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Information flow as reproductive governance. Patient journey analysis of information barriers and facilitators to abortion care in the republic of Ireland

Duffy, Deirdre ORCID logoORCID: https://orcid.org/0000-0001-9941-1587, Mishtal, Joanna, Grimes, Lorraine, Murphy, Mark, Reeves, Karli, Chakravarty, Dyuti, Chavkin, Wendy, Favier, Mary, Horgan, Patricia, Stifani, Bianca and Lavelanet, Antonella F (2022) Information flow as reproductive governance. Patient journey analysis of information barriers and facilitators to abortion care in the republic of Ireland. SSM - Population Health, 19. p. 101132. ISSN 2352-8273

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Abstract

Background Information flow – information communication and transmission pathways and practices within healthcare systems – impacts patient journeys. Historically, regulating information flow was a key technology of reproductive governance in the Republic of Ireland. Pre-2018, law and the State sustained informational barriers to and through abortion care in Ireland. An expanded abortion service was implemented in January 2019. Method Patient Journey Analysis (PJA) interrogates informational facilitators and barriers to/through post-2019 abortion care in Ireland. We focus on information flow at the interfaces between the ‘public’ sphere and ‘point of entry’, ‘point of entry’ and primary care, and primary and secondary care. Materials The paper uses data from a mixed-method study. A tool for assessing online abortion service information (ASIAT), desktop research, and qualitative data from 108 in-depth interviews with providers, policy-makers, advocacy groups, and service users informed the analysis. Results Abortion patient journeys vary. Information flow issues, e.g. communication of how to access services, referral systems, and information handover, act as barriers and facilitators. Barriers increase where movement from primary to secondary is needed. Applications The article identifies good practice in information flow strategy, as well as areas for development. It illustrates the significance of information flow in accomplishing reproductive governance.

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