Caring for Women with Abortion Complications in Ethiopia: National Estimates and Future Implications

Gebreselassie, Hailemichael; Fetters, Tamara; Singh, Susheela; Abdella, Ahmed; Gebrehiwot, Yirgu; Tesfaye, Solomon; Geressu, Takele; Kumbi, Solomon

doi:10.1363/3600610

Cited by 84 publications

(93 citation statements)

References 12 publications

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“…Thus, induced abortion-related complications are a significant problem in the DRC, and this observation is consistent with the results of many other studies that were conducted in developing countries [11–13, 16, 23, 26–32]. It should also be noted that the lowest rates of mortality due to induced abortions are observed in countries where post-abortion care units have been established [33–39]. …”

Section: Discussionsupporting

confidence: 89%

Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo

2018

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BackgroundDue to a lack of relevant data on induced abortions in the Democratic Republic of the Congo (DRC) as well as the persistence of maternal deaths in the country, this study aims to analyse the induced abortion-related complications in women who were admitted to the Kinshasa Reference General Hospital (KRGH).MethodsThis is a cross-sectional study on 368 obstetric and gynecological patients who were admitted, as emergency cases, to the KRGH during 2014. This health facility was selected because it is a tertiary health facility with an obstetric and gynecological emergency unit most used in the city of Kinshasa. Patient data were collected from patient records and analyzed.ResultsFrom the 368 patients admitted to receive obstetric and gynecological emergency care services in 2014 at the KRGH, 12.2% (95% CI: 9.1–16.1%) had complications due to induced abortion that was significantly diagnosed to adolescents (p < 0.001), single or separated or divorced women or widow(p < 0.001), and to patients with history of one or several induced abortions(p < 0.001). The median duration of hospitalization was ten days and this period of time was significantly longer for the patients who underwent surgery for pelvic peritonitis due to uterine perforation(p < 0.001) compared with the group of patients who underwent Caesarean section/hysterectomy.The mortality rate related to them is 37.8% (95% CI: 23.8–53.5%) with an increase of risk of death in the presence of a post-abortive pelvic peritonitis-type complication, 56.3% of deaths occurred after two days of hospitalization.ConclusionThe complications of induced abortions are a major public health problem due to its frequency among patients admitted to the KRGH, as well as the poor medical management, and mortality percentage related to them. Therefore, there is a need to understand the reason for the poor medical management to fill in and provide an adequate intervention package.

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Section: Discussionsupporting

confidence: 89%

Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo

2018

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“…Consistent findings were obtained in previous studies in Ethiopia [33], Ghana [37] and South Africa [38], where abortion was found to be high among older women. On the contrary, other studies in Ghana, Kenya, Nigeria, and Ethiopia [39–42] have found that the prevalence of abortion is high among younger women compared to older ones. In many settings, it is alleged that distribution by age of abortion is high among women in the youngest age groups who want to postpone childbearing and women at the end of their childbearing years, who believe they cannot get pregnant at that age, are most likely to get induced abortions.…”

Section: Discussionmentioning

confidence: 81%

Socio – economic determinants of abortion among women in Mozambique and Ghana: evidence from demographic and health survey

Dickson

2018

Arch Public Health

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BackgroundDespite the variances in abortion laws accounting for differences in incidence of abortion among African countries, it appears there is absence of literature on other factors that may also account for the differences in incidence of abortion. Specifically, there is paucity of information on how socio-demographic factors account for the disparities in prevalence of pregnancy termination among women of reproductive age in sub-Saharan Africa. In view of this, this paper examined how socio-demographic factors influence pregnancy termination among women in reproductive age in Mozambique and Ghana.MethodsThe study made use of data from the 2014 Ghana and 2011 Mozambique Demographic and Health Survey for the study. For the purpose of this study a sample of 9375 and 13,660 made up of women in their reproductive ages (15–49) in Ghana and Mozambique respectively was used. The results on the analysis of the association between socio-demographic factors and pregnancy termination are presented as odds ratio (OR) with 95% confidence intervals (CI).ResultsThe results revealed that about 25% of the respondents in Ghana and 9% of the respondents in Mozambique reported ever had a pregnancy terminated. In both countries, the odds of pregnancy termination were high among women with primary education, those in the older age groups, women who were Christians and women who were employed. Similarly, higher odds of pregnancy termination were found among ever married women, those who less than four births or more and those who have had access to social media (radio and television).ConclusionTo reduce unintended pregnancies that could lead to pregnancy termination, there is a need for regular integrated community-based outreach programs targeted at generating community responsiveness of effective contraception and prevention of unintended pregnancy.

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“…Providing women with referrals to health facilities was an integral part of the training provided, yet even where this option exists, as it does in some parts of Zambia, some women are too ashamed, afraid or lack the knowledge or ability to navigate the formal health system to obtain a legal abortion as has also been found in studies in Cambodia, Ethiopia and South Africa. 6,[13][14][15] Ensuring that pharmacy workers reflect on their responsibility to respect women's autonomy and choices and provide them with evidence-based information on their options, including self-induction, to mitigate as much harm as possible, was also an integral component of the training provided.…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

Using a harm reduction lens to examine post-intervention results of medical abortion training among Zambian pharmacists

Fetters¹,

Raisanen²,

Mupeta

et al. 2014

Reproductive Health Matters

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Despite broad grounds for legal abortion in Zambia, access to abortion services remains limited. Pharmacy workers, a primary source of health care for communities, present an opportunity to bridge the gap between policy and practice. As part of a larger operations study, 80 pharmacy workers, both registered pharmacists and their assistants, participated in a training on medical abortion in 2009 and 2010. Fifty-five of the 80 pharmacy workers completed an anonymous, structured training pre-test, treated as a baseline questionnaire; 53 of the 80 trainees were interviewed 12-24 months post-training in face-to-face interviews to measure the retention of information and training effectiveness. Survey questions were selected to illustrate the principles of a harm reduction approach to unsafe abortion. Bivariate analysis was used to examine pharmacy worker knowledge, attitudes and dispensing behaviours pre-training and at follow-up. A higher percentage of pharmacy workers reported referring women to a health care facility between surveys (47% to 68%, p = 0.03). The number of pharmacy workers who reported dispensing ineffective abortifacients decreased from baseline to end-line (30% to 25%) but the difference was non-significant. However, study results demonstrate that Zambian pharmacy workers have a role to play in safe abortion services and some are willing to play that role.

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Caring for Women with Abortion Complications in Ethiopia: National Estimates and Future Implications

Cited by 84 publications

References 12 publications

Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo

Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo

Socio – economic determinants of abortion among women in Mozambique and Ghana: evidence from demographic and health survey

Using a harm reduction lens to examine post-intervention results of medical abortion training among Zambian pharmacists

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