BEYOND BARRIERS: ENHANCING ABORTION CARE IN SOUTHEAST ASIA

Abstract

WHO estimates show that 45% of abortions globally are unsafe and responsible for up to 13 % of maternal deaths, a burden that is disproportionately high in regions with restrictive abortion law such as developing regions like Southeast Asia. Our scoping review explores the knowledge, attitudes, practices (KAP), barriers, and limitation related to abortion care in Southeast Asia from 2019 to 2023. This review was conducted following PRISMA-ScR guidelines. Articles published between 2019 and 2024 were identified using PubMed, ScienceDirect, Scopus, and Google Scholar. Inclusion criteria focused on studies from Southeast Asia addressing abortion care, including PAC, with qualitative, cross-sectional, cohort, or intervention designs. Data were synthesized descriptively by themes such as KAP, barriers, and policy implications. From 584 identified records, 11 studies met inclusion criteria. Findings revealed significant knowledge gaps among healthcare providers and the general population, influenced by cultural and religious stigmas. Support for abortion was higher in medically critical situations than for socio-economic reasons. Barriers included stigma, legal restrictions, and inadequate training. Findings emphasize the importance of addressing cultural and systemic barriers, enhancing provider training, and incorporating PAC into primary healthcare systems. Global practices, such as telemedicine in China and mid-level provider training in Ethiopia, provide valuable models for Southeast Asia. To improve PAC access and quality in Southeast Asia, culturally sensitive, decentralized, and collaborative approaches are essential. Governments, healthcare systems, and communities must work together to ensure equitable and inclusive reproductive health services.