Educational attainment, media and pregnancy termination among women of reproductive age in Ghana

Abstract

Background Pregnancy termination is considered a major global public health challenge, especially in developing countries, where a large proportion of unsafe pregnancy terminations occur. In Ghana, pregnancy termination is a significant contributor to maternal morbidity and death among women of reproductive age. Maternal level of education and media exposure may have effects on pregnancy termination due to better access to reproductive health information including abortion. Although many published studies in Ghana have examined pregnancy terminations, none of these studies examined educational attainment, media exposure in relation to pregnancy termination. This study aimed to assess the association between educational attainment, media and pregnancy termination in Ghana. Methods This quantitative cross-sectional study utilized the women's file from the 2014 Ghana Demographic and Health Survey (GDHS), which is part of the DHS program monitoring health indicators in low- and middle-income countries. Using a cluster sampling technique, the study sampled 5,882 women who had previously terminated a pregnancy and had complete data on all variables of interest. Data analysis, including descriptive and inferential statistics, was conducted in three phases using SPSS Version 27. Results The results revealed that women who have attained primary and secondary education (OR=1.38, 95% CI=1.14, 1.67; OR=1.16, 95% CI=0.94, 1.44), women who listen to the radio message on reproductive health (OR=1.11, 95% CI=0.96, 1.29), watched TV programme on reproductive health (OR=1.05, 95% CI=0.88, 1.24), read newspapers/magazines (OR=1.08, 95% CI=0.77, 1.50), and exposed to the internet (OR=1.28, 95% CI=1.08, 1.51) were more likely to terminate pregnancy when compared with their colleagues who were not. The results further show that women in the ages between 25-34 years (OR=1.63, 95% CI=1.35, 1.97), 35-44 years (OR=1.72, 95% CI=1.39, 2.12), women who were married and cohabiting had higher odds (OR=1.42, 95% CI=0.93, 1.97; OR=1.46, 95% CI=1.07, 1.98) of pregnancy termination. Again, women in the richer and richest income quintile were more likely to terminate their pregnancy (OR=1.72, 95% CI=1.32, 2.23; OR=1.83, 95% CI=1.36, 2.47) when compared with those in the poorest income quintile. Conclusions This study demonstrates that educational levels of primary and secondary schooling, as well as exposure to reproductive health content through radio, television, internet, and newspapers, are significantly linked to an increased likelihood of pregnancy termination among women. Policies aimed to regulate pregnancy termination should target educated women and women who have been exposed to radio, television, internet and newspaper messages on reproductive health education, and women who are rich, married, cohabiting, residing in urban areas and aged 25-34 and 35-44.