Educational content of professional ethics in postgraduate dental education.

PURPOSE: Inclusion of proper educational content with respect to professional ethics in dental curricula is an important step to achieve objectives of ethics education especially in postgraduate programs when the time and opportunities for explicit instruction of ethics are limited. This study aimed to find and discuss the topics of ethics and professionalism for dental postgraduate programs. METHODS: A modified Delphi survey of experts' opinions with three rounds was conducted to establish a consensus on the need to teach professional ethics topics. The topics were identified through a literature review and according to the opinion of the experts. Items scored as highly important by over 80% of the participants in each round of the survey were considered educational needs. RESULTS: A total of 154 ethical issues were identified and classified into 29 topical categories to design the initial questionnaire. A consensus was developed on 24 ethics and professionalism topics for inclusion in the professional ethics curriculum for all dental postgraduate programs. CONCLUSIONS: Based on the results of this study, the same educational content in professional ethics is needed for all dental residency programs in all specialties. Most of the topics on which experts reached a consensus to be included in the ethics educational content were related to ethical and professional standards of conduct.

Challenges of the Medical Ethics PhD curriculum in Iran: A qualitative study.

Background: Bioethics is the foundation of medical practices, and can be applied in the different levels of medicine. In Iran, Medical Ethics started to be taught in the form of PhD course in Tehran University of Medical Sciences (TUMS) in 2007. Although many aspects of this plan are successfully implemented, some deficits also are frequently pointed out by many professors and students. The purpose of this study was to recognize the deficits and weaknesses of the current curriculum. Methods: This study was a qualitative descriptive type which was conducted based on semi-structured deep interview with open questions. The sample population of this research was composed of faculty members in Medical Ethics department of TUMS, students and graduates of PhD in Medical Ethics and also, the experts who worked on codification of the initial curriculum. Results: Overall, eleven individuals were interviewed. In general, "Practical application", "Feeling the Need", "Professional Doctorate", "Human Sciences", "Paramedical", "Possible", "Impossible", "Defining the Discipline Nature", "Student Attraction", "Professor", "Training", "Evaluation Procedure", "Student Admission", "Educational Content", "Teaching Method", :Student Evaluation", and "Course Management" were the main themes. Conclusion: With regard to the deficiencies in Medical Ethics training and also, the problems identified through interviews, it seems that a great deal of problems are possible to solve if Medical Ethics is considered an interdisciplinary field instead a monodisciplinary one. One of the main purposes in interdisciplinary fields is investigating, analyzing and introducing measures for issues and problems that cannot be known and solved by a single discipline.

The scientific productions in Iranian biomedical ethics: A combined study of bibliometrics and social network analysis.

This study aims at increasing our understanding of the research activities of Iranian researchers and institutions in the field of biomedical ethics from 1995 to 2015. A combination of bibliometrics and social network analysis was used to examine the bibliographic data of 580 documents published on Iranian biomedical ethics in Web of Science and Scopus databases to investigate the publication trend, scientific impact, subject keywords network, and social network analysis indicators for international and cross-institutional co-authorship networks. The results showed that the publication of documents has had a consistent and increasing growth and that the citation trend has grown along with it. The analysis of thematic clusters by keyword co-occurrence network shows that Iranian biomedical ethics research has dealt with various topics and that has introduced different research directions. Researchers from 28 countries were identified in the international collaboration network. The main partners of Iranian researchers were from the US (17.8%) and the UK (9.2%). However, there is a tendency to develop and complete cooperation with researchers from different countries. The cross-institutional collaboration network comprises of 63 institutes, of which Tehran University of Medical Sciences (38%), Shahid Beheshti University of Medical Sciences (11%) and Shiraz University of Medical Sciences (7%) have the largest share in publishing documents. The superiority of the first two universities based on centralization indicators in the cross-institutional collaboration network has caused the exchange of cross-network knowledge between and via these players. The network density indicator shows that almost half of the co-authorship links within the international collaboration network and 8% of the co-authorship links within the cross-institutional collaboration network have been implemented and that these networks are not very coherent.

Developing a professional guideline for the use of cyberspace by health-care professionals in Iran: a mixed methods study.

The present study aimed to compile and develop a professional guideline for health-care providers in Iran regarding cyberspace usage. This was a mixed-methods study, conducted in three phases. In the first phase, the principles of ethics in cyberspace were collected through a review of the literature and available documents, and were then subjected to content analysis. In the second phase, the views of experts on medical ethics, virtual education, information technology and medical education, as well as clinical sciences experts and representatives of medical students and graduates were evaluated using the focus group method. In the third phase, the draft was evaluated by various stakeholders. Finally, after receiving the comments, the necessary modifications were applied to the guideline. The professional guideline for the use of cyberspace by health-care professionals comprised 30 codes in 5 domains, including the general regulations domain, care and treatment, research, education, and personal development. This guideline presents the various ways professionalism can be maintained in cyberspace interactions. Adherence to the principles of professionalism in cyberspace is required to protect and preserve the public trust in health-care professionals.

Priority Setting of Ventilators in the COVID-19 Pandemic from the Public's Perspective.

Background: Ventilator allocation plan for a public health crisis should be developed through recognizing the values of society and engaging the general public. This study was conducted to assess the Iranian citizens' attitude about some principles and criteria for allocation of ventilators in the current COVID-19 epidemic.Materials and Methods: An electronic self-administered questionnaire was publicly distributed through social networks of Telegram and WhatsApp to perform this cross-sectional study. The questionnaire consisted of 11 statements about the selection and prioritization of patients for the use of a ventilator.Results: 1262 persons, including 767 citizens and 495 health care providers participated in this study. More than 95% of participants agreed upon the necessity to avoid discrimination and avoid prioritization according to patients' gender, economic and political status. While 40.9% of citizens and 49.6% of healthcare workers believed that a ventilator can be disconnected from a patient with a poor prognosis to help another patient who has a better prognosis (P-value = 0.13), 34.3% of people and 29.6% of healthcare workers believed that the earlier admitted patients have the right to receive the device even if the likeliness of his/her survival is less than the next patient (P-value = 0.009).Conclusions: Maximizing health benefits as a measure of ventilator allocation in the pandemic of COVID-19 is an accepted criterion. Meanwhile, periodic evaluation of patients and disconnecting the device from a patient that no longer benefits from ICU services requires its scientific and ethical basis to be brought in public discourse.

Teaching professionalism in cadaver dissection: medical students' perspective.

This study was designed to facilitate freshman medical students' adaptation to the dissection room and familiarize them with the related ethical codes. Single-group post-test design research was conducted at Tehran University of Medical Sciences in 2018 - 2019. The program began with a brief explanation of the necessity of the subject, and after a documentary film was shown, the principles of professional and ethical behaviors in the dissection room were discussed by a panel of experts. In the end, a valid and reliable evaluation questionnaire (Cronbach's alpha coefficient = 0.89) was distributed among the students. A total of 129 questionnaires were completed and returned. Overall, 94.4% of the students believed that the program provided an excellent opportunity to reflect on professional behaviors during practical anatomy sessions. In addition, 92.8% of the students believed that they would use the ethical points mentioned in the program in the future. Content analysis of the open questions produced three main categories: "motivating learning", "application of theory in practice" and "changing the attitude toward responsibility". The results indicate that adequate preparation for cadaver dissection sessions and learning about professional behavior codes in the first exposure can help medical students to better understand the principles of professional behaviors.

Medical students' perception of professionalism climate in clinical settings.

Medical professionalism has a crucial role in educating medical students. The role of professionalism in the clinical environment is therefore an important factor in medical education. This study attempts to evaluate the opinions of medical students in the teaching hospitals of Tehran University of Medical Sciences (TUMS) about the professionalism environment in this university. A sample of 165 students filled out the Persian translation of UMKC-SOM (Climate of Professionalism Survey) questionnaire. This instrument evaluates students' perspectives on the degree of adherence to professionalism by faculty, residents and other students. The results of the study revealed that the total score of professionalism climate was 53.9 for faculty, 42.09 for residents, and 50.76 for students and the difference between these three groups was statistically significant (p-value < 0.01). Results of further analysis through post-hoc tests for multiple comparisons among the groups revealed that the students found their fellow students and faculty more professional than residents. The study also showed that the medical ethics course had no impact on perceptions observations (p-values > 0.05). The study results also revealed that the students found their fellow students and faculty more professional than residents. This finding demonstrates the importance of teaching professionalism to residents since they serve as role models for students. Further multicenter studies are needed to improve the professionalism climate in the medical teaching environment.

Developing and validating an instrument to measure: the medical professionalism climate in clinical settings.

This study was conducted to develop and validate an instrument to measure the medical professionalism climate in clinical settings. The item pool was developed based on the Tehran University of Medical Sciences Guideline for Professional Conduct. The items were distributed between two questionnaires, one for health-care providers and the other for patients. To assess the construct validity of the questionnaires, 350 health-care providers and 88 patients were enrolled in the study. The reliability of the questionnaires was evaluated by calculating Cronbach's alpha and ICC. At first a 74-item pool was generated. After assessing and confirming face and content validity, 41 items remained in the final version of the scale. Exploratory factor analysis revealed the three factors of "personal behavior", "collegiality" and "respect for patient autonomy" in a 25-item questionnaire for service providers and a single factor of "professional behavior" in a 6-item questionnaire for patients. The three factors explained 51.775% of the variance for service providers' questionnaire and the single factor explained 63.9% of the variance for patients' questionnaire. The findings demonstrated that from the viewpoints of patients and service providers, this instrument could be applied to assess the medical professionalism climate in hospital clinical settings.

Developing a comprehensive tool to assess professional attitude among physicians and medical students.

It appears that up until now, no comprehensive tool has been developed to assess medical students' attitudes toward the different dimensions of professionalism. The present study aimed to develop a comprehensive quantitative tool to evaluate medical students' attitudes toward professionalism. This study consisted of two phases: The first phase was item generation and questionnaire design based on literature review and a qualitative survey. The qualitative data were extracted from 49 semi-structured individual interviews and one focus group discussion. In the second phase, the questionnaire was developed and its face, content, and structure validity and reliability were evaluated. To measure the construct validity of the questionnaire, a cross-sectional study was conducted on 354 medical students at different academic levels at Isfahan University of Medical Sciences. The final questionnaire was loaded on five factors. The factors accounted for 43.5% of the total variance. Moreover, Cronbach's alpha was 0.84 for the total scale, and the interclass correlation coefficient was 0.77 for the test-retest reliability. The 17-item questionnaire measuring medical students' professional attitude had acceptable validity and reliability and can be adopted in other studies on physicians' and medical students' professional attitudes.

Turning unprofessional behaviors around using Holmes' reflection approach: a randomized controlled study.

Many medical schools around the world have included professionalism training in their formal curriculum. However, these efforts may not be adequate; given the exposure of students to unprofessional behaviors in the clinical settings. In the present study, we aimed to design, implement, and evaluate a longitudinal program to improve professionalism among medical students upon their transition to clinical settings. A total of 75 medical students were enrolled in the study and randomly assigned to two groups. The control group did not receive any training, while for the intervention group; a 10-hour program through 16 weeks was organized based on the Holmes' reflection approach. The effectiveness of the program was evaluated by measuring three outcomes in both groups. Data analysis was performed using paired t-test and Multiple Linear Regression. Scores of judgment of professionalism increased in the intervention group (from 7.56 to 10.17; P< 0.001), while there was no significant improvement in the control group's scores. Students' attitudes towards professionalism and their professional behaviors did not change significantly. Based on our findings, the Holmes reflection approach helps students improve their cognitive base of professionalism. Long-term follow-up and further qualitative studies will help us better understand the effects of this approach on other desirable outcomes.

Personal factors affecting medical professionalism: a qualitative study in Iran.

Professional behavior with patients and interactions with colleagues, the institution and professional bodies are influenced by many factors. The purpose of this manuscript is to clarify those personal factors affecting medical professionalism in clinical settings affiliated with Tehran University of Medical Sciences. For this purpose, a qualitative study was carried out. One hundred and eighty-two participants were recruited through purposive sampling of clinical staff, physicians, and medical students in Tehran. Data were collected through 22 focus group discussions, and conventional content analysis was used to analyze the data. The results were reported in five categories to present the participants' views. Categories were extracted from 103 codes and consisted of 1) people's belief in professionalism, 2) personality traits, 3) problems in family, 4) mental or physical health status, and 5) communication skills. The results showed that despite the facilitator roles of some personal factors, others act as barriers to professional behaviors. In order to control their impact, it is crucial to pay attention to them at the time of student/staff selection. Strengthening support systems in the organization is also essential for decreasing the effect of family problems or physical and mental health problems.

Developing "Code of Ethics for Medical Professionals, Medical Council of Islamic Republic of Iran".

BACKGROUND: The medical profession has always been an inspiration for human societies throughout its diverse history. This position and historical authority in the field of ethics has had a different and higher status, in such a way that many of the norms of general ethics and professional ethics, especially principles, such as trust, confidentiality and respect for human dignity, have been developed by medical professionals. Developing guidelines of general and professional ethics is one of the inherent duties of the Medical Council of the Islamic Republic of Iran (IRIMC) as a professional organization. In this regard, the Supreme Council of IRIMC has approved the "Code of Ethics for Medical Professionals" and, in accordance with its legal authority, has annexed it to the disciplinary regulations of IRIMC. METHODS: A draft document, the result of extensive literature review, was discussed in 27 expert panel meetings and after receiving and endorsing the stakeholders' point of view, was approved by the IRIMC Supreme Council. RESULTS: The first edition of "Code of Ethics for Medical Professionals, Medical Council of Islamic Republic of Iran" was developed on July 6, 2017 by the Supreme Council of IRIMC. The guideline was set to take effect one year after its enactment. The first edition was revised and completed and final edition was adopted on August 9, 2018 by IRIMC in 13 chapters and 140 articles (original full text is available in the Supplementary file 1). CONCLUSION: According to the approved decision by the Supreme Council of IRIMC on May 10, 2018, the final edition takes effect as of October 7, 2018.

Cost-consciousness among Iranian internal medicine residents.

Background: Study aimed at assessing residents' cost awareness and their attitude about health care costs.Methods: Internal medicine residents at teaching hospitals of Tehran University of Medical Sciences were surveyed during August-December 2016 using a researcher-made questionnaire comprising attitude statements and cost estimation of diagnostic and treatment items.Results: Eighty-nine residents completed the survey (response rate = 56.6%). The results indicate that less than one quarter (23.69%) of cost estimates were in the range of correct answers. The mean (SD) for correct estimation of medications (out of 8 scores), lab tests (out of 20 scores), and total (out of 35 scores) were 1.25 (0.96), 4.92 (0.27), and 7.97 (0.34), respectively. An analysis of variance showed that the level of residency was positively correlated with residents' correct cost estimation (F (3, 77)=9.98, p = 0.029). There was a significant positive correlation between age of residents with the correct estimate of medication prices (p = 0.018, r = 0.261).Conclusions: The internal medicine residents of Tehran University of Medical Sciences have poor knowledge of health care costs, including medications, diagnostic tests, and hospitalization costs. The results of this study explain the necessity of developing a training program for the transfer of cost information to physicians.

Barriers of students' adherence to dress code policy in clinical settings: dental students' viewpoint.

Medical universities have called for a professional dress code to preserve the dignity of the medical profession, creating a sense of respect, tranquility, and trust in healthcare recipients and improve patient safety. This study aims to explain the reasons behind poor adherence to the professional dress code by students of the dentistry school. A qualitative study was conducted to explain the viewpoints of dentistry students of Tehran University of Medical Sciences (TUMS). Twenty-three in-depth interviews with dentistry students of different genders, study years, living in different accommodations, and having different tuition payment status were conducted. Conventional content analysis was used to analyze the data. One hundred and twenty initial codes were extracted. They were categorized into common causes of non-adherence to the TUMS Dress Code and specific causes of not following a specific section of the dress code (hygiene, jewelry, and makeup sections). The codes of common causes were categorized into 4 main categories including defects in education, management shortcomings, changes in societal culture, and personal factors. All components of the educational system must be aligned with each other to overcome the barriers against the students' adherence to professional dress and put forward appropriate interventions at the policymaking, regulatory and educational levels.

Obstacles of professional behavior among medical trainees: A qualitative study from Iran (2018).

INTRODUCTION: Despite all efforts that have been made to promote professional behavior among medical trainees, unfortunately, reports from medical schools around the world confirm the prevalence of nonprofessional behaviors by medical students. Experts in the field of medical ethics and medical education in different countries have suggested several reasons for failing to minimize unprofessional performance among medical students. MATERIALS AND METHODS: This qualitative study aimed to promote our understanding from the challenges faced by Iranian medical students in providing professional behavior. The study was first conducted in the form of a semi-structured face-to-face interview with medical students and then completed with a focus group discussion (FGD) session. Forty-nine medical students participated in the interviews and 11 students participated in the FGD session. Qualitative conventional content analysis was used for examining the data. RESULTS: The participants classified the obstacles of professional behavior into the following three main categories: problems related to educational system, problems related to the society, and problems related to students themselves. CONCLUSION: Regarding the impact of various personal, social, and educational factors on the creation and expansion of unprofessional behaviors among medical students, it is essential to have a comprehensive approach for solving the problem.

Educational system defects and observing professional behavior: A qualitative study.

BACKGROUND: Observing professional behavior in clinical settings encounters many obstacles. In this research, the effect of defects of the educational system in observing professional behavior in clinical settings of Tehran University of Medical Sciences (TUMS) has been investigated. MATERIALS AND METHODS: This qualitative content analysis study was conducted using focused group discussions in TUMS. Twenty-two focused group discussions with 182 faculty members, medical students, and clinical staff were conducted. Conventional content analysis was used to analyze the data. RESULTS: One hundred and sixty codes (90 codes from the viewpoint of clinical staff and 70 codes from the viewpoint of faculty members and medical students) were extracted. The codes are categorized into 4 categories and 17 subcategories. The categories include "educators' imperfections," "inadequate initial training," "lack of attention to continuous professional education," and "lack of passion for professionalism education." CONCLUSION: Greater efforts to empower educators, planning for the effectiveness of initial education, and motivating employees might play a role in promoting the observance of professional behavior in clinical settings. Professional behavior training should be considered at the entrance into the system. This education should be strengthened by continuing theoretical and practical training and addressed by proper supervision. It is also important to focus on attracting the attention of teachers to their own model role in observing professional behavior by others.

Factors influencing the attitudes of NICU physicians toward care of neonates with very poor prognosis.

Attitudes of physicians toward neonates with poor prognosis greatly influence their decisions regarding the course of treatment and care. The present study aimed to investigate factors contributing to attitudes of medical practitioners toward poor prognosis neonates. This was a cross-sectional, descriptive-analytic study. Questionnaires for assessing subjects' attitudes toward care of very poor prognosis neonates were administered to all neonatologists, pediatricians, neonatology assistants, and pediatric residents (a total of 88 individuals) working in the NICUs of Imam Khomeini Hospital. Participants' attitudes were determined through analysis of responses to seven questions on a 5-point Likert scale ranging from "strongly agree" to "strongly disagree". Presence of anomalies incompatible with an acceptable quality of life, birth weight, gestational age, responses to neonatal diagnostic tests, certain types of diseases, parental marital status and practitioner predictions about patient prognosis were the factors contributing to practitioners' attitude (P-value < 0.005). However, no significant relationship was found in connection with religious beliefs, socioeconomic status, opinions of consulting physicians, hospital treatment protocols, standards of the Association of Neonatal Physicians, and ethics committee expectations (P-value > 0.005). It can be concluded that the attitudes of practitioners toward intensive care of poor prognosis neonates is determined by the medical condition of the neonate rather than socio-demographic characteristics.

Patient privacy: Awareness and attitudes of Iran University of Medical Sciences medical students.

Background: Respecting patients' privacy is an essential professional responsibility for physicians and other health team members. In this regard, this study investigates medical students' knowledge and attitude about confidentiality and disclosure of patients' information. Methods: In this cross-sectional study, 160 medical students of Iran University of Medical Sciences participated who were selected using stratified random sampling. Data were gathered using a valid and reliable self-report questionnaire. Student's knowledge and attitude toward medical confidentiality were assessed using self-administered and researcher-made questionnaires. Cronbach's alpha coefficients for knowledge and attitude levels were 79.7 and 82.2, respectively. Results: The average of medical students' responses to knowledge and attitude questions were 56.6% (9.6/ 17) and 55.3% (9.4 out of 17), respectively. On average, females had an acceptable attitude about 57.5% of the questions, whereas this was 50.9% for males. On average, females had an acceptable knowledge about 59.5% of the questions, whereas this was 50.6% for males. Therefore, female's attitudes and knowledge were more correct than their male counterparts (p<0.001). Conclusion: The low level of knowledge and attitude of medical students towards medical confidentiality indicates that revision of Iranian medical education curriculum to reinforce attention and knowledge of medical students on this issue to render appropriate care to patients is a necessity. Medical students' knowledge and attitude towards patient's confidentiality rights is not fulfilling.

Prevalence of Induced Abortion in Iran: A Comparison of Two Indirect Estimation Techniques.

CONTEXT: Surveys that use direct questions to ascertain women's history of induced abortion tend to underestimate abortion prevalence, especially in such contexts as Iran where the procedure is legally restricted and highly stigmatized. No previous study has compared two indirect techniques for estimating abortion prevalence. METHODS: A sample of 708 married women were recruited from one public hospital in Tehran between August and December 2013. Participants completed a survey, which included induced abortion estimation using the randomized response technique (RRT) and the unmatched count technique (UCT), as well as questions about demographic characteristics, trust in direct questions about abortion, and comprehensibility of and trust in RRT and UCT. Prevalence of induced abortion was calculated for each technique. Spearman correlation was used to evaluate whether comprehensibility of and trust in estimation methods were associated with women's age and education. RESULTS: The prevalence of induced abortion was estimated to be 14% using RRT and 12% using UCT; the estimates were not significantly different. Ninety-one percent of women reported that UCT was very easy to comprehend; the proportion for RRT was 78%. Sixty-three percent of women reported completely trusting in the confidentiality of UCT; the proportion for RRT was 50%. Age was inversely associated with comprehensibility for UCT (correlation coefficient, -0.13), and with trust for both RRT and UCT (-0.12 and -0.08, respectively); education was directly associated with trust for both methods (0.24 and 0.22). CONCLUSIONS: Of the two indirect methods, UCT may be simpler and more dependable for the estimation of induced abortion prevalence in low-literacy, abortion-restricted settings.

RESUMEN Contexto: Las encuestas que utilizan preguntas directas para determinar el historial de abortos inducidos de las mujeres tienden a subestimar la prevalencia del aborto, especialmente en contextos como Irán, donde el procedimiento está legalmente restringido y está altamente estigmatizado. Ningún estudio previo ha comparado dos técnicas indirectas para estimar la prevalencia del aborto. Métodos: Entre agosto y diciembre de 2013, en un hospital público en Teherán, se reclutó una muestra de 708 mujeres casadas. Las participantes completaron una encuesta, que incluyó la estimación del aborto inducido mediante la técnica de respuesta aleatoria (RRT) y la técnica de conteo no pareado (UCT), así como preguntas sobre características demográficas, nivel de confianza en preguntas directas sobre el aborto, así como comprensión y confianza en la RRT y la UCT. Se calculó la prevalencia del aborto inducido para cada técnica. Se usó la correlación de Spearman para evaluar si la comprensión y la confianza en los métodos de estimación estaban asociadas con la edad y escolaridad de las mujeres. Resultados: Se estimó que la prevalencia de aborto inducido era del 14% con la RRT y del 12% con la UCT. Las estimaciones no fueron significativamente diferentes. El noventa y uno por ciento de las mujeres informaron que la UCT era muy fácil de comprender; la proporción para la RRT fue del 78%. El sesenta y tres por ciento de las mujeres reportaron confiar completamente en la confidencialidad de la UCT. La proporción para la RRT fue del 50%. La edad se asoció inversamente con la comprensibilidad para la UCT (coeficiente de correlación, −0.13) y con la confianza tanto para la RRT como para la UCT (­0.12 y −0.08, respectivamente); la escolaridad se asoció directamente con la confianza en ambos métodos (0.24 y 0.22). Conclusiones: De los dos métodos indirectos, la UCT puede ser más simple y más confiable para la estimación de la prevalencia del aborto inducido en entornos de baja alfabetización y de aborto restringido.

RÉSUMÉ Contexte: Les enquêtes faisant appel aux questions directes pour évaluer les antécédents d'avortement provoqué des femmes tendent à sous-estimer la prévalence de la pratique, en particulier dans les contextes tels que l'Iran où la procédure est limitée par la loi et fortement stigmatisée. Aucune étude antérieure n'a comparé deux techniques indirectes d'estimation de la prévalence de l'avortement. Méthodes: Un échantillon de 708 femmes mariées a été recruté dans un hôpital public de Téhéran entre août et décembre 2013. Les participantes ont été invitées à répondre à un questionnaire, avec estimation de l'avortement provoqué selon la technique de la réponse aléatoire (RRT) et celle du dénombrement d'items (UCT). Le questionnaire couvrait aussi les caractéristiques démographiques, la confiance à l'égard des questions directes relatives à l'avortement, la compréhensibilité des méthodes RRT et UCT et la confiance à leur égard. La prévalence de l'avortement provoqué a été calculée pour chaque technique. La question de savoir si la compréhensibilité et la confiance relatives aux méthodes d'estimation étaient associées à l'âge et à l'éducation des femmes a été évaluée par corrélation de Spearman. Résultats: La prévalence de l'avortement provoqué a été estimée à 14% selon la technique RRT et à 12% selon la méthode UCT, soit une différence non significative. Quatre-vingt-onze pour cent des femmes ont déclaré la technique UCT très facile à comprendre; la proportion correspondante était de 78% pour la technique RRT. Soixante-trois pour cent des femmes ont indiqué avoir pleine confiance en la confidentialité de la méthode UCT; cette proportion était de 50% pour la technique RRT. L'âge s'est avéré inversement associé à la compréhensibilité pour la technique UCT (coefficient de corrélation, −0,13) et à la confiance pour les deux techniques (­0,12 pour RRT et −0,08 pour UTC); l'éducation s'est révélée directement associée à la confiance pour les deux méthodes (0,24 et 0,22). Conclusions: Des deux méthodes indirectes, la technique UCT peut être plus simple et plus fiable pour l'estimation de la prévalence de l'avortement provoqué dans les contextes à faible niveau d'alphabétisation sujets à restriction de l'avortement.