{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:35:32Z","timestamp":1777944932649,"version":"3.51.4"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Women\u2019s decision to access medication abortion (MA) in clinics or pharmacies may be shaped by several factors, but is an area that has not been adequately researched. Little is also known about the primary predictors of choice of MA provider.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Our study examined the factors associated with choice of MA provider and identified the primary predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A non-inferiority and prospective design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We utilized data from a non-inferiority and prospective study that recruited women who had MA from selected clinics and pharmacies in Ghana. Our sample comprises 1045 and 929 women from clinics and pharmacies, respectively. We used a multivariate binary logistic model to examine the factors associated with MA providers. Following this, a decision tree model was utilized to shed light on the main predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Our results show that women were more likely to spend more on accessing MA in clinics than in pharmacies (adjusted odds ratio (AOR)\u2009=\u20091.0,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Notably, results from the decision tree model indicate that MA cost has the strongest effect on provider selection (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u2009937,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Additionally, women over 24\u2009years old (AOR\u2009=\u20090.7,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), those with secondary education (AOR\u2009=\u20090.5,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01), those who learned about MA from friends or close relatives (AOR\u2009=\u20090.5,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01), and those who previously had MA before their recent MA (AOR\u2009=\u20090.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01) were less likely to access MA in clinics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found that cost has the strongest effect on women\u2019s choice of MA provider in Ghana. In addition, sociodemographic and abortion-related factors play a role. These factors should be considered in developing strategies to enhance equal opportunity in accessing high-quality and safe MA. For instance, developing strategies to reduce MA costs in clinical settings could reduce the burden on vulnerable women, including those younger who may prefer clinic providers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251347032","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:51:09Z","timestamp":1750143069000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathways to care: Factors predicting women\u2019s access to clinic versus pharmacy-based medication abortion in Ghana"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9022-7433","authenticated-orcid":false,"given":"Caesar","family":"Agula","sequence":"first","affiliation":[{"name":"Regional Institute for Population Studies, University of Ghana, Accra, Greater Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Biney","sequence":"additional","affiliation":[{"name":"Regional Institute for Population Studies, University of Ghana, Accra, Greater Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pearl","family":"Kyei","sequence":"additional","affiliation":[{"name":"Regional Institute for Population Studies, University of Ghana, Accra, Greater Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayaga A.","family":"Bawah","sequence":"additional","affiliation":[{"name":"Regional Institute for Population Studies, University of Ghana, Accra, Greater Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization (WHO). 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