{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:00:36Z","timestamp":1785463236922,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates the effectiveness of targeted interventions implemented in Zambia from June 2023 to May 2024 in improving access to self\u2010managed medical abortion (SMA) care, following the identification of barriers among providers and community through a baseline assessment and subsequent endline survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pre\u2010 and post\u2010survey using quantitative method focused on barriers for healthcare providers and community, including Access and Physical Environment; Guidelines and Documents; Equipment and Supplies; Provision and Staff Training; and Financial Aspects. Interventions included improving access, provider training, commodity strengthening, and community sensitization. Participants included healthcare providers, community members, and peer educators across 30 health facilities. STATA was used for descriptive analysis and McNemar's test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our study revealed notable improvements in the provision of SMA services across the 30 participating facilities. Facilities offering SMA services increased from 25.3% at baseline to 44% at endline, while the proportion of facilities with adequate sticks of combipacks and misoprostol increased significantly. There was also a documented rise in hospital leadership support and a reduction in charges for SMA services. Access to telemedicine services also improved, increasing from 5.3% to 20.9%. Among community health volunteers, social acceptance of SMA care increased from 54.7% to 79.3%. There was also a greater preference for home administration of SMA medication and self\u2010assessment of effectiveness. Facilities with trained community health volunteers delivering SMA education rose markedly from 25.3% to 93.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings demonstrated significant improvements from baseline to endline, highlighting that SMA interventions were effective in improving access to safe abortion care in Zambia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70775","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T06:40:03Z","timestamp":1768027203000},"page":"1554-1561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the impact of targeted interventions on access to self\u2010managed abortion care in Zambia"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8896-3658","authenticated-orcid":false,"given":"Meek","family":"Mwila","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Kabwe Central Hospital  Kabwe Zambia"},{"name":"Young Emerging Scientists Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Kaonga","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedictus","family":"Mangala","sequence":"additional","affiliation":[{"name":"Zambia Association of Gynaecologists and Obstetricians  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musonda","family":"Makasa","sequence":"additional","affiliation":[{"name":"Zambia Association of Gynaecologists and Obstetricians  Lusaka Zambia"},{"name":"Women and Newborn Hospital University Teaching Hospitals  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swebby","family":"Macha","sequence":"additional","affiliation":[{"name":"Zambia Association of Gynaecologists and Obstetricians  Lusaka Zambia"},{"name":"Women and Newborn Hospital University Teaching Hospitals  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kachali","family":"Lambwe","sequence":"additional","affiliation":[{"name":"Zambia Association of Gynaecologists and Obstetricians  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarate Nzala","family":"Munakampe","sequence":"additional","affiliation":[{"name":"Department of Policy and Management, School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwansa Ketty","family":"Lubeya","sequence":"additional","affiliation":[{"name":"Young Emerging Scientists Zambia  Lusaka Zambia"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health University of Zambia  Lusaka Zambia"},{"name":"Zambia Association of Gynaecologists and Obstetricians  Lusaka Zambia"},{"name":"Women and Newborn Hospital University Teaching Hospitals  Lusaka Zambia"},{"name":"Department of Policy and Management, School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization.Comprehensive Abortion Care (CAC) Guidelines.2022.https:\/\/srhr.org\/abortioncare\/"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00461-7"},{"key":"e_1_2_11_4_1","unstructured":"Zambia Termination of Pregnancy Act 26 of 1972.https:\/\/zambialii.org\/akn\/zm\/act\/1972\/26\/eng@1996\u201012\u201031"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14351"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-024-03179-9"},{"key":"e_1_2_11_7_1","first-page":"59","article-title":"Exploring polish women's experiences using a medication abortion telemedicine service: a qualitative study","volume":"23","author":"Foster A","year":"2018","journal-title":"Eur J Contracept Reprod Health 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