Factors Associated with Reporting a History of Induced Abortion among Adolescent Girls in Ghana during 2012-2017
International Journal of Research and Reports in Gynaecology,
Page 1-14
Abstract
Aims: Adolescent girls are misinformed about safe sex, contraception, and lack access to modern contraceptive methods to prevent unwanted pregnancies and unsafe abortions. This study sought to explore the factors associated with reporting a history of abortion among sexually active adolescent girls in Ghana during 2012-2017.
Study design: A cross-sectional study
Place and duration of study: This study was conducted in Ghana in April, 2020
Methodology: We analyzed a nationally representative sample of 1,902 sexually active adolescent girls aged 15-19 years. The study relied on secondary data from the 2017 Ghana Maternal Health Survey. The Chi-square (χ2) test and survey multivariable logistic regression were performed to determine the association between selected demographic and reproductive characteristics of the adolescents and reporting a history of abortion during 2012-2017.
Results: Of the 1,902 adolescent girls, 146 (7.68%; 95% CI: 6.19-9.53) reported a history of abortion over the study period. The findings also showed that 70.5% of the abortions were unsafely performed. The current use of contraception among the sample was low (26.6%). In multivariable analysis, the odds of reporting a history of abortion significantly decreased with an increase in the age at first sexual intercourse (AOR=0.79; 95% CI: 0.68-0.91), but significantly increased with being a Christian (AOR=4.57; 95% CI: 1.76-11.90) and knowing the ovulation period (AOR=2.24; 95% CI: 1.09-4.63).
Conclusion: Reporting a history of abortion among adolescent girls in Ghana was relatively low. However, more than two-thirds of these abortions were unsafely performed. The early provision of information on sexuality, provision of adolescent-friendly reproductive health services, as well as access to safe abortion services, may reduce unwanted pregnancies and unsafe abortions among adolescent girls in Ghana.
Keywords:
- Teenage
- sexuality
- pregnancy
- reproduction
- contraceptive
How to Cite
Achinkok, D., & Boah, M. (2021). Factors Associated with Reporting a History of Induced Abortion among Adolescent Girls in Ghana during 2012-2017. International Journal of Research and Reports in Gynaecology, 4(2), 1-14. Retrieved from https://journalijrrgy.com/index.php/IJRRGY/article/view/30121
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Tesfaye G, Hambisa MT, Semahegn A. Induced Abortion and Associated Factors in Health Facilities of Guraghe Zone, Southern Ethiopia. J Pregnancy. Hindawi Publishing Corporation. 2014;2014. DOI:10.1155/2014/295732
Ilboudo PGC, Somda SMA, Sundby J. Key determinants of induced abortion in women seeking postabortion care in hospital facilities in Ouagadougou, Burkina Faso. Int J Womens Health. 2014;6:565–572. DOI:10.2147/IJWH.S60709
Mekbib T-A, Gebrehiwot Y, Fantahun M. Survey of unsafe abortion in selected health facilities in Ethiopia. Ethiop J Reprod Heal. 2007;1:28–42.
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Ahiadeke C. Incidence of Induced Abortion in Southern Ghana. Int Fam Plan Perspect. 2001;27:96.
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Schwandt HM, Creanga AA, Adanu RMK, Danso KA, Agbenyega T, Hindin MJ. Pathways to unsafe abortion in Ghana: The role of male partners, women and health care providers. Contraception. Elsevier Inc. 2013;88:509–517.
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Atakro CA, Addo SB, Aboagye JS, Menlah A, Garti I, Amoa-Gyarteng KG, et al. Contributing factors to unsafe abortion practices among women of reproductive age at selected district hospitals in the Ashanti region of Ghana. BMC Womens Health. BMC Women’s Health; 2019;19: 60.
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Adanu RMK, Ntumy MN, Tweneboah E. Profile of women with abortion complications in Ghana. Trop Doct. 2005;35:139–142.
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Asamoah BO, Moussa KM, Stafström M, Musinguzi G. Distribution of causes of maternal mortality among different socio-demographic groups in Ghana; a descriptive study. BMC Public Health. 2011;11:159.
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Sundaram A, Juarez F, Bankole A, Singh S. Factors Associated with Abortion-Seeking and Obtaining a Safe Abortion in Ghana. Stud Fam Plann. 2012;43:273–286.
Mote C V, Larsen-Reindorf R, Otupiri E, Hindin MJ. Factors associated with Induced Abortion among Women in Hohoe, Ghana. Afr J Reprod Health. 2010;14:110–116.
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Woog, Vanessa, Susheela Singh, Alyssa Browne JP. Adolescent Women’s Need for and Use of Sexual and Reproductive Health Services in Developing Countries [Internet]. New York; 2015.
Available:https://www.guttmacher.org/sites/default/files/report_pdf/adolescent-srhs-need-developing-countries.pdf
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DOI:10.1016/j.contraception.2018.07.135
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Prabhu TRB. Legal Abortions in the Unmarried Women: Social Issues Revisited. J Obstet Gynecol India. 2014;64:184–188.
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Ushie BA, Izugbara CO, Mutua MM, Kabiru CW. Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data. BMC Womens Health. BMC Women’s Health. 2018;18: 41.
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Tesfaye G, Hambisa MT, Semahegn A. Induced Abortion and Associated Factors in Health Facilities of Guraghe Zone, Southern Ethiopia. J Pregnancy. Hindawi Publishing Corporation. 2014;2014. DOI:10.1155/2014/295732
Ilboudo PGC, Somda SMA, Sundby J. Key determinants of induced abortion in women seeking postabortion care in hospital facilities in Ouagadougou, Burkina Faso. Int J Womens Health. 2014;6:565–572. DOI:10.2147/IJWH.S60709
Mekbib T-A, Gebrehiwot Y, Fantahun M. Survey of unsafe abortion in selected health facilities in Ethiopia. Ethiop J Reprod Heal. 2007;1:28–42.
World Health Organization. The Prevention and Managment of Unsafe Abortion. Report of a Technical Working Group Geneva 12-15 April 1992. Geneva: World Health Organization; 1993.
Polis CB, Castillo PW, Otupiri E, Keogh SC, Hussain R, Nakua EK, et al. Estimating the incidence of abortion: using the Abortion Incidence Complications Methodology in Ghana, 2017. BMJ Glob Heal. 2020;5:e002130.
DOI:10.1136/bmjgh-2019-002130
Mushwana L, Monareng L, Richter S, Muller H. Factors influencing the adolescent pregnancy rate in the Greater Giyani Municipality, Limpopo Province - South Africa. Int J Africa Nurs Sci. Elsevier Ltd. 2015;2: 10–18.
DOI:10.1016/j.ijans.2015.01.001
Salih NA, Metaferia H, Reda AA, Biadgilign S. Premarital sexual activity among unmarried adolescents in northern Ethiopia: a cross-sectional study. Sex Reprod Healthc. Elsevier B.V.. 2015;6:9–13.
DOI:10.1016/j.srhc.2014.06.004
Ganatra B, Hirve S. Induced Abortions Among Adolescent Women in Rural Maharashtra, India. Reprod Health Matters. 2002;10:76–85.
DOI:10.1016/S0968-8080(02)00016-2
Glasier A, Gülmezoglu AM, Schmid GP, Moreno CG, Van Look PF. Sexual and reproductive health: a matter of life and death. Lancet. 2006;368:1595–1607. DOI:10.1016/S0140-6736(06)69478-6
Pereira JIF, Pires RSA, Araújo-Pedrosa AF, Canavarro MCCSP. Reproductive and relational trajectories leading to pregnancy: Differences between adolescents and adult women who had an abortion. Eur J Obstet Gynecol Reprod Biol. Elsevier Ireland Ltd. 2018;224: 181–187.
DOI:10.1016/j.ejogrb.2018.03.052
Llika A, Anthony I. Unintended Pregnancy Among Unmarried Adolescents and Young Women in Anambra State, South East Nigeria. Afr J Reprod Health. 2004;8:92–102.
Rasch V, Silberschmidt M, Mchumvu Y, Mmary V. Adolescent girls with illegally induced abortion in Dar es Salaam: The discrepancy between sexual behaviour and lack of access to contraception. Reprod Health Matters. 2000;8:52–62. DOI:10.1016/S0968-8080(00)90006-5
Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. J Adolesc Heal. Elsevier Inc. 2015;56:223–230.
DOI:10.1016/j.jadohealth.2014.09.007
Reime B, Schücking BA, Wenzlaff P. Reproductive outcomes in adolescents who had a previous birth or an induced abortion compared to adolescents’ first pregnancies. BMC Pregnancy Childbirth. 2008;8:4.
DOI:10.1186/1471-2393-8-4
Ahiadeke C. Incidence of Induced Abortion in Southern Ghana. Int Fam Plan Perspect. 2001;27:96.
DOI:10.2307/2673822
Schwandt HM, Creanga AA, Adanu RMK, Danso KA, Agbenyega T, Hindin MJ. Pathways to unsafe abortion in Ghana: The role of male partners, women and health care providers. Contraception. Elsevier Inc. 2013;88:509–517.
DOI:10.1016/j.contraception.2013.03.010
Ghana Statistical Service, Ghana Health Service, ICF. Ghana Maternal Health Survey 2017 [Internet]. Accra, Ghana; 2018.
Available:www.dhsprogram.com/publications/publication-fr340-other-final-reports.cfm
Tagoe-Darko E. “Fear, Shame and Embarrassment”: The Stigma Factor in Post Abortion Care at Komfo Anokye Teaching Hospital, Kumasi, Ghana. Asian Soc Sci. 2013;9:134–141.
DOI:10.5539/ass.v9n10p134
Bain LE, Zweekhorst MBM, Amoakoh-Coleman M, Muftugil-Yalcin S, Abejirinde I-OO, Ecquet R, et al. To keep or not to keep? Decision making in adolescent pregnancies in Jamestown, Ghana. Bartels S, editor. PLoS One. 2019;14:e0221789. DOI:10.1371/journal.pone.0221789
Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, et al. Unsafe abortion: the preventable pandemic. Lancet. 2006;368:1908–1919.
DOI:10.1016/S0140-6736(06)69481-6
Atakro CA, Addo SB, Aboagye JS, Menlah A, Garti I, Amoa-Gyarteng KG, et al. Contributing factors to unsafe abortion practices among women of reproductive age at selected district hospitals in the Ashanti region of Ghana. BMC Womens Health. BMC Women’s Health; 2019;19: 60.
DOI:10.1186/s12905-019-0759-5
Morhee RA., Morhee ES. Overview of the law and availability of abortion services in Ghana. Ghana Med J. 2010;40:80–86. DOI:10.4314/gmj.v40i3.55256
Adanu RMK, Ntumy MN, Tweneboah E. Profile of women with abortion complications in Ghana. Trop Doct. 2005;35:139–142.
DOI:10.1258/0049475054620725
Asamoah BO, Moussa KM, Stafström M, Musinguzi G. Distribution of causes of maternal mortality among different socio-demographic groups in Ghana; a descriptive study. BMC Public Health. 2011;11:159.
DOI:10.1186/1471-2458-11-159
Klutsey EE, Ankomah A. Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana. Int J Womens Health. 2014;6: 809–816.
DOI:10.2147/IJWH.S62018
Geelhoed DW, Nayembil D, Asare K, Van Leeuwen JHS, Van Roosmalen J. Contraception and induced abortion in rural Ghana. Trop Med Int Heal. 2002;7: 708–716.
DOI:10.1046/j.1365-3156.2002.00912.x
Sundaram A, Juarez F, Bankole A, Singh S. Factors Associated with Abortion-Seeking and Obtaining a Safe Abortion in Ghana. Stud Fam Plann. 2012;43:273–286.
Mote C V, Larsen-Reindorf R, Otupiri E, Hindin MJ. Factors associated with Induced Abortion among Women in Hohoe, Ghana. Afr J Reprod Health. 2010;14:110–116.
DOI:10.1016/j.biotechadv.2011.08.021.Secreted
Adjei G, Enuameh Y, Asante KP, Baiden F, A Nettey OE, Abubakari S, et al. Predictors of abortions in Rural Ghana: a cross-sectional study. BMC Public Health. 2015;15:202.
DOI:10.1186/s12889-015-1572-1
Taghizadeh Moghaddam H, Bahreini A, Ajilian Abbasi M, Fazli F, Saeidi M. Adolescence health: The needs, problems and attention. Int J Pediatr. 2016;4:1423–1438.
DOI:10.22038/ijp.2016.6569
Woog, Vanessa, Susheela Singh, Alyssa Browne JP. Adolescent Women’s Need for and Use of Sexual and Reproductive Health Services in Developing Countries [Internet]. New York; 2015.
Available:https://www.guttmacher.org/sites/default/files/report_pdf/adolescent-srhs-need-developing-countries.pdf
United Nations Population Fund. How Universal is Access to Reproductive Health ? A review of the evidence [Internet]. New York; 2010.
Available:www.unfpa.org/sites/default/files/pub-pdf/universal_rh.pdf
Mann CJ. Observational research methods Research design II : cohort,cross-sectional, and case-control studies. Emerg Med J. 2003;20:54–60.
Cheng HG, Phillips MR. Secondary analysis of existing data: opportunities and implementation. Shanghai Arch Psychiatry. 2014;26:371–375.
DOI:10.11919/j.issn.1002-0829.214171
Vyas S, Kumaranayake L. Constructing socio-economic status indices: How to use principal components analysis. Health Policy Plan. 2006;21:459–468.
DOI:10.1093/heapol/czl029
Adisah-Atta I, Dim EE. Justification of Abortion in West Africa and Interplay of Sociodemographic Predictors: A Comparative Study of Ghana and Nigeria. SAGE Open. 2019;9:1–9.
DOI:10.1177/2158244019834368
Demographic and Health Survey. Guide to DHS statistics. Demographic and Health Surveys Methodology. Rutstein SO, Rojas G, editors. Calverton, Maryland, Maryland, USA: Demographic and Health Surveys, ORC Macro; 2006.
Archer KJ, Lemeshow S. Goodness-of-fit test for a logistic regression model fitted using survey sample data. Stata J. 2006;6: 97–105.
DOI:https://www.stata-journal.com/sjpdf.ht ml?articlenum=st0099
Rasch V, Muhammad H, Urassa E, Bergström S. The problem of illegally induced abortion: Results from a hospital-based study conducted at district level in Dar es Salaam. Trop Med Int Heal. 2000;5: 495–502.
DOI:10.1046/j.1365-3156.2000.00584.x
Sully EA, Atuyambe L, Bukenya J, Whitehead HS, Blades N, Bankole A. Estimating abortion incidence among adolescents and differences in postabortion care by age: a cross-sectional study of postabortion care patients in Uganda. Contraception. The Authors; 2018;98:510–516.
DOI:10.1016/j.contraception.2018.07.135
Kwankye SO. Female Adolescents And Reproductive Change In Ghana: Evidence From An Adolescent Survey Of Two Communities. African Popul Stud. 2013;21: 119–150.
DOI:10.11564/21-1-353
Prabhu TRB. Legal Abortions in the Unmarried Women: Social Issues Revisited. J Obstet Gynecol India. 2014;64:184–188.
DOI:10.1007/s13224-014-0510-y
Ushie BA, Izugbara CO, Mutua MM, Kabiru CW. Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally-representative data. BMC Womens Health. BMC Women’s Health. 2018;18: 41.
DOI:10.1186/s12905-018-0521-4
Kapil Ahmed M, van Ginneken J, Razzaque A. Factors associated with adolescent abortion in a rural area of Bangladesh. Trop Med Int Heal. 2005;10: 198–205.
DOI:10.1111/j.1365-3156.2004.01362.x
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