Delays to care-seeking, by country.

Lack of access to safe abortions continues to be a major sexual and reproductive health concern. Adolescents can face barriers to safe abortions due to the unique implications of their age. Understanding adolescent abortion experiences and care trajectories is critical. Qualitative and quantitative evidence is analysed from interviews with 313 adolescents aged 10–19 years who sought abortion-related care in public health facilities in Addis Ababa (Ethiopia), Lilongwe (Malawi), and Lusaka (Zambia) between April 2018 and September 2019. The trajectories framework is used to understand how adolescent abortion-related care-seeking differs across a range of socio-legal national contexts. A comparative study design incorporates varying levels of restriction on access to abortion: Ethiopia (legal on broad social or economic grounds, services implemented); Zambia (legal on broad social or economic grounds, complex services with barriers to implementation and information provision); and Malawi (legally highly restricted). Most adolescents (n = 97, 98%) in Ethiopia obtained a medically safe abortion, and most adolescents (n = 70, 64%) in Zambia and almost all adolescents (n = 94, 94%) in Malawi obtained a less medically safe abortion. There is a significant association between country and whether an adolescent tried to end a pregnancy before coming to the facility, X²(2, N = 313) = 135.93, p无法获得安全堕胎服务仍是性与生殖健康领域的重大关切。青少年群体因年龄特殊性，在获取安全堕胎服务时往往面临独特障碍。深入了解青少年的堕胎经历与诊疗轨迹，具有关键意义。本研究对2018年4月至2019年9月期间，在埃塞俄比亚亚的斯亚贝巴、马拉维利隆圭以及赞比亚卢萨卡的公立卫生机构寻求堕胎相关诊疗服务的313名10至19岁青少年的访谈资料开展定性与定量分析。本研究采用诊疗轨迹框架，以探究不同社会法律国情下，青少年堕胎相关诊疗寻求行为的差异。本比较研究设计涵盖了不同程度的堕胎服务准入限制：埃塞俄比亚（基于宽泛的社会或经济事由合法，且已落实相关服务）；赞比亚（基于宽泛的社会或经济事由合法，但服务实施与信息提供均存在诸多障碍，流程复杂）；马拉维（法律层面限制极为严格）。埃塞俄比亚的多数青少年（n=97，占比98%）接受了医学安全堕胎手术，而赞比亚的多数青少年（n=70，占比64%）与马拉维几乎所有青少年（n=94，占比94%）仅接受了医学安全性较低的堕胎服务。国家因素与青少年在前往医疗机构前是否曾尝试自行终止妊娠之间存在显著关联，χ²(2, N = 313) = 135.93, p