Quality of care from the perspective of people obtaining abortion: a qualitative study in four countries.

OBJECTIVE: This qualitative study aimed to identify person-centred domains that would contribute to the definition and measurement of abortion quality of care based on the perceptions, experiences and priorities of people seeking abortion. METHODS: We conducted interviews with people seeking abortion aged 15-41 who obtained care in Argentina, Bangladesh, Ethiopia or Nigeria. Participants were recruited from hospitals, clinics, pharmacies, call centres and accompaniment models. We conducted thematic analysis and quantified key domains of quality identified by the participants. RESULTS: We identified six themes that contributed to high-quality abortion care from the clients' perspective, with particular focus on interpersonal dynamics. These themes emerged as participants described their abortion experience, reflected on their interactions with providers and defined good and bad care. The six themes included (1) kindness and respect, (2) information exchange, (3) emotional support, (4) attentive care throughout the process, (5) privacy and confidentiality and (6) prepared for and able to cope with pain. CONCLUSIONS: People seeking abortion across multiple country contexts and among various care models have confirmed the importance of interpersonal care in quality. These findings provide guidance on six priority areas which could be used to sharpen the definition of abortion quality, improve measurement, and design interventions to improve quality.

Effect of pedestrian characteristics and their road crossing behaviors on driver yielding behavior at controlled intersections.

INTRODUCTION: Globally, pedestrians are one of the most vulnerable road-user groups. Their vulnerability increases while crossing the road at controlled intersections during the "don't walk" phase. Previous literature shows that driver yielding behavior has an association with pedestrian safety at intersections. Though several studies have explored driver yielding behavior towards pedestrians at conflict points, evidence on how pedestrian actions influence driver yielding behavior at intersections is yet to be investigated. METHOD: To pursue this end, a binary logistic regression model was developed using the collected data to explore the effect of non-compliant pedestrian characteristics and their road crossing behavior on driver yielding behavior towards pedestrians at six controlled intersections of Dhaka, Bangladesh. The data were collected through videography survey. RESULTS: Results showed that drivers were more likely to yield to pedestrians who were female, crossing in a group, carrying baggage, not using a mobile, making some hand gesture to the driver, or crossing by rolling gap strategy. PRACTICAL APPLICATIONS: These findings add new insights for transportation planners into the complex interaction between vehicles and pedestrians at busy controlled intersections, and thus would help to make a pedestrian friendly street.

Experiences of a 'screen and treat' cervical cancer prevention programme among brothel-based female sex workers in Bangladesh: A qualitative interview study.

OBJECTIVES: Little is known about sex workers' experiences of cervical cryotherapy. We sought to understand sex workers' perspectives of 'screen and treat' programmes and their management of the World Health Organization post-treatment guidance to abstain from sex or use condoms consistently for 4 weeks. We explored contraceptive preferences and use of menstrual regulation services. METHODS: We conducted semi-structured interviews with 16 sex workers and six brothel leaders in an urban brothel complex in Bangladesh between October and November 2018. All had undergone cryotherapy. We conducted a thematic analysis using deductive coding, informed by a priori themes, and inductive data-driven coding. RESULTS: Most sex workers could not abstain from sex during the healing period. Consistent condom use was challenging due to economic incentives attached to condomless sex and coercive behaviours of clients. The implications of non-adherence among high-risk groups such as sex workers are not known. Use of short-acting methods of contraception was common, and discontinuation was high due to side effects and other perceived health concerns. The majority of sex workers and brothel leaders had utilized menstrual regulation services. Barriers to accessing timely menstrual regulation and other sexual and reproductive health services included limited mobility, economic costs, and discriminatory attitudes of health care workers. CONCLUSION: Service innovations are required to enable sex workers to abstain or use condoms consistently in the post-cryotherapy healing phase and to address sex workers' broader sexual and reproductive health needs. Further research is required to assess the risk of HIV and other sexually transmitted infection transmission following cryotherapy among high-risk groups.

Factors influencing pedestrians' decision to cross the road by risky rolling gap crossing strategy at intersections in Dhaka, Bangladesh.

Pedestrian road-crossing strategy is one of the most important pedestrian road-crossing behaviors. The safety of the pedestrians often depends on it. Among the road-crossing strategies, rolling gap crossing strategy is the riskiest one. The objective of this research was to explore the factors that influenced pedestrians' decision to cross the road by rolling gap crossing at intersection. Data regarding road-crossing strategy of the pedestrians, their characteristics, their road-crossing behavior, intersection geometry, and traffic environmental condition were collected through videography survey method, on-site observation, and secondary source from six intersections of Dhaka, Bangladesh. A binary logistic regression model was developed in this study by using the collected data. Results of the developed model showed that seven statistically significant factors strongly influenced pedestrians' decision to cross the road by rolling gap crossing at intersections. These factors were intersection control type, median width, vehicle flow, available gap on the road, age group of the pedestrians, their crossing group size, and their behavior of crosswalk usage. The results of this study would help the policymakers to take proper interventions to alleviate pedestrian safety problems.