Abortion among adolescents in Africa: A review of practices, consequences, and control strategies

Atuhaire, Shallon

doi:10.1002/hpm.2842

Cited by 30 publications

(33 citation statements)

References 26 publications

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“…In Nigeria, the situation is further exacerbated by socio-cultural and religious beliefs whereby termination of pregnancy is viewed as murder and carries harsh penalties for providers [ 8 , 9 ]. These factors contribute to women seeking clandestine abortion services with private providers who are mostly untrained, carry out procedures in unsafe environments using dangerous invasive methods [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…While much research has been published reporting on young people’s knowledge, attitudes, practices and prevalence of pregnancy termination in SSA especially in Nigeria [ 3 , 9 , 12 , 14 ], fewer studies have investigated factors influencing termination. The prevalence of pregnancy termination is higher in women of older age [ 8 , 15 , 16 ]; young age of sexual debut [ 17 ]; employed women [ 13 ], unintended pregnancy [ 8 , 16 ], forced or transactional sex [ 18 ], physical or sexual intimate partner violence [ 19 , 20 ], higher number of living children [ 18 , 21 ], and higher wealth index [ 13 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Trends in and predictors of pregnancy termination among 15–24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018

Onukwugha

Magadi

Sarki³

et al. 2020

BMC Pregnancy Childbirth

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Background Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15–24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15–24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among 15–24 year-old women in Nigeria. Methods We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15–24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis and are reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for 15–24 year-old women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for reproductive health service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR = 4.2; 95% CI 2.7–6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR = 2.3; 95% CI 1.9–2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR = 3.0; 95% CI 2.5–3.7). Conclusion Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trends in and predictors of pregnancy termination among 15–24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018

Onukwugha

Magadi

Sarki³

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…While much research has been published reporting on young people's knowledge, attitudes, practices and prevalence of pregnancy termination in SSA especially in Nigeria [3,9,12,14], fewer studies have investigated factors in uencing termination. The prevalence of pregnancy termination is higher in women of older age [8,[15][16]; young age of sexual debut [17]; employed women [13], unintended pregnancy [8,16], forced or transactional sex [18], physical or sexual intimate partner violence [19,20], higher number of living children [18,21], and higher wealth index [13,22].…”

Section: Introductionmentioning

confidence: 99%

Trends in and predictors of pregnancy termination among 15-24 yer old women in Nigeria: a multi-level analysis of Demographic and Health Surveys 2003-2018

Onukwugha

Magdi

Sarki³

et al. 2020

Preprint

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Background: Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15-24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15-24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among 15-24 year-old women in Nigeria. Methods: We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15-24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis and are reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for 15-24 year-old women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for reproductive health service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR=4.2; 95% CI 2.7-6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR=2.3; 95% CI 1.9-2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR=3.0; 95% CI 2.5-3.7).Conclusion: Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.

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“…Moreover, adolescent girls with unintended pregnancies may opt for unsafe abortions further complicating their SRH outcomes. For instance, it is estimated that 41% of annual unsafe abortions in developing countries occur among women aged 15-25 years with 70% of complications due to unsafe abortion occurring among girls below 20 years of age (10). A nationally representative cross-sectional study on abortion complication severity and associated factors in Kenya established a high abortion complication fatality rate; adolescents aged between 12-19 years constituted approximately 34% of patients presenting for post-abortion care in Kenya with almost half, 47% being unmarried (11).…”

Section: Introductionmentioning

confidence: 99%

“…Realistically, most adolescents are already forming ideas and engaging in sexual practices during this period (3,10).…”

Section: Introductionmentioning

confidence: 99%

“Those Are Things for Married People”: Exploring Parents’/adults’ and Adolescents’ Perspectives on Contraceptives in Kenya

Mwaisaka

Dibaba²,

Ouedraogo

et al. 2020

Preprint

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BackgroundContraceptive use among adolescent girls is low in many sub-Saharan African countries including Kenya. One factor likely to limit contraceptive use among adolescent girls is the attitude of parents and other community members including adolescent girls themselves. Understanding parents’, other adults’ in the community and adolescent girls’ perspectives and attitudes towards contraceptive use might help to unravel the cause of low use of contraception among adolescent girls. This study therefore sought to explore and compare adults’/parents’ and adolescent girls’ narratives and perspectives about contraception in Narok and Homa Bay counties, Kenya. MethodsQualitative data from 45 in-depth-interviews conducted with purposively selected consenting adolescent girls aged 15-19 was used. Additionally, twelve focus group discussions were held with 86 consenting adults conveniently recruited from the two counties. All discussions were conducted in the local language and audio recorded following consent of the study participants. Female moderators were engaged throughout the study making it appropriate for the study to solicit feedback from the targeted respondents.Results Findings highlighted adults’ perceptions on adolescents’ sexuality and the presence of stringent conceptions about the side-effects of contraception in the study communities. Some participants underscored the need for open contraceptive talk between parents and their adolescent girls. Four main themes emerged from the discussions; i) Perceptions about adolescents’ sexuality and risk prevention, ii) Conceptions about contraception among nulligravida adolescents: fear of infertility, malformation and sexual libertinism, iii) Post-pregnancy contraceptive considerations and iv) Thinking differently: divergent views regarding contraceptives and parent/adolescent discussion.ConclusionsOur findings suggest that there is a need for increased attention towards adolescents and their caregivers particularly in demystifying contraceptive misconceptions. Programmatic efforts should therefore be directed towards the provision of sexual and reproductive health knowledge and services through a well-informed approach that will provide accurate information on how contraceptive methods work, the side effects of each method and the benefits associated with them at the family and community levels. Programmatic efforts should further seek to enhance the capacity of parents to discuss sexuality with adolescents.

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Abortion among adolescents in Africa: A review of practices, consequences, and control strategies

Cited by 30 publications

References 26 publications

Trends in and predictors of pregnancy termination among 15–24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018

Trends in and predictors of pregnancy termination among 15–24 year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018

Trends in and predictors of pregnancy termination among 15-24 yer old women in Nigeria: a multi-level analysis of Demographic and Health Surveys 2003-2018

“Those Are Things for Married People”: Exploring Parents’/adults’ and Adolescents’ Perspectives on Contraceptives in Kenya

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