Factors Influencing Delay in Seeking Post-abortion Care among Women in Keffi, Nasarawa State

Authors

  • RT Kever
  • MK Gana
  • SF Binga

DOI:

https://doi.org/10.30442/ahr.1003-03-243

Keywords:

Delay in Seeking Care, Induced Abortion, Post-abortion Care, Post-abortion Complications, Nigeria

Abstract

Background: Unsafe abortion complications are a significant public health concern, particularly in underdeveloped countries, resulting in maternal mortality. Delays in seeking Post-abortion Care (PAC) at the clinical area leave health workers minimal options for resolving the situation.

Objective: To identify the factors that contribute to the delay in obtaining PAC among women with post-abortion complications in Keffi, Nasarawa State.

Methods: A mixed-method, prospective, cross-sectional survey was carried out at the Federal Medical Centre Keffi. A total of 60 patients were polled, and 15 of the polled patients participated in in-depth interviews. Quantitative and qualitative data were gathered by questionnaires and structured interview guides, respectively.

Results: The predictors of delayed presentation were age 15-24 years (OR = 16, CI = 1.42 – 180.90, p = 0.047), a secondary level of education (OR = 38, CI = 4.15 – 347.89, p < 0.001), earning less than ₦30,000/Month (OR = 25.00, CI = 3.45 – 180.98, p = 0.001), living in rural areas (OR = 5.20, CI = 1.72 – 47.30, p < 0.001), having an abortion performed at a chemist's shop (OR = 7.564, CI = 6.70 – 10.00, p = 0.011), and use of herbs to induce abortion (OR = 1.23, CI = 1.04 – 1.45, p = 0.047).

Conclusion: The study identified younger age, low level of education, occupation, place of residence, low income, and previous history of induced abortion as factors contributing to delayed presentation for PAC. Effective counselling for the use of contraceptives among women who are not ready for pregnancy is recommended.

References

World Health Organization. Unsafe Abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2020. Geneva: https://apps.who.int/iris/handle/10665/42976.

Ngalame A, Tchounzou BR, Neng H, Mangala FG, Inna R, Kamdem DM, et al. Improving Post Abortion Care (PAC) Delivery in Sub-Sahara Africa. Open J Obstet Gynecol 2020;10:1295-1306. http://dx.doi.org/10.4236/ojog.2020.1090119.

World Health Organization. Trends in maternal mortality: 1990-2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations population division: Executive summary. World Health Organization, 2015.

Bell SO, Omoluabi E, Ola-Olorun F, Shankar M, Moreau C. Inequities in the incidence and safety of abortion in Nigeria BMJ Global Health 2020;5:e001814. https://doi.org/10.1136/bmjgh-2019-001814

Bankole A, Adewole IF, Hussain R, Awolude O, Singh S, Akinyemi JO. The Incidence of Abortion in Nigeria. Int Persp Sexual Reprod Health 2015;41(4):170–181. https://doi.org/10.1363/4117015

Centre for Reproductive Rights. Nigeria’s Abortion Provisions. 2020 Https://reproductiverights.org/en/world-abortion-laws/nigerias-aborion-provisions.

Srinil S. Factors associated with severe complications in unsafe abortion. J Med Assoc Thai 2011;94:408–414.

Sustainable Development Goals: 17 goals to develop our World.2015 https://www.fao.org/3/CA3121EN/ca3121en.pdf. Accessed on 16 October 2023

Barnes-Josiah D, Myntti C, Augustin A. The "three delays" as a framework for examining maternal mortality in Haiti. Social Science & Medicine. 1998;46:981–993. https://doi.org/10.1016/S0277-9536(97)10018-1

Andersen RM. National health surveys and the behavioural model of health services use. Med Care 2008;46:647–653. DOI: 10.1097/MLR.0b013e31817a835d

Guest G, Namey E, Chen M. A simple method to assess and report thematic saturation in qualitative research. PLoS ONE, 2020;15:1-17. https://doi.org/10.1371/journal.pone.0232076

Mutua MM, Maina BW, Achia TO, Izugbara, CO. Factors associated with delays in seeking post-abortion care among women in Kenya. BMC Preg Childbirth 2015;15:240-248. https://doi.org/10.1186/s12884-015-0660-7.

Tormey R, Laperrouza M. The development, validation, and use of an interprofessional project management questionnaire in engineering education" Eur J Eng Educ 2023;48:502-517. https://doi.org/10.1080/03043797.2023.2171854

Wang H, Liu Y, Xiong R. Factors associated with seeking post-abortion care among women in Guangzhou, China. BMC Women’s Health 2020;20:120-128. https://doi.org/10.1186/s12905-020-00980-0.

Tunde AI. Socio-economical and sociological factors as predictors of illegal abortion among adolescents in Akoko West local government area of Ondo state. Nigeria. Pub Health Res 2013;3:33–36. https://doi.org/10.5923/j.phr.20130303.01

Bain LE, Zweekhorst MB, Amoakoh-Coleman M, Muftugil-Yalcin S, Omolade AI, Becquet R, et al. To keep or not to keep? Decision making in adolescent pregnancies in Jamestown, Ghana. PloS one. 2019;14:1–18.

https://doi.org/10.1371/journal.pone.0221789

Bright T, Felix L, Kuper H, Polack S. Systematic review of strategies to increase access to health services among children over five in low-and middle-income countries. Trop Med Int Health 2018;23:476–507. https://doi.org/10.1111/tmi.13044

Bankole A, Malarcher S. Removing barriers to adolescents’ access to contraceptive information and services. Stud Fam Plann 2010;41:117–124. https://doi.org/10.1111/j.1728-4465.2010.00232.x

Håkansson M, Oguttu M, Gemzell-Danielsson K, Makenzius M. Human rights versus societal norms: a mixed methods study among healthcare providers on social stigma related to adolescent abortion and contraceptive use in Kisumu, Kenya. BMJ Global Health 2018;3;1-13:e000608. https://doi.org/10.1136/bmjgh-2017-000608

Olukoya P. Reducing maternal mortality from unsafe abortion among adolescents in Africa. African Journal of Reproductive Health/La Revue Africaine de la Santé Reproductive 2004;8:57–62. https://doi.org/10.2307/3583306

White JS, Speizer IS. Can family planning outreach bridge the urban-rural divide in Zambia? BMC Health Serv Res 2007;7:143-152. https://doi.org/10.1186/1472-6963-7-143

Al Riyami A, Afifi M, Mabry RM. Women's Autonomy, Education and Employment in Oman and their Influence on Contraceptive Use. Reprod Health Matters 2004;12:144–154. http://dx.doi.org/10.1016/S0968- 8080(04)23113-5

Kabiru CW, Ushie BA, Mutua MM, Izugbara CO, Kabiru CW. Previous induced abortion among young women seeking abortion-related care in Kenya: a cross-sectional analysis. BMC Preg Childbirth 2016;16:104-114. https://doi.org/10.1186/s12884-016-0894-z

Gelaye AA, Taye KN, Mekonen T, Gelaye AA. Magnitude and risk factors of abortion among regular female students in Wolaita Sodo University, Ethiopia. BMC Womens Health. 2014;14:50-59. https://doi.org/10.1186/1472-6874-14-50

Gabrysch S, Campbell OMR. Still too far to walk A literature review of the determinants of delivery services use. BMC Pregnancy Childbirth. 2009;9:1-18. https://doi.org/10.1186/1471-2393-9-34

Kabakyenga JK, Östergren P, Turyakira E Pettersson KO. Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda. Reprod Health 2011;8:33-43. https://doi.org/10.1186/1742-4755-8-33

Islam M, Yoshida S. Women are still deprived of access to lifesaving essential and emergency obstetric care. Int J Gynecol Obstet 2009;106:120-124. https://doi.org/10.1016/j.ijgo.2009.03.022

Echoka E, Makokha A, Dubourg D, Kombe Y, Nyandieka L, Byskov J. Barriers to emergency obstetric care services: accounts of survivors of life-threatening obstetric complications in Malindi District, Kenya. Pan Afr Med J 2014;17(Supp 1):4:15-20. https://doi.org/10.11694/pamj.supp.2014.17.1.3042

Gelman A, Rosenfeld EA, Nikolajski C, Freedman LR, Steinberg JR, Borrero S. Abortion stigma among low-income women obtaining abortions in western Pennsylvania: a qualitative assessment. Perspect Sex Reprod Health 2017;49:29–36. https://doi.org/10.1363/psrh.12014

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Published

2024-09-29

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Original Research