Female autonomy and reported abortion-seeking in Ghana, West Africa Sarah D. Rominski, Mira Gupta, Raymond Aborigo, Phillip Adongo, Cyril Engman, Abraham Hodgson, Cheryl Moyer PII: DOI: Reference:

S0020-7292(14)00242-2 doi: 10.1016/j.ijgo.2014.03.031 IJG 7976

To appear in:

International Journal of Gynecology and Obstetrics

Received date: Revised date: Accepted date:

4 October 2013 6 March 2014 7 May 2014

Please cite this article as: Rominski Sarah D., Gupta Mira, Aborigo Raymond, Adongo Phillip, Engman Cyril, Hodgson Abraham, Moyer Cheryl, Female autonomy and reported abortion-seeking in Ghana, West Africa, International Journal of Gynecology and Obstetrics (2014), doi: 10.1016/j.ijgo.2014.03.031

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ACCEPTED MANUSCRIPT CLINICAL ARTICLE

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Female autonomy and reported abortion-seeking in Ghana, West Africa

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Engman e, Abraham Hodgson b,f Cheryl Moyer a,g

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Sarah D. Rominski a,*, Mira Gupta a, Raymond Aborigo b,c, Phillip Adongo d, Cyril

Global REACH, University of Michigan Medical School, Ann Arbor, USA

b

Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana

c

Jeffrey Cheah School of Medicine and Health Sciences, MONASH University, Sunway

Campus, Subang Jaya, Malaysia

Department of Social and Behavioural Sciences, School of Public Health, University of

Ghana, Accra, Ghana

Department of Pediatrics and Maternal Child Health, Schools of Medicine and Public

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e

TE

D

d

MA

NU

a

Health, University of North Carolina, Chapel Hill, USA f

Ghana Health Service, Accra, Ghana

g

Department of Medical Education, University of Michigan Medical School, Ann Arbor,

USA

* Corresponding author: Sarah D. Rominski Senior Research Associate, Global REACH, University of Michigan Medical School, 240 Victor Vaughn Building, 3111 Catherine St, Ann Arbor, MI 48109, USA. Tel.: +1 734 764 6108; fax: +1 734 615 6300. E-mail address: [email protected]

ACCEPTED MANUSCRIPT

Keywords: Abortion; Autonomy; Empowerment; Low-resource countries; Maternal

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health; Reproductive health

Synopsis: Previously identified demographic differences in reported abortion-seeking

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may be explained by sociocultural factors such as individual autonomy, and should be

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MA

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considered when making policy.

ACCEPTED MANUSCRIPT ABSTRACT Objective: To investigate factors associated with self-reported pregnancy termination in

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Ghana and thereby appreciate the correlates of abortion-seeking in order to understand

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safe abortion care provision.

Methods: In a retrospective study, data from the Ghana 2008 Demographic and Health

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Survey were used to investigate factors associated with self-reported pregnancy

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termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was

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created to explore the role of female autonomy in reported abortion-seeking behavior. Results: Among 4916 women included in the survey, 791 (16.1%) reported having an

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abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic

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regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P

Female autonomy and reported abortion-seeking in Ghana, West Africa.

To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order...
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