Post Abortion Care in Ghana: Analysis of the Ghana Maternal Health Survey, 2017

Abstract

Introduction: A significant proportion of women continue to die from unsafe abortion. Post Abortion Care (PAC) is an important public health intervention to reduce unintended pregnancies and unsafe abortion. The purpose of this study was to determine PAC services in Ghana using the Ghana Maternal Health Survey (GMHS), 2017. Methodology: Data on socio-demographic characteristics, complications and treatment and contraception were extracted from the GMHS, 2017. Analysis was done using STATA version 16. Frequencies and percentages were used to describe categorical variables in the study whilst mean and standard deviation were used to summarize continuous variables. The Rao Scott’s chi square and logistic regression were used to measure the association between the independent and dependent (Post Abortion Care and Complications) variables. Results: Out of 1,880 women who had induced an abortion, 61.7% were unsafe. Prevalence of unsafe abortion was highest among women 15-19 years (69.6%). Majority of the women (65.4%) lived in urban areas. There was a significant association between the age group of the women and the prevalence of unsafe abortion. (χ2= 3.73, p = 0.011). Pain (11.4%) and bleeding (8.3%) were the commonest complications reported. More than half (57.5.%) of women received treatment for various complications with 41.5% receiving antibiotics. Family planning and contraceptive counselling after abortion was 26% higher among women who had abortion from a safe provider (aOR: 0.26, 95% CI: 0.11-0.60, p=0.002) compared to those who used an unsafe provider. Conclusion: The rate of unsafe abortion continues to be high among Ghanaian women especially young women. Factors influencing unsafe abortion include age, marital status, level of education and wealth index quintile. Provision of FPC services was low with majority being provided by safe providers. Effective implementation of PAC will significantly reduce maternal mortality and morbidity from unsafe abortion. Circumstances under which abortion can be sought needs to be made clearer through public education to make safe abortion available and easily accessible.