Using Respondent-Driven Sampling to measure abortion safety in restrictive contexts: Results from Kaya (Burkina Faso) and Nairobi (Kenya)

Zan, Lonkila Moussa; Owolabi, Onikepe; Baguiya, Adama; Ouedraogo, Ramatou; Bangha, Martin; Kim, Caron; Rossier, Clémentine

doi:10.4054/demres.2024.50.47

Cited by 3 publications

(2 citation statements)

References 55 publications

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“…RDS is a sampling approach used to study hard-to-reach populations and hidden practices through peer-to-peer recruitment [ 27 , 28 ]. Though recent, the use of RDS in abortion studies has proven to be appropriate and effective in generating representative samples of women who have had abortions [ 29 , 30 ]. For this study, the RDS targeted women who had abortions in the past three years and were living in the study sites (Korogocho and Viwandani).…”

Section: Methodsmentioning

confidence: 99%

“…Once they identified the recruits, they referred them to the central venue for the study, where they submitted the coupons that they had been issued by their study referent. The recruits were then screened for eligibility, and those who met the requirements and expressed the willingness to participate were interviewed (more details on the recruitment process are described in Zan et al paper [ 30 ]. Overall, we completed 551 RDS interviews.…”

Section: Methodsmentioning

confidence: 99%

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“I always know she cannot betray me.” Disclosure of abortion and methods of abortion used in informal settlements in Nairobi, Kenya

Ouedraogo,

Wanjiru,

Zan

et al. 2024

PLOS Glob Public Health

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Despite abortion being stigmatized and legally restricted in Kenya, women still disclose their abortions within their network. Evidence has shown how stigma can influence and regulate individual abortion disclosure decisions and behaviors. This paper seeks to understand why and how women make the decisions to disclose their abortion and the associated methods used. The data are from a qualitative formative study and a respondent-driven sampling survey conducted between 2020 and 2021 in two informal settlements in Nairobi, Kenya. The data were analyzed using a descriptive analysis approach for the quantitative data, and thematic analysis for the qualitative data. Our findings reveal that information sharing about abortion is enclosed in a social dynamic of secrecy. This dynamic contributes to making abortion a secret that respondents decided to share with confidants in 81% of the abortion cases. These confidants include intimate relationships such as trusted friends (62%), followed by female relatives. Information was shared in many cases either to get support (i.e. method to use), or because participants had close ties with the confidants. Regarding the methods used, unidentified pills were the most used regardless of the confidant; followed by traditional methods especially among those who sought help with their mothers/aunts/grandmothers (33%), while Medical Abortion and Manual Vacuum Aspiration were rarely used, mostly by those who confided in friends or sisters/cousins. Our findings show that the disclosure of abortion is a complex process embedded in existing codes regarding the circulation of information on sensitive issues and “help” seeking. Our findings show that the need for information on safe abortion and lack of financial resources frequently empowers them to overcome the fear of stigma and disclose their abortion. However, this often resulted in use of unsafe procedures. The findings suggest the need for strengthening the circulation of information on safe methods within communities, using community champions and intermediaries to increase the likelihood of women being directed through safe methods to enhance their use.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“I always know she cannot betray me.” Disclosure of abortion and methods of abortion used in informal settlements in Nairobi, Kenya

Ouedraogo,

Wanjiru,

Zan

et al. 2024

PLOS Glob Public Health

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Searching for Needles in a Haystack: Exploring Alternative Operational Approaches to Classify the Safety of Induced Abortions Using Respondent‐Driven Sampling Data From Two Sub‐Saharan African Settings

Owolabi,

Rossier,

Compaore

et al. 2024

Studies in Family Planning

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This study aims to describe the circumstances under which women obtained abortions in two sites, explore more nuanced approaches to classify abortion safety and examine the relationship between safety and self‐reported health outcomes. We analyze data on the most recent abortion or only abortion reported by 551 women in Nairobi slums and 479 women in rural Kaya ages 15–49 years within the three years preceding the study, recruited via respondent‐driven sampling. Using the most liberal safety classification, there were very few safe abortions (8 percent in Nairobi and 5 percent in Burkina Faso). A significant proportion of women reported using unidentified pills which we hypothesize may be medication abortion. Although a smaller proportion of women with safe abortions reported side effects, more of them reported side effects suggestive of infections and sought care for their symptoms. It is important that we explore and move towards more nuanced global safety classifications that more accurately reflect the risk associated with different methods and can capture women's access to comprehensive abortion care and its impact on their health.

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Estimating the Social Visibility of Abortions in Uganda and Ethiopia Using the Game of Contacts

Giorgio,

Shiferaw,

Makumbi

et al. 2024

Studies in Family Planning

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Social network–based data collection methods that rely on third‐party reporting have emerged as a promising approach for measuring abortion in restrictive settings. In order for these methods to accurately measure abortion incidence, they must also assess the visibility of abortions within social networks. Failure to do so may result in estimates affected by transmission bias, caused by imperfect knowledge of all abortions within one's social network. In this paper, we present exploratory research that uses respondent‐driven sampling (RDS) and the game of contacts method to measure abortion visibility in four sites in Uganda and Ethiopia. We assess the existence of potential biases in the game of contacts estimate of abortion visibility in each site by conducting several internal and external validity tests. While these tests provided some promising results, other factors such as the representativeness of the RDS samples, direct versus indirect abortion knowledge transfers, and the generalizability of the study sites may have introduced biases into the final estimates of abortion visibility in this study. We conclude by making recommendations on how applications of this methodology could be improved to better estimate abortion‐related transmission bias.

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Using Respondent-Driven Sampling to measure abortion safety in restrictive contexts: Results from Kaya (Burkina Faso) and Nairobi (Kenya)

Cited by 3 publications

References 55 publications

“I always know she cannot betray me.” Disclosure of abortion and methods of abortion used in informal settlements in Nairobi, Kenya

“I always know she cannot betray me.” Disclosure of abortion and methods of abortion used in informal settlements in Nairobi, Kenya

Searching for Needles in a Haystack: Exploring Alternative Operational Approaches to Classify the Safety of Induced Abortions Using Respondent‐Driven Sampling Data From Two Sub‐Saharan African Settings

Estimating the Social Visibility of Abortions in Uganda and Ethiopia Using the Game of Contacts

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