHODS
The study employed convergent parallel design and the results were brought together in the overall interpretation. A cross-sectional design was used for quantitative approach, while descriptive phenomenology was used for qualitative approach. Two universities were randomly selected, one public and one private university. The study included final year midwifery, nursing and medical students. Participants for qualitative were purposively sampled while for quantitative were randomly sampled using systematic sampling. Quantitative data was collected using a self-administered questionnaire and focused group discussions were used to collect qualitative data. The dependent variable was willingness to provide safe abortion and was measured on a likert scale to gauge agreement with statements related to provide safe abortion care. The responses were later categorized into two “willing” and “not willing”. While thematic analysis was used to analyse qualitative data.
RESULTS
Quantitative data were collected from a total of 246 students. Qualitative data was collected from 5 focused group discussions. The median for age was 26 years (24-28). Majority (63.1%) were not willing to provide safe abortion services after graduating. Being Catholics (AOR = 2.56; 95% CI: 1.01 – 6.45), frequently attending church (AOR = 1.85; CI: 1.10 – 3.37) and not confident with ability to perform medical abortion (AOR = 3.18; CI:1.36 – 7.45) are more likely not willing to provide safe abortion care in future. Furthermore, qualitative results show that students experienced lack of supervision and support during clinical placement and also described the clinical environment as a restricted environment for clinical practice.
CONCLUSION
Study findings show that future providers are not willing to provide safe abortion care services after graduating. Factors influencing the willingness are different from the reviewed literature and this could be attributed to different learning and training environment. Factors identified could be addressed through comprehensive coverage of safe abortion during training. Additionally, providing mentorship and student support while on the clinical area to ensure optimal clinical exposure to safe abortion care services.
Keywords: Willingness, safe abortion care, students
