Determinants of Induced Abortion Intention among Adolescents Seeking Youth-Friendly Services in Homa Bay County, Kenya

Abstract

Background: Approximately 6.4 million women die because of unsafe abortion in Africa. Abortion contributes to 35% of maternal deaths nationally, out of these adolescents account for 17%. Homa Bay County is among the 15 high-burden counties in the country, which accounts for 97% of maternal deaths. Interestingly, 23% of the deaths are as a result of teenage pregnancy. The study aimed to determine the induced abortion intention among adolescents seeking youth-friendly services in Homa Bay County.

Methods And Material: A cross-sectional was implemented for the study from April to June 2020. Systematic random sampling was used to select 332 participants among 1652 adolescents in the study areas. Data was collected through self-administered questionnaires. Univariate analysis, stepwise selection and multivariate logistic regression were employed to find determinants of induced abortion intention. The study was approved by the Ethical Review Committee of Masinde Muliro University of Science and Technology (MMU/COR: 509099) and NACOSTI offered a research permit NACOSTI/P/20/4496.

Results: The study revealed a significant association between induced abortion intention and being multiparous (OR: 0.064; 95% CI: 0.005-0.918: p= 0.028). The current study found a strong association between adolescents' belief that their physical health reduces the likelihood of pregnancy from unprotected sex. Respondents who had a low perception of physical health were susceptible and had higher odds of having induced abortion intention. Similarly, the respondents who agreed that they do not talk to their partners about pregnancy were thrice as likely to have had induced abortion intention (OR: 3.2; 95% CI: 1.7- 6.1: p= 0.0002). In addition, those who believed that if they continued with the pregnancy their academic career would be endangered were 4.3 times as likely to have had induced abortion intention (OR: 4.3: 95% CI: 2.2 – 8.1; p < 0.0001).

Conclusion: In this study, induced abortion intention was significant among adolescents who had a misinformed perception of their physical health and chances of getting pregnant even if they practised unprotected sex, lacked disclosure to partners and were urged not to discontinue their career and profession. Governments should embrace and operationalize multisectoral and pre-counselling approaches coupled with comprehensive sexual reproductive health education in and out of school in Adolescents programs. Similarly, Adolescent' programs should scale up male involvement.