Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys.

Autor:	Giorgio M; Guttmacher Institute, New York, NY, United States of America., Makumbi F; School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda., Kibira SPS; School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda., Shiferaw S; School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia., Seme A; School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia., Bell SO; Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, and Reproductive Health, Baltimore, MD, United States of America., Sully E; Guttmacher Institute, New York, NY, United States of America.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Sep 08; Vol. 3 (9), pp. e0002340. Date of Electronic Publication: 2023 Sep 08 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0002340
Abstrakt:	Unsafe abortion is a major contributor to maternal morbidity and mortality. To gain insight into the ways in which abortion restrictions and stigma may shape reproductive health outcomes, we present self-reported data on abortions in Ethiopia and Uganda and compare these findings across the two varying legal contexts. W investigate differences in sociodemographic characteristics by whether or not a woman self-reported an abortion, and we describe the characteristics of women's most recent self-reported abortion. In Ethiopia only, we classified abortions as being either safe, less safe, or least safe. Finally, we estimate minimum one-year induced abortion incidence rates using the Network Scale-Up Method (NSUM). We find that women who self-reported abortions were more commonly older, formerly married, or had any children compared to women who did not report an abortion. While three-quarters of women in both settings accessed their abortion in a health facility, women in Ethiopia more commonly used public facilities as compared to in Uganda (23.0% vs 12.6%). In Ethiopia, 62.4% of self-reported abortions were classified as safe, and treated complications were more commonly reported among least and less safe abortions compared to safe abortions (21.4% and 23.1% vs. 12.4%, respectively). Self-reported postabortion complications were more common in Uganda (37.2% vs 16.0%). The NSUM estimate for the minimum one-year abortion incidence rate was 4.7 per 1000 in Ethiopia (95% CI 3.9-5.6) and 19.4 per 1000 in Uganda (95% C 16.2-22.8). The frequency of abortions and low levels of contraception use at the time women became pregnant suggest a need for increased investments in family planning services in both settings. Further, it is likely that the broadly accessible nature of abortion in Ethiopia has made abortions safer and less likely to result in complications in Ethiopia as compared to Uganda. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Giorgio et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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