Browsing by Author "Sesay, F.R."
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Item Determinants of Abortion in Sierra Leone Using the 2013 Demographic Health Survey Data(University of Ghana, 2018-07) Sesay, F.R.BACKGROUND: It is estimated that a woman dies every eight minutes somewhere in a developing country as a result of unsafe abortion. Sierra Leone is classified as a category two under the world‟s abortion laws meaning abortion is only permitted when it is performed to protect a woman‟s life and health. It has some of the worst maternal health indicators in sub-Sahara Africa- whilst the regional Maternal Mortality Ratio (MMR) is 647 deaths per 100,000 live births, the country has 857 deaths per 100,000 live births. The above situation has been compounded by the fact that the health system is not functioning properly. The civil war (1991-2002) and the Ebola outbreak (2014-2015) have resulted in the loss of both human resources and the physical infrastructure of the health system. Recent report shows one in seventeen women of reproductive age in Sierra Leone have a lifetime risk of death associated with childbirth. OBJECTIVE: To assess the determinants of abortion in Sierra Leone using the 2013 Demographic Health Survey data. METHODS: Data from 9,535 female respondents of the 2013 Sierra Leone Demographic Health Survey were used. The outcome measure is women who ever had a terminated pregnancy. Stata SE version14 was used to analyse the data. Chi-square, Fisher exact test and logistic regression models were used to determine associations between selected variables and outcome measure. RESULTS: The following demographic variables significantly influenced abortion; age (χ2=158.9578, P< 0.001), education (χ2=37.3905, P<0.001), marital status (χ2= 83.4940, P<0.001), age group at first sex (χ2= 127.2242, P<0.001), religion (P=0.001), knowledge of family planning methods (χ2= 6.2044, P=0.013) and contraceptive use (χ2= 6.2156, P=0.013). The associations between the following were found not to be significant: place of residence University of Ghana http://ugspace.ug.edu.gh xii (χ2=3.3360, P=0.068), region (χ2=6.9998, P=0.072) and types of contraceptive methods used (χ2=7.0866, P=0.069). A significant number of abortion cases were reported among women above 25 years old, married, uneducated, employed, Muslims and those residing outside the capital city (Freetown). CONCLUSION: Researchers have long identified the association between unsafe abortion and maternal mortality and morbidity. Continuous dialogue and debates would help women contribute to the challenges of unsafe abortion by openly voicing out their opinions and views on abortion. Legalizing abortion in developing countries and provision of affordable contraceptives are key steps to reducing its adverse effect.Item Determinants of induced abortion among women of reproductive age: evidence from the 2013 and 2019 Sierra Leone Demographic and Health Surve(BMC Women’s Health, 2023) Sesay, F.R.; Anaba, E.A.; Manu, A.; Maya, E.; Torpey, K.; Adanu, R.M.K.Background Worldwide, pregnancy termination due to unintended pregnancy is crucial in maternal health, par ticularly in settings where abortion laws are restrictive. Presently, there is a paucity of literature on determinants of induced abortion among women of reproductive age in Sierra Leone. The study fndings could be used to improve the country’s maternal mortality indices and inform health programs and reproductive health policies geared toward tackling induced abortion. Methods We analyzed secondary data from the 2013 and 2019 Sierra Leone Demographic and Health Surveys. The surveys were nationally representative, with weighted samples comprising 16,658 (2013) and 15,574 (2019) women of reproductive age. Descriptive statistics, including frequencies and percentages, were computed, while Chi-square and Binomial Logistics Regression were employed to identify correlates of induced abortion. Results The results showed that a minority (9%) of the participants had induced abortion in both surveys. Abor tion was signifcantly associated with age, marital status, employment status, education, parity, and frequency of listening to the radio and watching television (p<0.05). For instance, women aged 45–49 years (AOR=7.91; 95% CI: 5.76–10.87), married women (AOR=2.52; 95% CI: 1.95–3.26), and working women (AOR=1.65; 95% CI: 1.45–1.87) had a higher likelihood of induced abortion compared to their counterparts. Moreover, women with primary educa tion (AOR=1.27; 95% CI:1.11–1.46) and those who watch television once a week (AOR=1.29; 95% CI: 1.11–1.49) were more likely to terminate a pregnancy. Women with six or more children (AOR=0.40; 95% CI: 0.31–0.52) were less likely to terminate a pregnancy compared to those with no child. Conclusion The study revealed that a minority of the women had induced abortions. The prevalence of induced abortion did not change over time. Induced abortion was infuenced by age, marital status, employment status, edu cation, parity, and exposure to mass media. Therefore, policies and programs to reduce unwanted pregnancies should focus on increasing access to modern contraceptives among women of lower socio-economic statusItem Determinants of induced abortion among women of reproductive age: evidence from the 2013 and 2019 Sierra Leone Demographic and Health Survey(BMC Women’s Health, 2023) Sesay, F.R.; Anaba, E.A.; Manu, A.; Maya, E.; Torpey, K.; Adanu, R.M.K.Background Worldwide, pregnancy termination due to unintended pregnancy is crucial in maternal health, particularly in settings where abortion laws are restrictive. Presently, there is a paucity of literature on determinants of induced abortion among women of reproductive age in Sierra Leone. The study findings could be used to improve the country’s maternal mortality indices and inform health programs and reproductive health policies geared toward tackling induced abortion. Methods We analyzed secondary data from the 2013 and 2019 Sierra Leone Demographic and Health Surveys. The surveys were nationally representative, with weighted samples comprising 16,658 (2013) and 15,574 (2019) women of reproductive age. Descriptive statistics, including frequencies and percentages, were computed, while Chi-square and Binomial Logistics Regression were employed to identify correlates of induced abortion. Results The results showed that a minority (9%) of the participants had induced abortion in both surveys. Abortion was significantly associated with age, marital status, employment status, education, parity, and frequency of listening to the radio and watching television (p<0.05). For instance, women aged 45–49 years (AOR=7.91; 95% CI: 5.76–10.87), married women (AOR=2.52; 95% CI: 1.95–3.26), and working women (AOR=1.65; 95% CI: 1.45–1.87) had a higher likelihood of induced abortion compared to their counterparts. Moreover, women with primary education (AOR=1.27; 95% CI:1.11–1.46) and those who watch television once a week (AOR=1.29; 95% CI: 1.11–1.49) were more likely to terminate a pregnancy. Women with six or more children (AOR=0.40; 95% CI: 0.31–0.52) were less likely to terminate a pregnancy compared to those with no child. Conclusion The study revealed that a minority of the women had induced abortions. The prevalence of induced abortion did not change over time. Induced abortion was influenced by age, marital status, employment status, education, parity, and exposure to mass media. Therefore, policies and programs to reduce unwanted pregnancies should focus on increasing access to modern contraceptives among women of lower socio-economic status.Item Factors associated with health insurance enrolment among ghanaian children under the fve years. Analysis of secondary data from a national survey(BMC Health Services Research, 2022) Anaba, E.A.; Tandoh, A.; Sesay, F.R.; Fokukora, T.Background: Health insurance enrolment provides financial access to health care and reduces the risk of catastrophic healthcare expenditure. Therefore, the objective of this study was to assess the prevalence and correlates of health insurance enrolment among Ghanaian children under five years. Methods: We analyzed secondary data from the 2017/18 Ghana Multiple Indicator Cluster Survey. The survey was a nationally representative weighted sample comprising 8,874 children under fve years and employed Computer Assisted Personal Interviewing to collect data from the participants. In addition, Chi-square and Logistic Regression analyses were conducted to determine factors associated with health insurance enrolment. Results: The results showed that a majority (58.4%) of the participants were insured. Health insurance enrollment was associated with child age, maternal educational status, wealth index, place of residence and geographical region (p<0.05). Children born to mothers with higher educational status (AOR=2.14; 95% CI: 1.39–3.30) and mothers in the richest wealth quintile (AOR=2.82; 95% CI: 2.00–3.98) had a higher likelihood of being insured compared with their counterparts. Also, children residing in rural areas (AOR=0.75; 95% CI: 0.61–0.91) were less likely to be insured than children in urban areas. Conclusion: This study revealed that more than half of the participants were insured. Health insurance enrolment was influenced by the child’s age, mother’s educational status, wealth index, residence, ethnicity and geographical region. Therefore, interventions aimed at increasing health insurance coverage among children should focus on children from low socio-economic backgrounds. Stakeholders can leverage these findings to help improve health insurance coverage among Ghanaian children under five years.