The non-governmental organisation Profamilia developed and implemented medical abortion through telemedicine in response to the Covid-19 pandemic. This service is now integrated as an alternative to in-person care and available to abortion-seekers across Colombia. Previous research has emphasised bottlenecks in abortion provision, but less is known about implementation processes and experiences. We assessed the feasibility and acceptability of telemedicine for medical abortion from the perspectives of key informants involved in the implementation in Colombia. We conducted 15 in-depth interviews with healthcare professionals, coordinators and support staff implementing telemedicine for medical abortion in the early phase of implementation, between March and October 2021. We analysed the data using the framework method and applied the normalisation process theory in our analysis and interpretation of findings. Our findings show that strong leadership, organisational efforts on pre-implementation training, monitoring and evaluation, and collaboration between diversely skilled and experienced providers are essential for successful implementation. Participants were generally positive towards the use of telemedicine for medical abortion; concerns related to effectiveness, safety and safeguarding existed mainly among providers with less clinical experience. We identified contextual barriers, such as social opposition, regulatory barriers, providers' unavailability, and poor phone and internet connections in rural areas, which impacted the feasibility of the intervention negatively. In conclusion, to ensure stakeholders' buy-in and for the service to reach all abortion seekers in need, future implementation endeavours must address concerns about safety and effectiveness, and tackle identified contexual barriers.Plain Language SummaryIn telemedicine for medical abortion, all or some components of abortion care, such as initial consultations, home delivery of abortion medication, and post-abortion follow up are provided with the use of telecommunications. Telemedicine for medical abortion has been shown to be a safe and effective form of service delivery.In this study, we interviewed 15 healthcare providers and staff involved in the implementation of a telemedicine service for medical abortion in Colombia to determine whether they deemed the service to be acceptable and feasible. We found that collaboration between providers of different backgrounds and levels of experience, appropriate training and strong leadership were key factors for successfully implementing the service. However, some healthcare providers, especially those with less clinical experience, were concerned that telemedicine for medical abortion may not be safe and may risk the health and well-being of abortion-seekers. Further, social opposition to abortion, unclear regulation and limited access to technology were identified as barriers that need to be addressed to ensure the service reaches all abortion-seekers in need.In conclusion, despite contextual barriers and some provider's concerns about medical safety, telemedicine for medical abortion was viewed as a positive and feasible form of service delivery in Colombia.

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在哥伦比亚通过远程医疗实施药物流产：一项定性研究。

非政府组织 Profamilia 通过远程医疗开发并实施了药物流产，以应对 Covid-19 大流行。这项服务现已成为当面护理的替代方案，可供哥伦比亚各地的堕胎寻求者使用。先前的研究强调了堕胎服务的瓶颈，但对实施过程和经验知之甚少。我们从哥伦比亚参与实施的关键知情人的角度评估了远程医疗用于药物流产的可行性和可接受性。2021 年 3 月至 10 月期间，我们对实施药物流产远程医疗的医疗保健专业人员、协调员和支持人员进行了 15 次深度访谈。我们使用框架方法对数据进行了分析，并在分析中应用了标准化过程理论和对调查结果的解释。我们的研究结果表明，强有力的领导、实施前培训、监测和评估方面的组织努力，以及技能多样、经验丰富的提供商之间的协作对于成功实施至关重要。参与者普遍对使用远程医疗进行药物流产持积极态度；对有效性、安全性和保障的担忧主要存在于临床经验较少的提供者中。我们发现了背景障碍，例如社会反对、监管障碍、提供商无法使用以及农村地区电话和互联网连接较差，这些因素对干预的可行性产生了负面影响。总之，为了确保利益相关者的支持并使服务惠及所有有需要的堕胎寻求者，未来的实施工作必须解决对安全性和有效性的担忧，并解决已识别的上下文障碍。通俗语言摘要在药物流产的远程医疗中，全部或部分堕胎护理的组成部分，例如初步咨询、堕胎药物送货上门以及堕胎后随访，都是通过电信提供的。药物流产远程医疗已被证明是一种安全有效的服务提供形式。在这项研究中，我们采访了哥伦比亚参与实施药物流产远程医疗服务的 15 名医疗保健提供者和工作人员，以确定他们是否认为该服务是可以接受和可行的。我们发现，不同背景和经验水平的提供商之间的合作、适当的培训和强有力的领导是成功实施该服务的关键因素。然而，一些医疗保健提供者，特别是那些临床经验较少的医疗保健提供者担心，药物流产的远程医疗可能不安全，可能会危及寻求堕胎者的健康和福祉。此外，社会上反对堕胎，