Methods women use for induced abortion and sources of services: insights from poor urban settlements of Accra, Ghana

Agula, Caesar; Henry, Elizabeth G.; Asuming, Patrick Opoku; Agyei-Asabere, Charles; Kushitor, Mawuli; Canning, David; Shah, Iqbal; Bawah, Ayaga A.

doi:10.1186/s12905-021-01444-9

Cited by 9 publications

(8 citation statements)

References 20 publications

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“…Knowledge of the gestation period within which it is safe to use MA is also very low and this finding is contrary to the findings by [14] whose results show that most women seeking MA services are aware of the gestation upon which those drugs should be used. Thus, courting potential complications that may ensue whenever medical abortion drugs are taken anyhow, without due consideration of the gestation period (safe window) and for effectiveness.…”

Section: Discussioncontrasting

confidence: 86%

Medical Abortion Self Use in Kenya: Results from a process evaluation of women’s experiences

Ogol¹,

Sigu²,

Akol³

et al. 2022

Preprint

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Background The consequences of unsafe abortions weigh heavily on individuals, families, society, and health care systems. Developing countries continue to experience a high prevalence of mistimed and unintended pregnancies resulting in induced abortions that are largely unsafe. Globally, 25 million unsafe abortions take place every year [1]. In Africa, 3 out of 4 abortions are categorized as unsafe [2]. In Kenya, it is estimated that 464,690 induced abortions occur annually- 2 out of 3 of these are unsafe[3]. With the high prevalence of mistimed and unwanted pregnancies in Sub-Saharan Africa and Kenya in particular, unsafe abortions will be on the rise unless deliberate measures and policies are put in place to guarantee safe abortion procedures[4]. Method Ipas Africa Alliance embarked on the Medical Abortion Self-Use (MASU) project aimed at reducing morbidity and mortality tied to unintended pregnancies among women in the Counties of Vihiga, Kisumu, Busia, Siaya, and Trans Nzoia. To inform on the progress and the potential for scale-up of the project, Ipas commissioned a process evaluation. This evaluation adopted both qualitative and quantitative methods. This involved in-depth interviews (IDIs), Focus Group Discussions (FGDs), and face-face-interviews through a semi-structured questionnaire. Results From the analysis, those seeking medical abortion were mainly youths under 25 years of age. There was low awareness of safe abortion practices and the gestation period within which safe medical abortion (MA) can be safely done. Nearly half (47%) of the women and girls reported being coerced to take post-abortion contraceptives they never wanted. Further, MA costs were not only found to be expensive but also varied greatly across the Counties. Some MA users experienced medical complications attributed to the failure of pharmacists responsible to provide the correct dose and correct route of administration. On the other hand, youth champions were found to be few and not able to fully cover their areas and only have basic knowledge of MA self-use services. Conclusion The IPAS MASU project intervention, in the five counties of Western Kenya namely Busia, Siaya, Vihiga, Kisumu, and Trans Nzoia, has increased access to safe Medical Abortion self-use, enhanced availability of MA drugs in pharmacies, the improved service delivery of MA services through regular training of pharmacists. Further, the project has enhanced awareness about MA services among young girls and women through trained Youth Champions and pharmacists, and the MASU project has significantly reduced cases of unsafe abortions and by extension deaths and medical complications associated with them. To realize more gains, the project needs to be scaled up within the five counties and beyond, specifically to target the rural areas where cases of unsafe abortion are still thought to be rampant.

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Section: Discussioncontrasting

confidence: 86%

Medical Abortion Self Use in Kenya: Results from a process evaluation of women’s experiences

Ogol¹,

Sigu²,

Akol³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…This study was embedded within a cross-sectional mixed-methods study under the “Willows Impact Evaluation” project conducted in Ghana and implemented by the Regional Institute for Population Studies at the University of Ghana. The larger study explored reproductive behaviours of contraceptive use among urban poor women along selected coastal towns (Osu klottey, La, Teshie and Nungua) and inland areas (La Nkwantanang, Abogba and Old Ashongman) in Accra, Ghana [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Enablers and inhibitors of exclusive breastfeeding: perspectives from mothers and health workers in Accra, Ghana

et al. 2022

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Background Despite the health and economic benefits of exclusive breastfeeding, there is evidence of a decline globally and in Ghana. Previous studies addressing this problem are mostly quantitative with only a few of such studies using qualitative or mixed methods to examine the predictors, benefits, ways of improving and managing exclusive breastfeeding, and the challenges associated with exclusive breastfeeding from the perspective of exclusive and nonexclusive breastfeeding mothers, and health workers. This study employs the health belief model to examine the experiences of mothers and health workers regarding exclusive breastfeeding to fill this gap in the literature. Methods A cross-sectional qualitative study involving in-depth interviews was conducted among health workers and mothers attending child welfare clinic at two polyclinics in Madina, Accra-Ghana in 2019. Purposive sampling was used to select health facilities and participants for the study. Twenty participants comprising ten exclusive breastfeeding mothers, six non-exclusive breastfeeding mothers and four health workers were interviewed for the study. The data were analyzed based on emerging themes from inductive and deductive coding. Results The decision to practice exclusive breastfeeding was based on mothers’ work, advertisement on exclusive breastfeeding and education on breastfeeding provided by health workers. Insufficient flow of breast milk, pressure from family and friends, and insufficient breast milk for infants were among the reasons for discontinuing exclusive breastfeeding. The factors that help improve exclusive breastfeeding include eating healthy food and breastfeeding on demand, while counselling and monitoring, restricting advertisement on infant formula and granting maternity leave for breastfeeding mothers were identified as factors that can facilitate the practice of exclusive breastfeeding. Conclusion Different levels of experience affect and shape exclusive breastfeeding practice in Ghana. The decision to practice exclusive breastfeeding, as well as the challenges and strategies employed in managing exclusive breastfeeding, emanates from mothers’ personal experiences and interactions with institutional factors. In view of this, there should be counselling on the management of challenges associated with exclusive breastfeeding and provision of accurate information on exclusive breastfeeding to enable mothers practice exclusive breastfeeding.

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“…Reproductive health practitioners should make efforts to destigmatize abortion to ensure the utilization of safe abortion services and reproductive health among students. Ghana's abortion law specifies the right procedures and places to conduct a safe abortion [24]. Safe abortion is one of the components of reproductive health that contributes to lowering maternal morbidity and mortality.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Knowledge and attitude towards Ghana’s abortion law: A cross-sectional study among female undergraduate students

Abubakari

Gmayinaam

Osei

2023

PLOS Glob Public Health

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Ghana amended its abortion law to permit abortion under certain circumstances due to the impacts of unsafe abortion. Even though the abortion law in Ghana is liberal, most women do not utilize the services. Studies have shown that lack of knowledge and attitude towards abortion laws are the barriers deterring women from using safe abortion services. This study, therefore, assessed the knowledge and attitudes of future female health professionals towards Ghana’s abortion law. This was an institutional-based cross-sectional study among 240 female students undertaking undergraduate courses at the Fred Newton Binka School of Public Health (FNBSPH), the University of Health and Allied Sciences (UHAS), Ghana. Knowledge was measured with 9 items using yes or no responses while Attitude was measured using a five-point Likert scale with 14 items. Factors associated with poor knowledge among the students were determined using logistic regression. All analyses were done using STATA version 16.0. Of the 240 participants, 24 (10%) reported ever being pregnant. Among these pregnancies, 20 (83.3%) ended in abortions, with 15 (75%) of them unsafely done. The majority (53.3%) of the students knew the conditions under which abortion is allowed in Ghana and most (61.7%) of them had positive attitudes towards the abortion legislation in the country. The year of study (aOR: 0.06; 95%CI: 0.01–0.23), residential status (aOR: 0.44; 95%CI: 0.20–0.74) and poor attitude towards the abortion law (Aor:0.46; 95% CI: 0.26–0.82) were associated with poor abortion law knowledge among the students. This study has demonstrated that knowledge and attitude towards Ghana’s abortion legislation among the students was fairly good. Students’ year of study, residential status and attitude towards the abortion law were also found associated with poor knowledge of Ghana’s abortion law. Increasing young women’s knowledge of the abortion law may lead to more favourable attitudes towards abortion, improving the utilization of safe and legal abortion services.

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Methods women use for induced abortion and sources of services: insights from poor urban settlements of Accra, Ghana

Cited by 9 publications

References 20 publications

Medical Abortion Self Use in Kenya: Results from a process evaluation of women’s experiences

Medical Abortion Self Use in Kenya: Results from a process evaluation of women’s experiences

Enablers and inhibitors of exclusive breastfeeding: perspectives from mothers and health workers in Accra, Ghana

Knowledge and attitude towards Ghana’s abortion law: A cross-sectional study among female undergraduate students

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