Abstract
Background Unsafe induced abortion is a major contributor to maternal morbidity and mortality in Ghana. Objective This study aimed to explore the predictors of unsafe induced abortion among women in Ghana. Methods The study used data from the 2017 Ghana Maternal Health Survey. The association between women's sociodemographic, obstetric characteristics, and unsafe induced abortion was explored using logistic regression. The analysis involved a weighted sample of 1880 women aged 15-49 years who induced abortion in the period 2012-2017. Analysis was carried out using STATA/IC version 15.0. Statistical significance was set at p <0.05. Results Of the 1880 women, 64.1% (CI: 60.97-67.05) had an unsafe induced abortion. At the univariate level, older women (35-49 years) (odds ratio=0.50, 95% CI: 0.28-0.89) and married women (odds ratio=0.61, 95% CI:0.44-0.85) were less likely to have an unsafe induced abortion while women who did not pay for abortion service (odds ratio=4.44, 95% CI: 2.24-8.80), who had no correct knowledge of the fertile period (odds ratio =1.47, 95% CI: 1.10-1.95), who did not know the legal status of abortion in Ghana (odds ratio =2.50, 95% CI: 1.68-3.72) and who had no media exposure (odds ratio =1.34, 95% CI: 1.04-1.73) had increased odds for an unsafe induced abortion. At the multivariable level, woman's age, payment for abortion services, and knowledge of the legal status of abortion in Ghana were predictors of unsafe induced abortion. Conclusion Induced abortion is a universal practice among women. However, unsafe abortion rate in Ghana is high and remains an issue of public health concern. We recommend that contraceptives and safe abortion services should be made available and easily accessible to women who need these services to reduce unwanted pregnancies and unsafe abortion rates, respectively, in the context of women's health. Also, awareness has to be intensified on abortion legislation in Ghana to reduce the stigma associated with abortion care seeking.
Highlights
Developing countries account for the greatest proportion of the global maternal deaths that occur annually [1]
The study by Sundaram and his colleagues is liable to underreporting of the outcome which has implications for planning purposes and decision making. This study addresses this gap and provides current information on unsafe abortion rate including the profile of women who procure unsafe abortion services in Ghana
The 2017 Ghana Maternal Health Survey (GMHS) was implemented by the Ghana Statistical Service (GSS) with technical support from ICF through the Demographic and Health Survey (DHS) program
Summary
Developing countries account for the greatest proportion of the global maternal deaths that occur annually [1]. Unsafe induced abortion is a major contributor to maternal morbidity and mortality in Ghana. This study aimed to explore the predictors of unsafe induced abortion among women in Ghana. The analysis involved a weighted sample of 1880 women aged 15-49 years who induced abortion in the period 2012-2017. Woman’s age, payment for abortion services, and knowledge of the legal status of abortion in Ghana were predictors of unsafe induced abortion. We recommend that contraceptives and safe abortion services should be made available and accessible to women who need these services to reduce unwanted pregnancies and unsafe abortion rates, respectively, in the context of women’s health. The mean age of the participants was 27.64±6.66 years (range 15-48 years) The majority had their first sexual encounter before 18 years (59.9%), were Christians (90.7%), and lived in the urban setting (65.4%). The main reason mentioned by many of the women (15.2%) for inducing abortion was ‘No money to care for baby.’
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