Determinants of Induced Abortion among Women in Reproductive Age at Marie Stopes International Centers of Excellence in the Greater Accra Region of Ghana

Abstract

Background: Globally, induced abortion remains a dire public health concern, particularly in developing countries where abortion-related complications are recorded annually. There has been little research done in Ghana to answer the question as to what factors influence the choices of women in reproductive age to induce abortions rather than resorting to contraceptive services. This study thus sought to assess the determinants of induced abortion among women in reproductive age presenting at the four Marie Stopes Centres of Excellence in the Greater Accra Region of Ghana. Methods: It was a quantitative cross-sectional study carried out between 10th January and 20th February 2020 among 342 randomly selected women aged 15 years and above using well-structured questionnaires for data collection. The data were keyed into Microsoft Excel and exported to STATA version 14.0 for descriptive and inferential analyses. The descriptive statistics involved the use of frequencies and percentages while the inferential statistics adopted Chi-square test and binary logistics analysis which reported odds ratios with their respective 95% confidence intervals signifying level of precision. The preformed statistical test was two-tailed with the significant alpha value set at 5% (p<0.05). Results: Majority of the respondents were young, single, nulliparous and Christians. Women with future pregnancy intentions [OR=0.56, 95%CI=0.32-0.97] were less likely to have an induced abortion compared to those without any intention to get pregnant in the future. Women with short birth interval were more likely to resort to induced abortion to terminate their pregnancy [OR=2.48, 95%CI=1.01-6.02] compared to those who had well -spaced interval. Those who earned GHC1000 and above [OR=0.41, 95%CI=0.22-0.74] were less likely to induce abortion compared to those who earned less than GHC500 a month. Respondents with secondary or vocational [OR=0.367, CI=0.12-0.74] and tertiary [OR=0.27, 95%CI=0.13-0.58] level education were less likely to resort to induced abortion. Women who had ever experienced contraceptive failure [OR=1.81, 95%CI=1.1-3.1] were more likely to resort to induced abortion compared to those who have never experienced contraceptive failure. In relation to the use of emergency contraception, women who indicated they have ever used emergency contraception were less likely to induce abortions [OR=0.45, 95% CI=0.28-0.73]. Conclusion: The determinants of induced abortion were future pregnancy intentions, reason for terminating pregnancy, monthly income, educational level, contraceptives failure and use of emergency contraception. Family planning educational and promotional activities should be concentrated on behaviour change to encourage contraceptive use among all age groups to help in either spacing or limiting of child birth. Women with short birth intervals should be educated by the nurses on how to space their children. Family planning services provided by the health centres and clinics in the region should focus on the use of more effective modern methods of contraception such as the long acting reversible methods.