title: The role of village health nurses in mediating abortions in rural Tamil Nadu, India.
abstract: This paper reports on qualitative research on abortion services in the Coimbatore district of Tamil Nadu in south India, and the role of government village health nurses (VHNs) in assisting women to obtain abortions. The aim of the research, carried out in 1997, was to document the process married women go through to obtain abortions in both the public and private sectors, particularly women in rural areas, and why they preferred private clinics. The research consisted of direct observation of "sterilization/medical termination of pregnancy camps" at rural primary health centres and in hospital settings, plus informal and in-depth, open-ended interviews with medical officers, gynaecologists, government medical administrators, VHNs and other health care personnel. It found that VHNs were not only helping their clients to obtain abortions in government facilities but also and more often with qualified private providers. Unmarried girls were excluded from this process by the need for secrecy, however, and were perceived to still be going to unqualified providers. Government records show that there were clear reductions in the availability of public abortion services in the rural areas throughout the 1990s. The widespread perception that private services were safer and treated women better, the increased availability of qualified private abortion providers and the help of VHNs to access private services all encouraged married women to use the private sector.
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects / Q000191:economics / Q000451:nursing*; D003152:Community Health Nursing; D005249:Fees and Charges; D005260:Female; D006801:Humans; D007194:India; D024802:Nurse's Role; D011247:Pregnancy; D017149:Private Sector; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019035:Rural Health Services; D012424:Rural Population; D000078329:Workforce