Sexual and Reproductive Health Literacy, Misoprostol Knowledge and Use of Medication Abortion in Lagos State, Nigeria: A Mixed Methods Study

Abstract

Little is known about the link between health literacy and women's ability to safely and successfully use misoprostol to self-induce an abortion. While abortion is only allowed to save a woman's life in Nigeria, misoprostol is widely available from drug sellers. We interviewed  women in  in Lagos State, Nigeria, who induced abortion using misoprostol obtained from a drug seller to determine their sexual and reproductive health literacy (SRHL) and misoprostol knowledge levels; and how these were associated with ending the pregnancy successfully or seeking care for (perceived) complications. Our results show that women's misoprostol knowledge (measured both quantitatively and qualitatively) was low, but that almost all women were nevertheless able to use the drug effectively and safely. Higher SRHL was associated with being more likely to end the pregnancy successfully and also seeking postabortion health care. Our study is the first to examine this association and adds to the scarce literature examining the relationship between health literacy and self-use of misoprostol to induce abortions in restrictive settings.

Sexual and reproductive health literacy among young people in Sub-Saharan Africa: evidence synthesis and implications

“…It empowers young people to seek, engage with, and use valid health information, or to make informed health decisions, and to work on and improve the factors that constitute their health chances [ 28 , 29 ]. Therefore, HL is a decisive issue that can help combat or mitigate SRH-related challenges among young people, especially in low-income countries, such as SSA, where there have been critical SRH problems like teenage pregnancy, life-threatening abortion, and STDs among adolescents [ 14 , 15 , 30–32 ].…”

Effectiveness of self-managed abortion during the COVID-19 pandemic: Results from a pooled analysis of two prospective, observational cohort studies in Nigeria

“…However, inequities exist in who is able to access safe versus unsafe methods of abortion [6,9]. As a result of limited access to clinical abortion care and a desire for privacy and autonomy, some Nigerians choose to obtain and use medication abortion pills (misoprostol alone, or in combination with mifepristone) to end their pregnancies on their own, without the support of a clinician [9][10][11][12][13][14]. This practice of ending a pregnancy on one's own is referred to as self-managed abortion [15].…”

“…Estimates suggest that more than half of the abortions in Nigeria each year are self-managed in a non-clinical setting [13]. A growing evidence base suggests that selfmanaged abortion is safe, effective, and high quality [15] including several recent studies in Nigeria [9][10][11][12][13][14][16][17][18]. Recognizing the need for safe, self-managed abortions, grassroots feminist organizations have formed over several decades to counsel people with information and support through a self-managed medication abortion at no cost.…”