Induced abortion among adolescent girls and young women: should geography matter in Ghana?

Abstract

Globally, there has been a slight reduction in abortion rates. However, abortion rates have increased in other major regions, including sub-Saharan Africa. Induced abortion rates vary by ecological zone and place of residence, and it is prevalent among women aged 15–24. This study examined the predictors of induced abortion in ecological zones by place of residence among adolescent girls and young women aged 15–24. The 2017 Ghana Maternal and Health Survey, which is a nationally representative household survey dataset, was used for this study. This analysis is restricted to 3194 Adolescent Girls and Young Women (AGYW) aged 15–24 years. A two-level multilevel binary logistic regression model was used to analyze the individual and contextual level characteristics associated with induced abortion. The results show that the prevalence rate of induced abortion among adolescent girls and young women is 26.0%. After adjusting for individual and community level factors, ecological zones and place of residence predicted induced abortion among AGYW. More importantly, the results demonstrate that AGYW residing in urban areas of the forest zones were statistically significant to report induced abortion compared to those in the rural areas. In conclusion, there is a strong association between place of residence, ecological zones and induced abortion in Ghana. Primarily, urban-dwelling women in the forest zone are more likely to report induced abortion. There is, therefore, a need to prioritize women residing in urban areas and the forest zone of Ghana. AGYW in these high-risk ecological zones should be reached with sufficient health education and sensitization about induced abortion. Given the protective factor of contraceptive use, it is recommended that the government and its health agencies strengthen campaigns to improve contraceptive use among AGYW across the country, particularly in the urban forest ecological zone.