Mystery Client Methodologies to Evaluate Abortion Care and Access: A Scoping Review

Area of Science:

• Reproductive Health
• Health Services Research
• Social Sciences

Background:

• Misinformation and disinformation significantly hinder access to abortion services globally.
• Mystery shopping, a method for evaluating health services, has not been extensively studied in abortion research.
• Understanding the application of mystery shopping is crucial for improving abortion care access.

Purpose of the Study:

• To conduct a scoping review of mystery shopping methodologies in international abortion research.
• To synthesize evidence on the application and findings of mystery shopping studies in the field of abortion.
• To identify themes and map findings to patient-centered access frameworks.

Main Methods:

• A comprehensive scoping review following JBI methodology was performed.
• Searches included English and French language studies utilizing mystery shopping (phone, in-person, online).
• No date or jurisdictional limitations were imposed on the search.

Main Results:

• Forty studies published between 2006 and 2025 were included, spanning 13 countries.
• Methods varied, including phone calls (20), in-person visits (18), and online/text methods (3).
• Key themes identified were service availability and information quality, mapped to the Levesque framework's access dimensions.

Conclusions:

• Mystery shopping effectively proxies patient experiences in accessing abortion care.
• Findings highlight the importance of affordability, cultural safety, and geographic proximity in improving abortion access.
• The method serves as a validity check, comparing self-reported practices with patient experiences.