Determinants and barriers to safe abortion care in Nigeria: A mixed method study

Abstract

Barriers to safe abortion care are major contributors to the high levels of maternal death, ill health, and disability in Nigeria. This study employed a mixed-method approach to investigate the determinants and barriers to safe abortion care in Nigeria. The quantitative aspect of this study used data from the 2019-2020 follow-up survey. These were 1388 women from six Nigerian states who reported an abortion experience in the 2018 baseline cross-sectional survey of Nigeria Performance Monitoring for Action (PMA) datasets. Twenty in-depth interviews were performed with women seeking post-abortion treatment at two teaching hospitals in southwest Nigeria (FETHI and LAUTECH). Approximately 30% of the 1388 abortions performed were unsafe. Younger women were less likely to practice safe abortion care (OR=0.64, p<0.05). The odds of safe abortion care increased with education level (OR=1.83, p<0.05),(OR=2.62, p<0.001), and (OR=3.84, p<0.001) for primary, secondary, and higher education. Other are residence, marital, and wealth status, The IDI results revealed that the majority of abortions are performed in a private, unconventional location. Low socioeconomic position, sociocultural norms, and legislative constraints all pose significant challenges to safe abortion care in Nigeria. To enhance access to safe abortion in Nigeria, the government must evaluate socio-legal obstacles.