Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil

Detalhes bibliográficos
Autor(a) principal: Amanda Almeida Mudjalieb
Data de Publicação: 2020
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7366
Resumo: The article reports on an experience developed by the Rio de Janeiro Municipal Health Department (SMS-RJ) to expand the number of municipal maternity hospitals that provide legal abortion for rape victims. Brazil’s legislation allows legal abortions in three cases: risk to the woman’s life, rape, and fetal anencephaly. Given the high rate of sexual violence against Brazilian women, health professionals working in the Brazilian Unified National Health System (SUS) need to be trained for such care with abortion as the potential outcome if that is the woman’s choice. Despite the legal provisions and guidelines, Brazilian women still experience important barriers when attempting to access this right. One of the main obstacles is health professionals’ claim of conscientious objection. The study aims to present an awareness-raising methodology for health professionals to improve the care for victims of sexual violence and expand access to legal abortion in the municipal maternity hospitals. The methodology involved three stages: a workshop, awareness-raising in the maternity hospitals, and monitoring. This experience resulted in an increase in the number of maternity hospitals that perform legal abortion for rape victims, from two hospitals in 2016 to ten in 2019. The experience also strengthened the guidelines for the improvement of care, such as prioritization of cases for reception of patients and risk classification, supply of multidisciplinary care, and safeguards for the presence of an accompanying person during the patient’s hospital stay. Factors that favored this work included political determination by the administration of the SMS-RJ, the wager on decentralized activities in permanent education, and the health professionals’ direct involvement.
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spelling Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, BrazilRelato de experiência sobre ampliação do acesso ao aborto legal por violência sexual no Município do Rio de Janeiro, BrasilAborto LegalDelitos SexualesMaternidadesEducación ContinuadaSistema Único de SaludLegal AbortionSex OffensesMaternity HospitalsContinuing EducationUnified Health SystemAborto LegalDelitos SexuaisMaternidadesEducação ContinuadaSistema Único de SaúdeThe article reports on an experience developed by the Rio de Janeiro Municipal Health Department (SMS-RJ) to expand the number of municipal maternity hospitals that provide legal abortion for rape victims. Brazil’s legislation allows legal abortions in three cases: risk to the woman’s life, rape, and fetal anencephaly. Given the high rate of sexual violence against Brazilian women, health professionals working in the Brazilian Unified National Health System (SUS) need to be trained for such care with abortion as the potential outcome if that is the woman’s choice. Despite the legal provisions and guidelines, Brazilian women still experience important barriers when attempting to access this right. One of the main obstacles is health professionals’ claim of conscientious objection. The study aims to present an awareness-raising methodology for health professionals to improve the care for victims of sexual violence and expand access to legal abortion in the municipal maternity hospitals. The methodology involved three stages: a workshop, awareness-raising in the maternity hospitals, and monitoring. This experience resulted in an increase in the number of maternity hospitals that perform legal abortion for rape victims, from two hospitals in 2016 to ten in 2019. The experience also strengthened the guidelines for the improvement of care, such as prioritization of cases for reception of patients and risk classification, supply of multidisciplinary care, and safeguards for the presence of an accompanying person during the patient’s hospital stay. Factors that favored this work included political determination by the administration of the SMS-RJ, the wager on decentralized activities in permanent education, and the health professionals’ direct involvement.Se trata de un relato sobre una experiencia, desarrollada en la Secretaría Municipal de Salud de Río de Janeiro (SMS-RJ), para ampliar el número de maternidades municipales que atienden abortos legales por violación. En Brasil, existen tres supuestos legales para abortar: riesgo para la vida de la gestante, violación y anencefalia del feto. Ante la alta ocurrencia de violencia sexual contra las mujeres, los profesionales que actúan en el Sistema Único de Salud (SUS)necesitan estar cualificados para este tipo de atención y desenlace potencial en aborto, en caso de que esta sea la elección de la mujer. A pesar de las normas y directrices, todavía existen barreras importantes en el acceso a este derecho, siendo la alegación de objeción de conciencia -por parte de los profesionales- uno de los principales obstáculos a los que se hace frente. El objetivo del trabajo es presentar una metodología de sensibilización para profesionales de salud, con el fin cualificar la atención a las víctimas de violencia sexual y ampliar el acceso al aborto legal en las maternidades municipales. La metodología contó con tres etapas: taller de trabajo, sensibilizaciones en maternidades y supervisión. Se realizó un seguimiento de esta experiencia, debido al aumento del número de maternidades donde se permite el aborto legal por violación, pasando de dos unidades en 2016 a diez en 2019. También se fortalecieron las directrices para la mejora en la atención, como la priorización de los casos en la acogida y clasificación de riesgo, la oferta de atención multiprofesional, así como la garantía de la presencia de un acompañante durante el internamiento. Los factores que favorecieron este trabajo fueron: voluntad política de la unidad de gestión de la SMS-RJ; la apuesta en acciones descentralizadas de educación permanente, así como la implicación de los profesionales de salud.Trata-se de relato de experiência desenvolvida na Secretaria Municipal de Saúde do Rio de Janeiro (SMS-RJ), para ampliar o número de maternidades municipais que atendem ao aborto legal por estupro. No Brasil, existem três permissivos legais para realização do aborto: risco à vida da gestante, estupro e anencefalia do feto. Diante da alta ocorrência de violência sexual contra as mulheres, os profissionais que atuam no Sistema Único de Saúde precisam estar qualificados para este atendimento e potencial desfecho em aborto, caso seja esta a escolha da mulher. Apesar das normas e diretrizes, ainda existem barreiras importantes no acesso a este direito, sendo a alegação da objeção de consciência pelos profissionais um dos principais obstáculos enfrentados. O objetivo do trabalho é apresentar uma metodologia de sensibilização de profissionais de saúde, para qualificar o atendimento às vítimas de violência sexual e ampliar o acesso ao aborto legal nas maternidades municipais. A metodologia contou com três etapas: oficina de trabalho, sensibilizações nas maternidades e monitoramento. Esta experiência foi acompanhada pelo aumento do número de maternidades que realizam o aborto legal por estupro, passando de duas unidades em 2016 para dez em 2019. Também fortaleceu diretrizes para melhoria no atendimento, como priorização dos casos no acolhimento e classificação de risco, oferta de atendimento multiprofissional e garantia da presença do acompanhante na internação. Fatores que favoreceram este trabalho foram: vontade política da gestão da SMS-RJ; aposta em ações descentralizadas de educação permanente; envolvimento dos profissionais de saúde.Reports in Public HealthCadernos de Saúde Pública2020-04-06info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7366Reports in Public Health; Vol. 36 No. 13 (2020): Supplement 1Cadernos de Saúde Pública; v. 36 n. 13 (2020): Suplemento 11678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7366/16234https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7366/16235https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7366/16236https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7366/16237Amanda Almeida Mudjaliebinfo:eu-repo/semantics/openAccess2024-03-06T15:29:54Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/7366Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:08:27.902163Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
Relato de experiência sobre ampliação do acesso ao aborto legal por violência sexual no Município do Rio de Janeiro, Brasil
title Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
spellingShingle Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
Amanda Almeida Mudjalieb
Aborto Legal
Delitos Sexuales
Maternidades
Educación Continuada
Sistema Único de Salud
Legal Abortion
Sex Offenses
Maternity Hospitals
Continuing Education
Unified Health System
Aborto Legal
Delitos Sexuais
Maternidades
Educação Continuada
Sistema Único de Saúde
title_short Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
title_full Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
title_fullStr Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
title_full_unstemmed Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
title_sort Report of an experience to expand access to legal abortion for rape victims in the city of Rio de Janeiro, Brazil
author Amanda Almeida Mudjalieb
author_facet Amanda Almeida Mudjalieb
author_role author
dc.contributor.author.fl_str_mv Amanda Almeida Mudjalieb
dc.subject.por.fl_str_mv Aborto Legal
Delitos Sexuales
Maternidades
Educación Continuada
Sistema Único de Salud
Legal Abortion
Sex Offenses
Maternity Hospitals
Continuing Education
Unified Health System
Aborto Legal
Delitos Sexuais
Maternidades
Educação Continuada
Sistema Único de Saúde
topic Aborto Legal
Delitos Sexuales
Maternidades
Educación Continuada
Sistema Único de Salud
Legal Abortion
Sex Offenses
Maternity Hospitals
Continuing Education
Unified Health System
Aborto Legal
Delitos Sexuais
Maternidades
Educação Continuada
Sistema Único de Saúde
description The article reports on an experience developed by the Rio de Janeiro Municipal Health Department (SMS-RJ) to expand the number of municipal maternity hospitals that provide legal abortion for rape victims. Brazil’s legislation allows legal abortions in three cases: risk to the woman’s life, rape, and fetal anencephaly. Given the high rate of sexual violence against Brazilian women, health professionals working in the Brazilian Unified National Health System (SUS) need to be trained for such care with abortion as the potential outcome if that is the woman’s choice. Despite the legal provisions and guidelines, Brazilian women still experience important barriers when attempting to access this right. One of the main obstacles is health professionals’ claim of conscientious objection. The study aims to present an awareness-raising methodology for health professionals to improve the care for victims of sexual violence and expand access to legal abortion in the municipal maternity hospitals. The methodology involved three stages: a workshop, awareness-raising in the maternity hospitals, and monitoring. This experience resulted in an increase in the number of maternity hospitals that perform legal abortion for rape victims, from two hospitals in 2016 to ten in 2019. The experience also strengthened the guidelines for the improvement of care, such as prioritization of cases for reception of patients and risk classification, supply of multidisciplinary care, and safeguards for the presence of an accompanying person during the patient’s hospital stay. Factors that favored this work included political determination by the administration of the SMS-RJ, the wager on decentralized activities in permanent education, and the health professionals’ direct involvement.
publishDate 2020
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https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7366/16236
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Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 36 No. 13 (2020): Supplement 1
Cadernos de Saúde Pública; v. 36 n. 13 (2020): Suplemento 1
1678-4464
0102-311X
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