High abortion rates - Result of inequities in access to safe services

They also found that women who had financial support from their partners were more likely to have a safe procedure. “A majority of women whose partners paid for some or all of the expenses had a safe abortion , while only few of women whose partners did not contribute  did so."

Presenting the research findings at a dissemination workshop attended by players in the area of reproductive health in Accra, Aparna Sundaram, lead author of the study, said age was also associated with a woman's ability to obtain a safe procedure.

“ Adolescents were especially vulnerable to having unsafe abortions. Teens were 77 per cent less likely to have a safe procedure than women in their 30s and 60 per cent less likely to do so than women in their 20s. The researchers attributed this disparity to adolescents having less knowledge about where to obtain safe legal abortion, poorer access to financial resources and being more concerned about stigma and, thus, likely to ask for help.

Previous studies have documented that even when safe legal options are available, the stigma associated with abortion is so powerful that it often leads women to seek an unsafe, clandestine abortion.

 "Our analysis makes clear that there is an urgent need to develop and enforce policies and programmes to lower unintended pregnancy rates and improve access to contraception and safe abortion services, especially among economically and socially disadvantaged women," said Aparna Sundaram.

 The researchers noted other important factors that lead women to obtain unsafe procedures, such as a limited number of qualified abortion providers and the lack of awareness of Ghana's fairly liberal abortion law. They stress that in order to reduce the incidence of unsafe abortion and its harmful consequences, efforts must be made to destigmatise the procedure and educate women and the general population about the legal status of abortion in Ghana.

A reproductive health expert working with the Guttmacher Institute in Ghana, Dr Joana Nerquaye-Tetteh,  said often, access to quality health services is  determined by circumstances rather than need, with the less well-off experiencing the worse outcomes.

 "The tragic reality is that many women continue to put their health and lives at risk to terminate a pregnancy, going to untrained providers or worse, attempting to self-induce. The resulting harm would be avoided if existing guidelines were actually implemented." she added.

The Country Director of Ipas, an international organisation which promotes the health of women, Dr Koma Jehu-Appiah, who moderated the workshop, reiterated that unsafe abortion remains a leading cause of maternal death and injury in Ghana.

He said to reverse this trend calls for the collaboration of stakeholders including, young people, women’s groups, religious groups and service providers.

Discussions that followed the presentation of the research findings referred to actions that can be taken by the country to reduce death and injury as a result of unsafe abortion.

On the subject of how to reduce unsafe abortion among young people, the workshop participants proposed the development of  appropriate Information, Education and Communication (IEC)/Behaviour Change Communication (BCC) messages for targeted youth populations, including in and out of school youth, rural youth and young people in poor communities.

Young people, they further said, should be assisted to develop decision making skills and empowered to make informed sexual and reproductive health decisions, while they are also provided youth friendly service delivery at all levels.

The participants further proposed that  women should be reached with information on safe abortion and the Ghana Health Service standards and protocols be fully implemented to generally expand facilities and ensure access to service delivery.

In addition, they said, subsidised and sometimes free services should be offered for the  less economically empowered women.

The role of religious bodies in preventing needless deaths of women through unsafe abortion also came up for discussion.

Participants proposed improved collaboration  between religious bodies and community development practitioners on important health issues including safe abortion.

Story by Rosemary Ardayfio

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