Shaping legal abortion provision in Ghana: Using policy theory to understand provider-related obstacles to policy implementation

Health Research Policy and Systems

Volumn 11, Issue 1, 2013, Pages

  Aniteye, Patience ^a   Mayhew, Susannah H ^b  

^a UNIVERSITY OF GHANA   (Ghana)

^b LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE   (United Kingdom)

Author keywords

Abortion; Ghana; Health policy; Lipsky; Policy implementation; Policy theory; Qualitative research

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; CONTROLLED STUDY; DOCTOR PATIENT RELATION; EVIDENCE BASED PRACTICE; FEMALE; GHANA; HEALTH CARE FACILITY; HEALTH CARE PERSONNEL; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH PERSONNEL ATTITUDE; HEALTH PRACTITIONER; HOSPITAL; HUMAN; INTERVIEW; LEGAL ABORTION; MEDICAL DOCUMENTATION; MIDWIFE; MORALITY; OBSTETRICS; ORGANIZATION AND MANAGEMENT; PUBLIC HEALTH PROBLEM; RELIGION; THEORY;

ABORTION, LEGAL; ADULT; ATTITUDE OF HEALTH PERSONNEL; COUNSELING; DELIVERY OF HEALTH CARE; FEMALE; GHANA; GYNECOLOGY; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH PLAN IMPLEMENTATION; HEALTH POLICY; HUMAN RIGHTS; HUMANS; MIDDLE AGED; MIDWIFERY; MORALS; OBSTETRICS; PHARMACY; PREGNANCY; PRENATAL CARE; REFERRAL AND CONSULTATION; RELIGION AND MEDICINE;

EID: 84879807244     PISSN: None     EISSN: 14784505     Source Type: Journal    
DOI: 10.1186/1478-4505-11-23     Document Type: Article

References (49)

1. Aniteye P, Mayhew S. Attitudes and Experiences of Women Admitted to Hospital with Abortion Complications in Ghana. Afr J Reprod Health 2011, 15(1):47-55.
2. Aboagye PK, Gebreselassie H, Quansah Asare G, Mitchell EMH, Addy J. An Assessment of the Readiness to Offer Contraceptives and Comprehensive Abortion Care in the Greater Accra, Eastern and Ashanti regions of Ghana 2007, Chapel Hill, NC: Ipas.
3. Ghana Health Service 2004-2008 Strategic Plan for the Implementation of Comprehensive Abortion Care Services in Ghana 2004, Accra: GHS, Ghana Health Service 2004-2008.
4. The Criminal Code (Amendment) Law PNDC L 102. The Gazette 1985, Accra and Tema: Ghana Publishing Corporation, The Criminal Code (Amendment) Law.
5. Brookman-Amissah E, Moyo JB. Abortion law reform in sub-Saharan Africa: no turning back. Reprod Health Matters 2004, 12(24):227-234. 10.1016/S0968-8080(04)24026-5, 15938178.
6. Ghana Health Service Prevention and management of unsafe abortion: comprehensive abortion care services 2006, Accra: GHS, Standards and Protocols, Ghana Health Service.
7. Ghana Health Service: A Strategic Assessment of Comprehensive Abortion Care in Ghana; Report 2005, GHS: Accra, Ghana Health Service: A Strategic Assessment of Comprehensive Abortion Care in Ghana;.
8. Sabatier PA, Mazmanian DA. The conditions for effective implementations: a guide to accomplishing policy objectives. Pol Anal 1979, 5:481-504.
9. Lipsky M. Street Level Bureaucracy: Dilemmas of the Individual in Public Services 1980, New York: Russell Sage Foundation.
10. Hogwood B, Gunn L. Policy Analysis for the Real World 1984, Oxford: Oxford University Press.
11. Sabatier PA. Top-down and bottom-up approaches to implementation research: a critical analysis and suggested synthesis. J Public Pol 1986, 6:21-48.
12. Sabatier PA. Theories of the Policy Process 1999, Boulder, CO: Westview.
13. Goggin ML, Bowman AOM, Lester JP, O'Toole LJ. Implementation Theory and Practice: Toward a Third Generation 1990, Glenview, IL: Scott Foresman/Little, Brown and Company.
14. Matland RE. Synthesizing the implementation literature: the ambiguity conflict model of policy implementation. J-PART 1995, 5(2):145-174.
15. Saetren H. Facts and myths about research on public policy implementation: out of fashion, allegedly dead, but still very much alive and relevant. Policy Studies J 2005, 33:559-582.
16. Hill M, Hupe P. Implementing Public Policy 2009, London: SAGE Publications, 2.
17. Buse K. Addressing the theoretical, practical and ethical challenges inherent in prospective health policy analysis. Health Policy Plan 2008, 23:351-360. 10.1093/heapol/czn026, 18664524.
18. Surjadjaja C, Mayhew SH. Can policy analysis theories predict and inform policy change? Reflections on a case study of the battle for legal abortion in Indonesia. Health Policy Plan 2011, 26(5):373-384. 10.1093/heapol/czq079, 3157919, 21183461.
19. Walt G, Gilson L. Reforming the health sector in developing countries: the central role of policy analysis. Health Policy Plan 1994, 9(4):353-370. 10.1093/heapol/9.4.353, 10139469.
20. Walker L, Gilson L. We are bitter but we are satisfied: nurses as street-level bureaucrats in South Africa. Social Sci Med 2004, 59:1251-1261.
21. Penn-Kekana L, Blaauw D, Schneider H. " It makes me want to run away to Saudi Arabia" : management and implementation challenges for public financing reforms from a maternity ward perspective. Health Policy Plan 2004, 19(Suppl 1):171-177.
22. Witter S, Arhinful DK, Kusi A, Zakariah-Akoto S. The experience of Ghana in implementing a user fee exemption policy to provide free delivery care. Reprod Health Matters 2007, 15(30):61-71. 10.1016/S0968-8080(07)30325-X, 17938071.
23. Armar-Klemesu M, Graham W, Arhinful D, Hussein J. An Evaluation of Ghana's Policy of Universal Fee Exemption for Delivery Care: Preliminary Findings 2006, Aberdeen: IMMPACT.
24. Voetagbe G, Yellu N, Mills J, Mitchell E, Adu-Amankwah A, Jehu-Appiah K, Nyante F. Midwifery tutors' capacity and willingness to teach contraception, post-abortion care and legal pregnancy termination in Ghana. Human Res Health 2010, 8:2.
25. Harries J, Stinson K, Orner P. Health care providers' attitudes towards termination of pregnancy: a qualitative study in South Africa. BMC Public Health 2009, 9:296. 10.1186/1471-2458-9-296, 2734857, 19689791.
26. Mokgethi NE, Ehlers VJ, van der Merwe MM. Professional nurses' attitudes towards providing termination of pregnancy services in a tertiary hospital in North West province of South Africa. Curationis Mar 2006, 29(1):32-39.
27. Jewkes RK, Gumede T, Westaway MS, Dickson K, Brown H, Rees H. Why are women still aborting outside designated facilities in metropolitan South Africa?. BJOG 2005, 112:1236-1242. 10.1111/j.1471-0528.2005.00697.x, 16101602.
28. Sibuyi MC. Provision of abortion services by midwives in Limpopo province of South Africa. Afr J Reprod Health 2004, 8(1):75-78. 10.2307/3583309, 15487617.
29. Mhlanga RE. Abortion: developments and impact in South Africa. Br Med Bull 2003, 67(1):115-126. 10.1093/bmb/ldg006, 14711758.
30. Varkey SJ, Fonn S, Ketlhapile M. Health Workers for Choice 2001, Johannesburg: Women's Project.
31. Hill ZE, Tawiah-Agyemang C, Kirkwood B. The context of informal abortions in rural Ghana. J Womens Health 2009, 18(12):2017-2022.
32. Henry R, Fayorsey C. Coping with Pregnancy: Experiences with Adolescents in Ga Mashi, Accra 2002, Calverton, MD: ORC Macro.
33. Sai F. An overview of unsafe abortion in Africa. Foreword. Afr J Fertil Sexual Reprod Heal 1996, 1(1):2-3.
34. Schuster S. Abortion in the moral world of the Cameroon grassfields. Reprod Health Matters 2005, 13(26):130-138. 10.1016/S0968-8080(05)26216-X, 16291494.
35. Lazarus ES. Politicizing abortion: personal morality and professional responsibility of residents training in the United States. Soc Sci Med 1997, 44:1417-1425. 10.1016/S0277-9536(96)00329-2, 9141173.
36. Garel M, Gosme-Seguret S, Kaminski M, Cuttini M. Ethical decision-making in prenatal diagnosis and termination of pregnancy: a qualitative survey among physicians and midwives. Prenat Diagn 2002, 22(9):811-817. 10.1002/pd.427, 12224077.
37. Onah HE, Ogbuokiri CM, Obi SN, Oguanuo TC. Knowledge, attitude and practice of private medical practitioners towards abortion and post abortion care in Enugu, south-eastern Nigeria. J Obstet Gynaecol 2009, 29(5):415-418. 10.1080/01443610902918613, 19603321.
38. Gilson L, Palmer N, Schneider H. Trust and health worker performance: exploring a conceptual framework using South African evidence. Social Sci Med 2005, 61(7):1418-1429.
39. Hessini L. Global progress in abortion advocacy and policy: an assessment of the decade since ICPD. Reprod Health Matters 2005, 13(25):88-100. 10.1016/S0968-8080(05)25168-6, 16035601.
40. Berer M. Provision of abortion by mid-level providers: international policy, practice and perspectives. Bull World Health Organ 2009, 87(1):58-63. 10.2471/BLT.07.050138, 2649591, 19197405.
41. Lupton D. Medicine as Culture. Illness, Disease and the Body in Western Societies 1994, London: Sage Publications.
42. Luker K. Abortion and the Politics of Motherhood 1984, Los Angeles: University of California Press Ltd.
43. Joffe CE, Weitz TA, Stacey CL. Uneasy allies: pro-choice physicians, feminist health activists and the struggle for abortion rights. Sociol Health Illness 2004, 26(6):775-796.
44. Puri M, Lamichhane P, Harken T, Blum M, Harper CC, Darney PD, Henderson JT. " Sometimes they used to whisper in our ears" : health care workers' perceptions of the effects of abortion legalization in Nepal. BMC Public Health 2012, 12:297. 10.1186/1471-2458-12-297, 3434092, 22520231.
45. Lee E. Abortion, Motherhood and Mental Health: Medicalising Reproduction in the United States and Great Britain. Social Problems and Social Issues 2003, Hawthorne, NY: Aldine de Gruyter.
46. Turner KL, Hyman AG, Gabriel MC. Clarifying values and transforming attitudes to improve access to second trimester abortion. Reprod Health Matters 2008, 16(31 Supplement):108-116.
47. Turner KL, Gabriel MC. Clarifying Values to Transform Attitudes about Abortion: Practical Applications of a New Theoretical Framework and Toolkit 2007, London, UK: Global Safe Abortion Conference.
48. Klugman B, Hlatshwayo Z. Strategy and action for abortion access: a comparative analysis. Advocating for Abortion Access: Eleven Country Studies 2000, 7-40. Witwatersrand: School of Public Health, University of the Witwatersrand, Klugman B, Budlender D.
49. Samandari G, Wolf M, Basnett I, Hyman A, Andersen K. Implementation of legal abortion in Nepal: a model for rapid scale-up of high-quality care. BMC Reprod Health 2012, 9:7.