PREDICTORS OF UNSAFE ABORTION AMONG WOMEN SEEKING POSTABORTION CARE AT THE NAKURU COUNTY REFERRAL HOSPITAL, NAKURU COUNTY KENYA
PREDICTORS OF UNSAFE ABORTION AMONG WOMEN SEEKING POSTABORTION CARE AT THE NAKURU COUNTY REFERRAL HOSPITAL, NAKURU COUNTY KENYA
Nyakambi Samuel Nyachwaya - Student, Master of Public Health (Monitoring and Evaluation) Kenyatta University, Kenya
Isaac Mwanzo - Lecturer, Department of Community Health and Epidemiology, Kenyatta University, Kenya
Joachim Osur - Lecturer, AMREF International University, Kenya
ABSTRACT
Unsafe abortion is common all over the world but is more prevalent in developing countries especially Africa. Kenya is one of the developing countries, where unsafe abortion is a common occurrence and it significantly contributes to maternal mortality in the country. Even when it has not been properly quantified in sub-Saharan Africa, studies in Kenya show that for many years’ unsafe abortion has caused many maternal deaths. Nakuru County is the fourth in the country on maternal mortality. In the referral hospitals there has been increased admission due to induced abortions many of them unsafe. The main objective of this study was to establish the predictors of unsafe abortion among women in Nakuru County. The specific objectives sought to establish if demographic factors influence the choice for unsafe abortion, to determine the extent to which women’s knowledge on reproductive health affect the choice of unsafe abortion and to determine how socio-cultural factors influence women’s choice for unsafe abortion in Nakuru County. The study was conducted at the Nakuru County referral hospital among women seeking post-abortion care (PAC) services. The study employed a mixed method design comprising cross-sectional survey, focus group discussions and key informant interviews. The sample size of the respondents was one hundred and Eighteen (118) selected to fill questionnaires using systematic sampling from the admission and out-patient registers. In addition, twelve community healthcare workers (CHVs) were selected for a Focus Group Discussion using simple random sampling. The study used purposive sampling to select four healthcare workers who work at the Post-Abortion Care units of Nakuru County Referral Hospital for interviews. Trained healthcare professionals were recruited as research assistants, who after training administered the semi-structured questionnaire and conducted the focus group discussion. The researcher conducted the key informant interviews. The data was then cleaned, coded, entered and analyzed using statistical package for social scientists (SPSS) version 25. The study found that age group, marital status, education level and monthly income influenced the choice of unsafe abortion among women in Nakuru County. However, it was found that religion, ethnicity, livelihood and residence of the women do not influence the choice of unsafe abortion among women in Nakuru County. The study found that Reproductive Health knowledge had statistically significant effect on unsafe abortion as evidenced by a t-statistic of 9.423 and p<0.905. The study established that socio-cultural factors do not affect the choice of unsafe abortion among women in Nakuru County. This is evidenced by t=6.258 and p<0.05. The study recommends legal measures are taken against healthcare workers both in public and private health facing helping young girls to procure abortion unless it is to save their lives. The study recommends use of provision measures that deter pregnancy even in the use family planning products, educating young girls and women on risk of abortions and encouraging girls to keep their pregnancy to full term. Health education is encouraged in the community as well as in schools by all health care workers on use of family planning is also recommended. The findings of this study may be used to develop policies & design program interventions to alleviate the problem of unsafe abortion.