"BACKGROUND: Even in countries where the abortion law is technically liberal, the full application of the law has been delayed due to resistance on the part of providers to offer services. Ghana has a liberal law, allowing abortions for a wide range of indications. The current study sought to investigate factors associated with midwifery students' reported likelihood to provide abortion services. METHODS: Final-year students at 15 public midwifery training colleges participated in a computer-based survey. Demographic and attitudinal variables were tested against the outcome variable, likely to provide comprehensive abortion care (CAC) services, and those variables found to have a significant association in bivariate analysis were entered into a multivariate model. Marginal effects were assessed after the final logistic regression was conducted. RESULTS:A total of 853 out of 929 eligible students enrolled in the 15 public midwifery schools took the survey, for a response rate of 91.8%. In multivariate regression analysis, the factors significantly associated with reported likeliness to provide CAC services were having had an unplanned pregnancy, currently using contraception, feeling adequately prepared, agreeing it is a good thing women can get a legal abortion and having been exposed to multiple forms of education around surgical abortion. DISCUSSION: Midwifery students at Ghana's public midwifery training colleges report that they are likely to provide CAC. Ensuring that midwives-in-training are well trained in abortion services, as well as encouraging empathy in these students, may increase the number of providers of safe abortion care in Ghana."
The background of the study is the very high prevalence of mortality and morbidity in Sub-Saharan countries due to abortions induced by unsafe methods. This paper draws on fieldwork conducted in 1998 and 1999 in the city of Bouake in Cote d'Ivoire. The study is based upon qualitative semi-structured interviews with men and women. This paper presents some case stories based on interviews with young women having had an abortion, or with men having had a young partner who has had an abortion, both married and unmarried. It discusses how illegally induced abortion may be understood in relation to ongoing social processes characterised by economic hardship and tensions between the sexes and generations. One important finding is that the young often choose abortion because they cannot count on economic and practical assistance from parents in feeding and raising the child. Parents are also often pushing their children to have an abortion.
"BACKGROUND: Unsafe abortion imposes heavy burdens on both individuals and society, particularly in low-income countries, many of which have restrictive abortion laws. Providing family planning counseling and services to women following an abortion has emerged as a key strategy to address this issue. STUDY DESIGN: This systematic review gathered, appraised and synthesized recent research evidence on the effects of post-abortion family planning counseling and services on women in low-income countries. RESULTS: Of the 2965 potentially relevant records that were identified and screened, 15 studies satisfied the inclusion criteria. None provided evidence on the effectiveness of post-abortion family planning counseling and services on maternal morbidity and mortality. One controlled study found that, compared to the group of non-beneficiaries, women who received post-abortion family planning counseling and services had significantly fewer unplanned pregnancies and fewer repeat abortions during the 12-month follow-up period. All 15 studies examined contraception-related outcomes. In the seven studies which used a comparative design, there was greater acceptance and/or use of modern contraceptives in women who had received post-abortion family planning counseling and services relative to the no-program group. CONCLUSIONS: The current evidence on the use of post-abortion family planning counseling and services in low-income countries to address the problem of unsafe abortion is inconclusive. Nevertheless, the increase in acceptance and/or use of contraceptives is encouraging and has the potential to be further explored. Adequate funding to support robust research in this area of reproductive health is urgently needed."
OBJECTIVE: We examined the effect of partner approval of contraception on intention to use contraception among women obtaining post-abortion care in Zanzibar. STUDY DESIGN: Our data source was a 2010 survey of 193 women obtaining post-abortion care at a large public hospital in Zanzibar. We used multivariable logistic regression analysis to assess associations between partner approval and intention to use contraception. RESULTS: Overall, 23% of participants had used a contraceptive method in the past, and 66% reported intending to use contraception in the future. We found that partner approval of contraception and ever having used contraception in the past were each associated with intending to use contraception in the future. In the multivariable model, adjusting for past contraception use, partner approval of contraception was associated with 20 times the odds of intending to use contraception (odds ratio, 20.25; 95% confidence interval, 8.45-48.56). CONCLUSIONS: We found a strong association between partner approval and intention to use contraception. Efforts to support contraceptive use must include both male and female partners. IMPLICATIONS: Public health and educational efforts to increase contraceptive use must include men and be targeted to both male and female partners. Given that male partners are often Not present when women obtain health care, creative efforts will be required to meet men in community settings.
The African Commission on Human and Peoples’ Rights recently adopted General Comment No 2 to interpret provisions of Article 14 of the Protocol to the African Charter on the Rights Women. The provisions relate to women’s rights to fertility control, contraception, family planning, information and education, and abortion. The present article highlights the General Comment’s potential to promote women’s sexual and reproductive rights in multiple ways. The General Comment’s human rights value goes beyond providing states with guidance for framing their domestic laws, practices, and policies to comply with treaty obligations. General Comment No 2 is invaluable in educating all stakeholders—including healthcare providers, lawyers, policymakers, and judicial officers at the domestic level—about pertinent jurisprudence. Civil society and human rights advocates can use the General Comment to render the state accountable for failure to implement its treaty obligations.
This study assessed coverage of reproductive health (RH) Issues--family planning (FP), abortion, and HIV--in the Ghanaian Daily Graphic newspaper. Using the composite week sampling technique, the researcher analyzed the contents of 62 editions of the paper. Prominence was measured using various attributes, and differences in mean coverage over time were assessed using analysis of variance. This review shows that coverage of RH Issues was extraordinarily poor, less than 1 percent each for FP, abortion, and HIV. RH news that was covered was given little prominence. These findings support the popular impression that the Daily Graphic does Not give priority to reproductive health Issues in its coverage. RH advocates need to develop innovative means of integrating RH content into existing media outlets.
A post-abortion care program was implemented in 11 primary and secondary health facilities in rural Tanzania in order to decentralize comprehensive post-abortion care to community level by upgrading midlevel providers to perform manual vacuum aspiration (MVA). Information about evacuation procedure and family planning (FP) service provided was obtained from the health facilities. In all, 2025 evacuations had been performed with MVA and D&C accounting for 65.6% and 34.4%, respectively. Among the women admitted with abortion complications, 59.8% left with a FP method. The proportion of women offered FP service differed by evacuation procedure, hence the proportion was higher among women evacuated by MVA. Upgrading midlevel providers to perform MVA is an efficient means to address the problem of unsafe abortion in rural areas. However, the sustainability of MVA service provision remains a challenge. Moreover, FP services should be offered to all post-abortion clients regardless of evacuation procedure.
In Ghana, abortion mortality constitutes 11% of maternal mortality. Empirical studies on possible disparities in abortion experience and access to safe abortion services are however lacking. Based on a retrospective survey of 1,370 women aged 15-49 years in two districts in Ghana, this paper examines disparities in women’s experiences of abortion and access to safe abortion care. Disparities in rates of abortion experience and access to safe abortion care were assessed using absolute (the difference in rates between groups), relative (the ratio of rates between selected and reference groups), and mean measures. Results suggest that 24% of women had at least one abortion in the five years preceding the survey. However, large gradients of socio-spatial disparities in abortion experience exist. The majority of abortions were also potentially unsafe: 53% of abortions occurred outside of any healthcare facility. Women themselves and medical doctors, respectively, performed 57% and 4% of all abortions. The majority of women also felt they could not get safe abortion even if they wanted one. Together, these results highlight the need for concerted multi-sectorial strategies, including legislative reform and provision of family planning services, to help transition from unsafe to safe abortions.
Background: Evidences indicate that unsafe abortion is one of the most important causes of maternal mortality in Ethiopia. Ethiopia strives to curb maternal mortality. Hence, current data on abortion, and its correlates are required. Objective: To assess the prevalence and associated factors of abortion among women of reproductive age (15 - 49 years) in rural kebeles of Gonji Kolela District. Methods: A community based cross-sectional study was conducted among randomly selected 611 women in six rural kebeles of Gonji Kolela District, Northwest Ethiopia. A structured pre-tested questionnaire was used to collect data on socio-demographic and obstetric histories. The data were checked for completeness and cross-checked for accuracy and consistency. Result: The overall prevalence of abortion was 12% (10.9% spontaneous and 1.1% induced). Of these, 12.3% of them had experienced abortion more than once. Most of abortion took place at home, no medical care. The most important predictor of abortion was educational status. Those women whose educational attainment was primary and above were 2.4 times more likely to experience abortion than those who were not able to read and write (AOR [95%CI] = 2.4 [1.13 - 5.10]). Most women attributed abortion to work overload. Conclusion: Abortion is high among rural women. Recommendation: Mechanism should be devised to educate the community about care to pregnant women. Why abortion is high among women who have visited school warrants further research