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Community perception of abortion, women who abort and abortifacients in Kisumu and Nairobi counties, Kenya


Autoři: Boniface Ayanbekongshie Ushie aff001;  Kenneth Juma aff001;  Grace Kimemia aff001;  Ramatou Ouedraogo aff001;  Martin Bangha aff001;  Michael Mutua aff001
Působiště autorů: African Population and Health Research Center, Nairobi, Kenya aff001
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226120

Souhrn

Background

Abortion draws varied emotions based on individual and societal beliefs. Often, women known to have sought or those seeking abortion services experience stigma and social exclusion within their communities. Understanding community perception of abortion is critical in informing the design and delivery of interventions that reduce the gaps in access to safe abortion for women.

Objective

We explored community perceptions and beliefs relating to abortion, clients of abortion services, and abortifacients in Kenya.

Methods

We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) in Kisumu and Nairobi counties in Kenya among a mix of adult men and women, pharmacists, nurses, and community health volunteers.

Results

Community perspectives around abortion were heterogeneous, reflecting a myriad of opinions ranging from total anti-abortion to more pro-choice positions, and with rural-urban differences. Notably, negative views on abortion became more nuanced and tempered, especially among young women in urban areas, as details of factors that motivate women to seek abortion became apparent. Participants were mostly aware of the pathways through which women and girls access abortion services. Whereas abortion is commonplace, multiple structural and socioeconomic barriers, as well as stigma, are prevalent, thus impeding access to safe and quality services.

Conclusion

Community perceptions on abortion are heterogeneous, varying by gender, occupation, level of education, residence, and position in society. Stigma and the hostile abortion environment limit access to safe abortion services, with several negative consequences. There is urgent need to strengthen community-based approaches to mitigate predisposing and enabling factors for unsafe abortions.

Klíčová slova:

Culture – Drug information – Chemists – Kenya – Pharmacists – Termination of pregnancy – Women's health – Ovine abortion


Zdroje

1. Gebremedhin M, Semahegn A, Usmael T, Tesfaye G. Unsafe abortion and associated factors among reproductive aged women in Sub-Saharan Africa: a protocol for a systematic review and meta-analysis. Systematic reviews. 2018;7(1):1–5. doi: 10.1186/s13643-017-0670-9 30144826.

2. Singh S, Remez L, Sedgh G, Kwoka L, Onda T. Abortion Worldwide 2017: Uneven Progress and Unequal Access. New York: Guttmacher Institute, 2017.

3. World Health Organization. Preventing unsafe abortion Geneva: WHO; 2019 [cited 2019 26/07/2019].

4. Atake E-H, Gnakou Ali P. Women’s empowerment and fertility preferences in high fertility countries in Sub-Saharan Africa. BMC Womens Health. 2019;19(1):54. doi: 10.1186/s12905-019-0747-9 30953494

5. Adanikin A, Umeora O, Nzeribe E, Agbata A, Ezeama C, Ezugwu F, et al. Maternal near-miss and death associated with abortive pregnancy outcome: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey. BJOG. 2019;126(S3):33–40. doi: 10.1111/1471-0528.15699 31050874

6. Prada E, Bankole A, Oladapo OT, Awolude OA, Adewole IF, Onda T. Maternal Near-Miss Due to Unsafe Abortion and Associated Short-Term Health and Socio-Economic Consequences in Nigeria. Afr J Reprod Health. 2015;19(2):52–62. 26506658.

7. Guillaume A, Rossier C. Abortion around the world. An overview of legislation, measures, trends, and consequences. Population. 2018;73(2):217–306.

8. APHRC, Ministery of Health Kenya, Ipas Nairobi, Guttmacher Institute. Incidence and complications of unsafe abortion in Kenya: Key findings of a national study. Nairobi: APHRC, 2013.

9. Mohamed SF, Izugbara C, Moore AM, Mutua M, Kimani-Murage EW, Ziraba AK, et al. The estimated incidence of induced abortion in Kenya: a cross-sectional study. BMC Pregnancy Childbirth. 2015;15:185–95. doi: 10.1186/s12884-015-0621-1 26294220.

10. Johnson BR Jr, Lavelanet AF. Realizing abortion law and policy reforms: Lessons from six country case studies. International Journal of Gynecology & Obstetrics. 2018;143(S4):1–2. doi: 10.1002/ijgo.12670 30374989

11. LAWS OF KENYA. The Constitution of Kenya 2010, (2010). Published by the National Council for Law Reporting with the Authority of the Attorney-General

12. KIPLAGAT S. Why Health ministry withdrew abortion guidelines. Daily Nation. 2018.

13. Latt SM, Milner A, Kavanagh A. Abortion laws reform may reduce maternal mortality: an ecological study in 162 countries. BMC Womens Health. 2019;19(1):1. doi: 10.1186/s12905-018-0705-y 30611257

14. Gibson L. WHO puts abortifacients on its essential drug list. BMJ (Clinical research ed). 2005;331(7508):331–68. doi: 10.1136/bmj.331.7508.68-c 16002864.

15. World Health Organization DoRHaR. Safe abortion: technical and policy guidance for health systems. Geneva: WHO, 2012.

16. Sneeringer RK, Billings DL, Ganatra B, Baird TL. Roles of pharmacists in expanding access to safe and effective medical abortion in developing countries: a review of the literature. J Public Health Policy. 2012;33(2):218–29. Epub 03/08. doi: 10.1057/jphp.2012.11 22402571.

17. Liambila W, Obare F, Ikiugu E, Akora V, Njunguru J, Njuma M, et al. Availability, Use and Quality Of Care For Medical Abortion Services In Private Facilities In Kenya. 2015.

18. Reiss K, Footman K, Akora V, Liambila W, Ngo TD. Pharmacy workers' knowledge and provision of medication for termination of pregnancy in Kenya. J Fam Plann Reprod Health Care. 2016;42(3):208–12. Epub 2016/02/13. doi: 10.1136/jfprhc-2013-100821 26869694; PubMed Central PMCID: PMCPMC4975816.

19. Healy J, Otsea K, Benson J. Counting abortions so that abortion counts: Indicators for monitoring the availability and use of abortion care services. Int J Gynaecol Obstet. 2006;95(2):209–20. Epub 2006/10/10. doi: 10.1016/j.ijgo.2006.08.002 17027759.

20. Banerjee SK, Andersen KL, Buchanan RM, Warvadekar J. Woman-centered research on access to safe abortion services and implications for behavioral change communication interventions: a cross-sectional study of women in Bihar and Jharkhand, India. BMC Public Health. 2012;12(1):175. doi: 10.1186/1471-2458-12-175 22404903

21. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. London: Taylor & Francis; 2012.

22. Marlow HM, Wamugi S, Yegon E, Fetters T, Wanaswa L, Msipa-Ndebele S. Women’s perceptions about abortion in their communities: perspectives from western Kenya. Reproductive Health Matters. 2014;22(43):149–58. doi: 10.1016/S0968-8080(14)43758-3 24908466

23. Omo-Aghoja L, W Omo-Aghoja V, Okonofua F, Aghedo O, Umueri C, Otayohwo R, et al. Perceptions and attitudes of a rural community to abortion in the Niger-delta region of Nigeria2009. 443–9 p.

24. Lancet The. Abortion: access and safety worldwide. The Lancet. 2018;391(10126):1121. doi: 10.1016/S0140-6736(18)30624-X

25. Casey SE, Steven VJ, Deitch J, Dumas EF, Gallagher MC, Martinez S, et al. “You must first save her life”: community perceptions towards induced abortion and post-abortion care in North and South Kivu, Democratic Republic of the Congo. Sexual and Reproductive Health Matters. 2019;27(1):1571309. doi: 10.1080/09688080.2019.1571309 31533559

26. Bleek W. Avoiding shame: the ethical context of abortion in Ghana. Anthropological quarterly. 1981;54(4):203–10. Epub 1981/10/01. 11655697.

27. Yegon EK, Kabanya PM, Echoka E, Osur J. Understanding abortion-related stigma and incidence of unsafe abortion: experiences from community members in Machakos and Trans Nzoia counties Kenya. The Pan African Medical Journal. 2016;24:258. Epub 2016/11/02. doi: 10.11604/pamj.2016.24.258.7567 27800111; PubMed Central PMCID: PMCPMC5075459.

28. Fergusson DM, Boden JM, Horwood LJ. Abortion Among Young Women and Subsequent Life Outcomes. Perspectives on Sexual and Reproductive Health. 2007;39(1):6–12. doi: 10.1363/3900607 17355376

29. Reardon DC. The abortion and mental health controversy: A comprehensive literature review of common ground agreements, disagreements, actionable recommendations, and research opportunities. SAGE open medicine. 2018;6: 1–38. doi: 10.1177/2050312118807624 30397472.

30. Moore AM, Kibombo R, Cats-Baril D. Ugandan opinion-leaders’ knowledge and perceptions of unsafe abortion. Health Policy and Planning,. 2013;29(7):893–901. doi: 10.1093/heapol/czt070 24064047

31. Mutua MM, Manderson L, Musenge E, Achia TNO. Policy, law and post-abortion care services in Kenya. PLoS One. 2018;13(9):e0204240. doi: 10.1371/journal.pone.0204240 30240408

32. African Union. Special Session of The African Union Conference Of Ministers Of Health Maputo, Mozambique 18–22 September 2006. Addis Ababa: AU, 2006.


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