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Table 2 Stage 1 activities and SEM factors influencing Stage 1 implementation

From: Evaluating implementation of the World Health Organization’s Strategic Approach to strengthening sexual and reproductive health policies and programs to address unintended pregnancy and unsafe abortion

Stage 1 activities SEM level factors influencing Stage 1 implementation
• Highlighted important issues related to unintended pregnancy and unsafe abortion and its impact on maternal deaths.
• Generated consensus on follow-up recommendations for reforming legislation and policies to improve access to and quality of SRH services, improving provider-level capacity, and increasing community-level education regarding SRH services.
• Individual/Community/Organizational: Country’s ability to establish a cross-sectoral, multidisciplinary assessment team and ensure collaboration among team members with diverging perspectives.
• Policy: Logistics of conducting strategic assessment fieldwork due to country size, geography, and language.
• Individual: HCPs’ and community members’ buy-in and willingness to participate in assessment interviews/discussions.
• Individual: Country stakeholders’ ability to reach consensus on recommendations to address assessment findings despite having different ideas about potential solutions;
E.g., some stakeholders perceived that all abortions were unsafe and that the solution was to increase access to contraception; others felt that they needed to increase access to safe abortion services.
• Organizational: The WHO’s support helped ensure that power differentials among country stakeholders did not inhibit open dialogue and equitable participation during the consensus process.