“They know everything”: the role of Community Health Workers in abortion access

In India, female community health workers (CHWs) are equipped with pregnancy testing kits, and are often present for women’s first acknowledgement or confirmation of pregnancy. As trusted confidants and sources of health information, women turn to CHWs for advice and support in their abortion decision-making. Task-shifting recommendations and policies centre CHWs as key personnel in abortion access, but their current roles in abortion access remain underexplored. Questionnaire data (n= 112) and in-depth interview data (n= 21) collected in two rural districts in India (2017) show that CHWs can enable or cause additional barriers in women’s abortion care-seeking pathways. Preliminary findings suggest that CHWs take on ‘counselling’ roles, and negative or positive attitudes towards abortion can affect the quality and nature of their advice. Where abortion is legal, recognising CHWs as pivotal actors and investing in their knowledge and training can make safe abortion more accessible, affecting women’s pathways to abortion.