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Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study
OBJECTIVES: To estimate age-specific abortion incidence and unintended pregnancy in Kinshasa, Democratic Republic of Congo and compare care experiences between adolescents (15–19 years) and older women (20–49 years). DESIGN: We used the age-specific variant of the Abortion Incidence Complications Me...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413879/ https://www.ncbi.nlm.nih.gov/pubmed/34475140 http://dx.doi.org/10.1136/bmjopen-2020-044682 |
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author | Fatusi, Adesegun Riley, Taylor Kayembe, Patrick K Mabika, Crispin |
author_facet | Fatusi, Adesegun Riley, Taylor Kayembe, Patrick K Mabika, Crispin |
author_sort | Fatusi, Adesegun |
collection | PubMed |
description | OBJECTIVES: To estimate age-specific abortion incidence and unintended pregnancy in Kinshasa, Democratic Republic of Congo and compare care experiences between adolescents (15–19 years) and older women (20–49 years). DESIGN: We used the age-specific variant of the Abortion Incidence Complications Method to estimate abortion and unintended pregnancy, with data from three primary sources: Health Facility Survey (n=361) provided postabortion care (PAC) caseloads; Prospective Morbidity Survey (n=1031) provided the age distribution and characteristics of women presenting for PAC and Health Professional Survey (n=115) provided an estimate of the proportion of abortions resulting in facility-based treatment of complications. Bivariate (χ(2), t-test) and multivariable (binary logistic regression, Cox proportional hazard) analyses were used to compare abortion care experiences. SETTING: Health facilities proving PAC in Kinshasa. PARTICIPANTS: Women who presented to PAC facilities with abortion complications and their care providers. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary measures were abortion incidence and proportion of pregnancies unintended. The secondary measures were the odd of reporting specific abortion care experiences. RESULTS: Adolescents had an estimated 27 590 induced abortions, constituting 18.8% of abortions in Kinshasa in 2016. Adolescents had the lowest abortion rate among women less than 35 years (55.2/1000 women) but the highest rate among ever sexually active women (138.4/1000) and recently sexually active women (167.2/1000). Also, adolescents had the highest abortion ratio (82.4/100 live births), proportion of pregnancies unintended (80%) and proportion of unintended pregnancies ending in abortion (49%). Compared with older women, adolescents had higher odds of reporting pregnancy unintendedness (adjusted OR, AOR 1.36, 95% CI 1.75 to 2.24), seeking abortion at later than first trimester (AOR 1.34, 95% CI 1.09 to 1.63) and from non-medical professionals (AOR 1.68, 95% CI 1.31 to 2.14), and not using contraceptives before pregnancy (AOR 2.23, 95% CI 2.77 to 3.43) or postabortion (AOR 2.46, 95% CI 1.87 to 3.29). CONCLUSIONS: Interventions are needed to reduce unintended pregnancy among adolescents in Kinshasa and improve their abortion care experiences. |
format | Online Article Text |
id | pubmed-8413879 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-84138792021-09-22 Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study Fatusi, Adesegun Riley, Taylor Kayembe, Patrick K Mabika, Crispin BMJ Open Public Health OBJECTIVES: To estimate age-specific abortion incidence and unintended pregnancy in Kinshasa, Democratic Republic of Congo and compare care experiences between adolescents (15–19 years) and older women (20–49 years). DESIGN: We used the age-specific variant of the Abortion Incidence Complications Method to estimate abortion and unintended pregnancy, with data from three primary sources: Health Facility Survey (n=361) provided postabortion care (PAC) caseloads; Prospective Morbidity Survey (n=1031) provided the age distribution and characteristics of women presenting for PAC and Health Professional Survey (n=115) provided an estimate of the proportion of abortions resulting in facility-based treatment of complications. Bivariate (χ(2), t-test) and multivariable (binary logistic regression, Cox proportional hazard) analyses were used to compare abortion care experiences. SETTING: Health facilities proving PAC in Kinshasa. PARTICIPANTS: Women who presented to PAC facilities with abortion complications and their care providers. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary measures were abortion incidence and proportion of pregnancies unintended. The secondary measures were the odd of reporting specific abortion care experiences. RESULTS: Adolescents had an estimated 27 590 induced abortions, constituting 18.8% of abortions in Kinshasa in 2016. Adolescents had the lowest abortion rate among women less than 35 years (55.2/1000 women) but the highest rate among ever sexually active women (138.4/1000) and recently sexually active women (167.2/1000). Also, adolescents had the highest abortion ratio (82.4/100 live births), proportion of pregnancies unintended (80%) and proportion of unintended pregnancies ending in abortion (49%). Compared with older women, adolescents had higher odds of reporting pregnancy unintendedness (adjusted OR, AOR 1.36, 95% CI 1.75 to 2.24), seeking abortion at later than first trimester (AOR 1.34, 95% CI 1.09 to 1.63) and from non-medical professionals (AOR 1.68, 95% CI 1.31 to 2.14), and not using contraceptives before pregnancy (AOR 2.23, 95% CI 2.77 to 3.43) or postabortion (AOR 2.46, 95% CI 1.87 to 3.29). CONCLUSIONS: Interventions are needed to reduce unintended pregnancy among adolescents in Kinshasa and improve their abortion care experiences. BMJ Publishing Group 2021-09-02 /pmc/articles/PMC8413879/ /pubmed/34475140 http://dx.doi.org/10.1136/bmjopen-2020-044682 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Public Health Fatusi, Adesegun Riley, Taylor Kayembe, Patrick K Mabika, Crispin Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study |
title | Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study |
title_full | Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study |
title_fullStr | Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study |
title_full_unstemmed | Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study |
title_short | Unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in Kinshasa, Democratic Republic of Congo: a cross-sectional study |
title_sort | unintended pregnancy, induced abortion and abortion care-seeking experiences among adolescents in kinshasa, democratic republic of congo: a cross-sectional study |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413879/ https://www.ncbi.nlm.nih.gov/pubmed/34475140 http://dx.doi.org/10.1136/bmjopen-2020-044682 |
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