Determinants of Abortion in Sierra Leone Using the 2013 Demographic Health Survey Data
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Date
2018-07
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University of Ghana
Abstract
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
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(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.
Description
Thesis (MPh)
Keywords
Abortion, Sierra Leone, Demographic, Health Survey Data, Determinants, Childbirth, Reproductive, women