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II. Methodology

This report is based on field research conducted in Lima, Peru, in June, July, and December 2007 by two Human Rights Watch researchers.

Human Rights Watch conducted individual interviews and group discussions with 77 key individuals about access to reproductive health services, primarily therapeutic abortion, in the public health sector in the capital city. The interviews were conducted in Spanish and, in most cases, at the subject’s workplace. Those interviewed included: 10 women who have experienced an abortion or crisis pregnancy;¹ 26 healthcare providers, including public hospital directors and employees, private practitioners, and heads of professional medical societies; more than 20 civil society advocates, mostly leaders in the women’s rights movement; 12 government officials from the Ministry of Health, the National Ombudsman Office for Human Rights, the Ministry of Women and Social Development, and the Presidential Council of Ministers; and three officials within the United Nations system. Interviews with representatives of international donor organizations, such as the Spanish Agency for International Cooperation and the United States Agency for International Development, and several others were conducted by telephone.

The interviews were completely voluntary with participants’ verbal informed consent obtained prior to the interview. Except for several highly publicized cases, the names of all women and some of the other interviewees for this report have been disguised with initials in the interest of the privacy and security of the individuals concerned. There was no compensation awarded for the interviews, but for some of the women interviewed, reimbursement for transportation to and from the interview was provided.

Lima has a population of more than 7.8 million in a country of 28.7 million inhabitants (that is, the capital accounts for 27 percent of the national population). Peru is in the process of decentralizing its health sector. In the meantime, tertiary- and higher-level public healthcare services in the country are still mostly centralized in Lima due to inadequate distribution of resources, long distances, and difficult terrain throughout the country. The largest number of specialized healthcare services—public and private—is offered in Lima. Therefore, the services represented here cannot be generalized, but may, in fact, represent a best-case scenario for the urban areas of the country as a whole.

Human Rights Watch investigated what happens to women in the public healthcare sector, as the state is obligated to provide services for the poorest and most vulnerable. A limitation of the research was the difficulty in identifying women who had sought or procured a therapeutic abortion in the public health system, in part, because there were so few. The lack of accurate medical records, misclassification of diagnoses, confusion about what constitutes a legal or therapeutic abortion, furtiveness, and stigma surrounding the procedure compounded the difficult search.

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