Background Unsafe abortion is an important public health problem in Ghana, making significant contributions to the morbidity and mortality of reproductive-aged women. Although mostly used in explaining mortality associated with perinatal care, recent calls for research on induced abortion in Africa suggest that the Three Delays Model could be used to enhance understanding of women’s experiences and access to induced abortion care. Methods We conducted 47 face-to-face interviews with women who had experienced unsafe abortions, with formal abortion providers (abortion providers in hospitals) and with informal and non-legal abortion providers (pharmacy workers and herb sellers). Study participants were recruited from selected hospitals, community pharmacies and markets within the Ashanti region of Ghana. We drew on phenomenology to analyse the data. Findings The first delay (in seeking care) occurred because of women’s poor knowledge of pregnancy, the influence of religion, and as a result of women underestimating the seriousness of abortion complications. Factors including cost, provider attitudes, stigma, and the proximity of pharmacies to women’s homes delayed their access to safe abortion and resulted in their experience of the second delay (in reaching a healthcare facility). The third delay (in receiving appropriate care) was a result of hospitals’ non-prioritisation of abortion complications and a shortage of equipment, resulting in long hospital waiting times before treatment. Conclusion This study has shown the value of the Three Delays Model in illustrating women’s experiences of unsafe abortions and ways of preventing the first, second and third delays in their access to care. No data are available. Not applicable.

中文翻译：

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三延迟模型应用于加纳预防不安全堕胎：一项定性研究

背景 不安全流产是加纳的一个重要公共卫生问题，对育龄妇女的发病率和死亡率作出了重大贡献。尽管主要用于解释与围产期护理相关的死亡率，但最近对非洲人工流产研究的呼吁表明，三延迟模型可用于加强对妇女经历和获得人工流产护理的了解。方法 我们对经历过不安全堕胎的妇女、正规堕胎提供者（医院的堕胎提供者）以及非正式和非合法堕胎提供者（药房工作人员和草药销售商）进行了 47 次面对面访谈。研究参与者是从加纳阿散蒂地区的选定医院、社区药房和市场招募的。我们利用现象学来分析数据。结果 第一次延误（寻求护理）是由于女性对怀孕的了解不足、宗教的影响以及女性低估了流产并发症的严重性所致。包括成本、提供者态度、耻辱感和药房靠近妇女家庭在内的因素延迟了她们获得安全堕胎的机会，并导致她们经历了第二次延误（到达医疗机构）。第三次延误（接受适当护理）是由于医院不优先考虑流产并发症和设备短缺，导致医院等待治疗前的等待时间过长。结论 本研究显示了三个延迟模型在说明妇女不安全堕胎的经历以及预防她们获得护理的第一次、第二次和第三次延迟方面的价值。没有可用的数据。不适用。