Female autonomy and reported abortion-seeking in Ghana, West Africa

Rominski SD 1 , Gupta M 2 , Aborigo R 3 , Adongo P 4 , Engman C 5 , Hodgson A 6 Show all authors , Moyer C 7

Affiliations 

  • 1 Global REACH, University of Michigan Medical School, Ann Arbor, USA. Electronic address: sarahrom@umich.edu
  • 2 Global REACH, University of Michigan Medical School, Ann Arbor, USA
  • 3 Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Jeffrey Cheah School of Medicine and Health Sciences, MONASH University, Sunway Campus, Subang Jaya, Selangor, Malaysia
  • 4 Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
  • 5 Department of Pediatrics and Maternal Child Health, Schools of Medicine and Public Health, University of North Carolina, Chapel Hill, USA
  • 6 Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Ghana Health Service, Accra, Ghana
  • 7 Global REACH, University of Michigan Medical School, Ann Arbor, USA; Department of Medical Education, University of Michigan Medical School, Ann Arbor, USA
Int J Gynaecol Obstet, 2014 Sep;126(3):217-22.
PMID: 24920181 DOI: 10.1016/j.ijgo.2014.03.031

Abstract

OBJECTIVE: To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision.
METHODS: In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior.
RESULTS: Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P < 0.05).
CONCLUSION: Although health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services.
KEYWORDS: Abortion; Autonomy; Empowerment; Low-resource countries; Maternal health; Reproductive health

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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