Medical technologies and abortion care in Eastern Uganda

Area of Science:

• Public Health
• Medical Anthropology
• Sociology of Health

Background:

• Uganda offers Manual Vacuum Aspiration (MVA), Dilation and Curettage (D&C), and medical abortifacients for abortion care.
• Legal and policy ambiguities significantly impact abortion care outcomes despite available technologies.

Purpose of the Study:

• To explore how legal restrictions and a financialized healthcare system influence the use of abortion technologies and care practices in Uganda.
• To understand the varying meanings and applications of abortion care across different health facility types.

Main Methods:

• Ethnographic study conducted in Eastern Uganda (August 2018 - March 2019).
• Data collected through interviews and observations of abortion care delivery, including quality improvement meetings.

Main Results:

• Health workers in public facilities act as state agents controlling women's bodies, while in private facilities, they act as transgressors using technologies surreptitiously.
• Pecuniary interests often drive health workers' motivations, overshadowing risks associated with abortion care.
• Normalized power dynamics and disciplinary actions contribute to unsafe abortion conditions and poor outcomes.

Conclusions:

• The study reveals mechanisms of domination and resistance in abortion care delivery within a restrictive context.
• Unsafe abortion outcomes are contingent upon specific systemic conditions, including financialization and legal ambiguities.
• Understanding these dynamics is crucial for improving abortion care safety and outcomes in Uganda.