Estimating the lifetime incidence of induced abortion and understanding abortion practices in a Northeastern Tanzania community through a household survey.


Journal

Contraception
ISSN: 1879-0518
Titre abrégé: Contraception
Pays: United States
ID NLM: 0234361

Informations de publication

Date de publication:
02 2021
Historique:
received: 02 06 2020
revised: 13 10 2020
accepted: 14 10 2020
pubmed: 26 10 2020
medline: 16 10 2021
entrez: 25 10 2020
Statut: ppublish

Résumé

All Tanzanian abortion estimates rely on health facility data that do not take into account completely the incidence of abortion. This papers aims to estimate the lifetime incidence of induced abortion in Arusha, Tanzania via direct and double list-experiment methods using community data and evaluate outcomes and behaviors of women who had an abortion. From January to May 2018, a face-to-face interview survey was conducted on a representative sample of sexually active women (n = 3658) living in Arusha, Tanzania. Participants were selected in a three-stage random process and questions were asked about reproductive history, contraceptive use, and health seeking behaviors. A direct question and double list-experiment was used to estimate lifetime incidence of abortion. Lifetime abortion incidence was 3% using the direct question compared to 7.7% using the double list-experiment method. However, post-estimation tests revealed a key study design violation thus invalidating list the experiment estimate. We find that 45% of women received their abortion outside the formal health care system, the most frequent method used was manyono pill (traditional medicine), and only 50% of women who experienced abortion complications sought treatment. We provide another example of the performance of list experiment in measuring abortion incidence. Nearly half of reported abortions took place outside of the formal health system highlighting the substantial underestimation while using facility data to measure abortion. Seeking health care for potential complications was low despite post-abortion care services being free and legal in Tanzania. Using administrative data to estimate lifetime incidence of abortion is inaccurate as we found half of our sample received abortions outside a health facility. Women should be encouraged to seek post-abortion care, when needed.

Identifiants

pubmed: 33098850
pii: S0010-7824(20)30383-8
doi: 10.1016/j.contraception.2020.10.013
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

127-131

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Bilikisu Elewonibi (B)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: elewonibi@hsph.harvard.edu.

Caroline Amour (C)

Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical College, P.O. Box 2240, Moshi, Tanzania.

Sarah Gleason (S)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Sia Msuya (S)

Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical College, P.O. Box 2240, Moshi, Tanzania.

David Canning (D)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Iqbal Shah (I)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

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