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Determinants of women’s preferred and actual abortion provision locations in Nigeria

BACKGROUND: Unsafe abortion remains a leading cause of maternal mortality globally. Many factors can influence women’s decisions around where to seek abortion care; however, little research has been done on abortion care decisions at a population-level in low-resource settings, particularly where ab...

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Autores principales: Byrne, Meagan E., Omoluabi, Elizabeth, OlaOlorun, Funmilola M., Moreau, Caroline, Bell, Suzanne O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627088/
https://www.ncbi.nlm.nih.gov/pubmed/34838089
http://dx.doi.org/10.1186/s12978-021-01290-w
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author Byrne, Meagan E.
Omoluabi, Elizabeth
OlaOlorun, Funmilola M.
Moreau, Caroline
Bell, Suzanne O.
author_facet Byrne, Meagan E.
Omoluabi, Elizabeth
OlaOlorun, Funmilola M.
Moreau, Caroline
Bell, Suzanne O.
author_sort Byrne, Meagan E.
collection PubMed
description BACKGROUND: Unsafe abortion remains a leading cause of maternal mortality globally. Many factors can influence women’s decisions around where to seek abortion care; however, little research has been done on abortion care decisions at a population-level in low-resource settings, particularly where abortion is legally restricted. METHODS: This analysis uses data from a 2019–2020 follow-up survey of 1144 women in six Nigerian states who reported an abortion experience in a 2018 cross-sectional survey. We describe women’s preferred and actual primary abortion care provider/location by distinguishing clinical, pharmacy/chemist, or other non-clinical providers or locations. We also examine factors that influence women’s decisions about where to terminate their pregnancy and identify factors hindering women’s ability to operationalize their preferences. We then examine the characteristics of women who were not able to use their preferred provider/location. RESULTS: Non-clinical providers (55.0%) were more often used than clinical providers (45.0%); however, clinical providers were preferred by most women (55.6%). The largest discrepancies in actual versus preferred abortion provider/location were private hospitals (7.6% actual versus 37.2% preferred), government hospitals (4.3% versus 22.6%), chemists (26.5% versus 5.9%) and pharmacies (14.9% versus 6.6%). “Privacy/confidentiality” was the most common main reason driving women’s abortion provider/location choice (20.7%), followed by “convenience” (16.9%) and “recommended” by someone (12.3%), most often a friend (60.8%), although top reasons differed by type of provider/location. Cost and distance were the two most common reasons that women did not use their preferred provider/location (46.1% and 21.9%, respectively). There were no statistically significant differences in the sociodemographic characteristics between women who were able to use their preferred provider/location and those who were not able to implement their preferred choice, with the exception of state of residence. CONCLUSIONS: These findings provide insights on barriers to abortion care in Nigeria, suggesting discretion is key to many women’s choice of abortion location, while cost and distance prevent many from seeking their preferred care provider/location. Results also highlight the diversity of women’s abortion care preferences in a legally restrictive environment.
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spelling pubmed-86270882021-11-30 Determinants of women’s preferred and actual abortion provision locations in Nigeria Byrne, Meagan E. Omoluabi, Elizabeth OlaOlorun, Funmilola M. Moreau, Caroline Bell, Suzanne O. Reprod Health Research BACKGROUND: Unsafe abortion remains a leading cause of maternal mortality globally. Many factors can influence women’s decisions around where to seek abortion care; however, little research has been done on abortion care decisions at a population-level in low-resource settings, particularly where abortion is legally restricted. METHODS: This analysis uses data from a 2019–2020 follow-up survey of 1144 women in six Nigerian states who reported an abortion experience in a 2018 cross-sectional survey. We describe women’s preferred and actual primary abortion care provider/location by distinguishing clinical, pharmacy/chemist, or other non-clinical providers or locations. We also examine factors that influence women’s decisions about where to terminate their pregnancy and identify factors hindering women’s ability to operationalize their preferences. We then examine the characteristics of women who were not able to use their preferred provider/location. RESULTS: Non-clinical providers (55.0%) were more often used than clinical providers (45.0%); however, clinical providers were preferred by most women (55.6%). The largest discrepancies in actual versus preferred abortion provider/location were private hospitals (7.6% actual versus 37.2% preferred), government hospitals (4.3% versus 22.6%), chemists (26.5% versus 5.9%) and pharmacies (14.9% versus 6.6%). “Privacy/confidentiality” was the most common main reason driving women’s abortion provider/location choice (20.7%), followed by “convenience” (16.9%) and “recommended” by someone (12.3%), most often a friend (60.8%), although top reasons differed by type of provider/location. Cost and distance were the two most common reasons that women did not use their preferred provider/location (46.1% and 21.9%, respectively). There were no statistically significant differences in the sociodemographic characteristics between women who were able to use their preferred provider/location and those who were not able to implement their preferred choice, with the exception of state of residence. CONCLUSIONS: These findings provide insights on barriers to abortion care in Nigeria, suggesting discretion is key to many women’s choice of abortion location, while cost and distance prevent many from seeking their preferred care provider/location. Results also highlight the diversity of women’s abortion care preferences in a legally restrictive environment. BioMed Central 2021-11-27 /pmc/articles/PMC8627088/ /pubmed/34838089 http://dx.doi.org/10.1186/s12978-021-01290-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Byrne, Meagan E.
Omoluabi, Elizabeth
OlaOlorun, Funmilola M.
Moreau, Caroline
Bell, Suzanne O.
Determinants of women’s preferred and actual abortion provision locations in Nigeria
title Determinants of women’s preferred and actual abortion provision locations in Nigeria
title_full Determinants of women’s preferred and actual abortion provision locations in Nigeria
title_fullStr Determinants of women’s preferred and actual abortion provision locations in Nigeria
title_full_unstemmed Determinants of women’s preferred and actual abortion provision locations in Nigeria
title_short Determinants of women’s preferred and actual abortion provision locations in Nigeria
title_sort determinants of women’s preferred and actual abortion provision locations in nigeria
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627088/
https://www.ncbi.nlm.nih.gov/pubmed/34838089
http://dx.doi.org/10.1186/s12978-021-01290-w
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