Estimates of the Incidence of Induced Abortion & Consequences of Unsafe Abortion in Senegal

CONTEXT

Abortion is highly restricted by law in Senegal. Although women seek care for abortion complications, no national estimate of abortion incidence exists.

METHODS

Data on postabortion care and abortion in Senegal were collected in 2013 using surveys of a nationally representative sample of 168 health facilities that provide postabortion care and of 110 professionals knowledgeable about abortion service provision. Indirect estimation techniques were applied to the data to estimate the incidence of induced abortion in the country. Abortion rates and ratios were calculated for the nation and separately for the Dakar region and the rest of the country. The distribution of pregnancies by planning status and by outcome was estimated.

RESULTS

In 2012, an estimated 51,500 induced abortions were performed in Senegal, and 16,700 (32%) resulted in complications that were treated at health facilities. The estimated abortion rate was 17 per 1,000 women aged 15–44 and the abortion ratio was 10 per 100 live births. The rate was higher in Dakar (21 per 1,000) than in the rest of the country (16 per 1,000). Poor women were far more likely to experience abortion complications, and less likely to receive treatment for complications, than nonpoor women. About 31% of pregnancies were unintended, and 24% of unintended pregnancies (8% of all pregnancies) ended in abortion.

CONCLUSIONS

Unsafe abortion exacts a heavy toll on women in Senegal. Reducing the barriers to effective contraceptive use and ensuring access to postabortion care without the risk of legal consequences may reduce the incidence of and complications from unsafe abortion.

Below:  Estimated percentage distribution of abortions, by outcome, according to region and women’s characteristics, Senegal, 2012

Below:  Estimated percentage distribution of pregnancies, by planning status and outcome, Senegal, 2011–2012

Full article at:  http://goo.gl/hdk18s

By:  Gilda Sedgh, principal research scientist, Amadou Hassane Sylla, statistician and technical advisor, Jesse Philbin, senior research assistant, Sarah Keogh, senior research scientist, and Salif Ndiaye, director

Guttmacher Institute, New York.

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Women's Perceptions About Abortion in Their Communities: Perspectives from Western Kenya

Unsafe abortion in Kenya is a leading cause of maternal morbidity and mortality. In October 2012, we sought to understand the methods married women aged 24-49 and young, unmarried women aged ≤ 20 used to induce abortion, the providers they utilized and the social, economic and cultural norms that influenced women's access to safe abortion services in Bungoma and Trans Nzoia counties in western Kenya. 

We conducted five focus groups with young women and five with married women in rural and urban communities in each county. We trained local facilitators to conduct the focus groups in Swahili or English. All focus groups were audiotaped, transcribed, translated, computerized, and coded for analysis. 

Abortion outside public health facilities was mentioned frequently. Because of the need for secrecy to avoid condemnation, uncertainty about the law, and perceived higher cost of safer abortion methods, women sought unsafe abortions from community midwives, drug sellers and/or untrained providers at lower cost. Many groups believed that abortion was safer at higher gestational ages, but that there was no such thing as a safe abortion method. 

Our aim was to inform the design of a community-based intervention on safe abortion for women. Barriers to seeking safe services such as high cost, perceived illegality, and fear of insults and abuse at public facilities among both age groups must be addressed.

Full article at: http://goo.gl/TS02dQ

By: Marlow HM1, Wamugi S2, Yegon E3, Fetters T4, Wanaswa L5, Msipa-Ndebele S6.

• 1Senior Associate, Research and Evaluation, Ipas, Chapel Hill, NC, USA. Electronic address: marlowh@ipas.org.
• 2Communications Associate, Programs, Africa Alliance Regional Policy, Ipas Africa Alliance, Nairobi, Kenya.
• 3Senior Research and Evaluation Associate, Programs, East Africa Region, Ipas Africa Alliance, Nairobi, Kenya.
• 4Senior Associate, Research and Evaluation, Ipas, Chapel Hill, NC, USA.
• 5Community Access Associate, Programs, East Africa Region, Ipas Africa Alliance, Nairobi, Kenya.
• 6Senior Community Access Associate, Programs, East Africa Region, Ipas, Chapel Hill, NC, USA.

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