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Abortion care seeking in India: patterns and predictors

Published online by Cambridge University Press:  10 September 2019

Palak Sharma Open the ORCID record for Palak Sharma [Opens in a new window]  and
Manas Ranjan Pradhan Open the ORCID record for Manas Ranjan Pradhan [Opens in a new window]
Palak Sharma*
Affiliation:
International Institute for Population Sciences, Mumbai, India
Manas Ranjan Pradhan
Affiliation:
International Institute for Population Sciences, Mumbai, India
*
*Corresponding author. Email: pal3193@gmail.com
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Abstract

Unsafe abortions remain a considerable public health problem and continue to be a leading cause of maternal morbidity and mortality throughout the world. This study assessed whether women’s choice of type of health care facility for abortion in India varied by their socio-demographic and economic characteristics, and aimed to determine the significant predictors of choice of health care facility. Data were taken from the 2015–16 Indian National Family and Health Survey (NFHS-4). The study sample included women aged 15–49 years, irrespective of their marital status, who had terminated their last pregnancy by induced abortion in the five years before the survey (N = 6876). A bivariate analysis was carried out to assess the pattern in the choice of health care facility type for an abortion, and a multinomial logistic regression model was fitted to assess the predictors affecting the choice of health care facility type for an abortion. The results showed that, at the time of the 2015–16 survey, women in India went to private facilities more than public facilities for abortion care, irrespective of their age, distance to facility and financial constraints. The probability of visiting a private facility increased with women’s age, gestational age and the wealth quintile. A wide variation in choice of health facility for abortion care by socioeconomic characteristics was observed.

Keywords

AbortionReproductive HealthMaternal and child health
Type
Research Article
Information
Journal of Biosocial Science , Volume 52 , Issue 3 , May 2020 , pp. 353 - 365
Copyright
© Cambridge University Press 2019

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References

Banerjee, SK, Andersen, KL and Warvadekar, J (2012) Pathways and consequences of unsafe abortion: a comparison among women with complications after induced and spontaneous abortions in Madhya Pradesh, India. International Journal of Gynecology & Obstetrics 118, S113–S120.CrossRefGoogle ScholarPubMed
Barge, S and Philips, G (1997) Situation analysis of medical termination of pregnancy services in Uttar Pradesh. Baroda: Center for Operations Research and Training, 1–3.Google Scholar
Barua, A and Apte, H (2007) Quality of abortion care: perspectives of clients and providers in Jharkhand. Economic and Political Weekly 42(48), 71–80.Google Scholar
Calvert, C, Owolabi, OO, Yeung, F, Pittrof, R, Ganatra, B, Tunçalp, Ö and Filippi, V (2018) The magnitude and severity of abortion-related morbidity in settings with limited access to abortion services: a systematic review and meta-regression. BMJ Global Health 3(3), e000692.CrossRefGoogle ScholarPubMed
Dalvie, SS (2008) Second trimester abortions in India. Reproductive Health Matters 16 (supplement 31), 37–45.CrossRefGoogle ScholarPubMed
Duggal, R and Ramachandran, V (2004) The abortion assessment project – India: key findings and recommendations. Reproductive Health Matters, 12 (supplement 24), 122–129.CrossRefGoogle ScholarPubMed
Elul, B (2010) Assessments of the importance of provider characteristics for abortion care: data from women in Rajasthan, India. Health Care for Women International 32(1), 72–95.CrossRefGoogle Scholar
Glenton, C, Sorhaindo, AM, Ganatra, B and Lewin, S (2017) Implementation considerations when expanding health worker roles to include safe abortion care: a five-country case study synthesis. BMC Public Health 17(1), 730.CrossRefGoogle ScholarPubMed
Government of India (1971) The Medical Termination of Pregnancy Act: Act No. 34, 1971. Government of India, New Delhi. URL: http://tcw.nic.in/Acts/MTP-Act-1971.pdf (accessed 20 December 2017).Google Scholar
IPAS (2015) Women’s Access to Safe Abortion in 2030: Agenda for Sustainable Development. Advancing Maternal Health, Gender Equality and Reproductive Rights. IPAS Health Access Rights. URL: https://www.srhr-ask-us.org/themencode-pdf-viewer-sc/?file%3d https://www.srhr-ask-us.org/wp-content/uploads/2017/10/6-Ipas_SafeAbortion.pdf&settings%3d001101111&lang%3den-US#page%3d&zoom%3dauto&pagemode%3d (accessed 13 April 2018).Google Scholar
Jejeebhoy, SJ, Kalyanwala, S, Zavier, AF, Kumar, R and Jha, N (2010) Experience seeking abortion among unmarried young women in Bihar and Jharkhand, India: delays and disadvantages. Reproductive Health Matters 18(35), 163–174.CrossRefGoogle ScholarPubMed
Johnston, HB (2004) Abortion Practice in India: A Review of Literature. Working Paper No. 1, Abortion Assessment Project, India, 2002; CEHAT and HealthWatch, Mumbai.Google Scholar
Khan, ME, Barge, S and Kumar, N (2001) Availability and Access to Abortion Services in India: Myth and Realities. Center for Operations Research and Training, Baroda. URL: https://pdfs.semanticscholar.org/c3bb/01b423f991c035efd540525d9d0d0dc18625.pdfGoogle Scholar
Prata, N, Bell, S and Gessessew, A (2013) Comprehensive abortion care: evidence of improvements in hospital-level indicators in Tigray, Ethiopia. BMJ Open 3(7), e002873.CrossRefGoogle ScholarPubMed
Santhya, KG and Verma, S (2004) Induced abortion: the current scenario in India. Regional Health Forum 8(2), 1–14.Google Scholar
Shrestha, DR, Regmi, SC and Dangal, G (2018) Abortion: still unfinished agenda in Nepal. Journal of Nepal Health Research Council 16(1), 93–98.CrossRefGoogle ScholarPubMed
Singh, S, Remez, L, Sedgh, G, Kwok, L and Onda, T (2018a) Abortion Worldwide 2017: Uneven Progress and Unequal Access Abortion Worldwide 2017: Uneven Progress and Unequal Access. URL: https://www.guttmacher.org/sites/default/files/report_pdf/abortion-worldwide-2017.pdf (accessed September, 2018).CrossRefGoogle Scholar
Singh, S, Shekhar, C, Acharya, R, Moore, AM, Stillman, M, Pradhan, MR and Sundaram, A (2018b) The incidence of abortion and unintended pregnancy in India, 2015. The Lancet Global Health 6(1), e111–e120.CrossRefGoogle Scholar
Sri, BS and Ravindran, TK (2012) Medical abortion: understanding perspectives of rural and marginalized women from rural South India. International Journal of Gynecology & Obstetrics 118(S1).CrossRefGoogle Scholar
Stillman, M, Frost, JJ, Singh, S, Moore, AM and Kalyanwala, S (2014) Abortion in India: A Literature Review. Guttmacher Institute, New York, pp. 12–14.Google Scholar
WHO (2003) Safe Abortion: Technical and Policy Guidance for Health Systems. WHO, Geneva.Google Scholar
WHO (2018) Preventing Unsafe Abortion. WHO, Geneva.Google Scholar