The Incidence of Menstrual Regulation Procedures and Abortion in Bangladesh, 2014

Singh, Sanjiv; Hossain, Md. Amzad; Maddow‐Zimet, Isaac; Vlassoff,; Bhuiyan, M. Delower H.; Ingerick,

doi:10.1363/43e2417

Cited by 43 publications

(59 citation statements)

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“…At 47·0 abortions per 1000 women aged 15–49 years, the abortion rate in India is within the range of reported estimates of abortion incidence in three other south Asian countries (figure 3). 21,22,29 Additionally, our estimate of 3·4 million facility-based abortions in 2015 is nearly five times the number that was reported 4 to government sources in 2014–15 (701 415 abortions). The difference was expected because official data on abortion are known to be highly underreported.…”

Section: Discussionmentioning

confidence: 64%

“…First, for-profit sales were increased by 5% to account for IMS Health’s incomplete data coverage. Second, total medication abortions (for-profit and non-profit) were reduced: (1) by 10% to account for wastage on the basis of available data of drug wastage in general (data on medication abortion drug wastage are unavailable); 18,19 (2) by 5% of all facility-based abortions to avoid double counting women who attempted a medication abortion outside of a facility but eventually received a successful abortion within a facility, where they are already counted in the HFS; 20 and (3) by 72 000 medication abortions in states that have borders with Nepal (Puri M, Center for Research on Environment Health and Population Activities, personal communication) 21 and by 21 000 medication abortions in states that have borders with Bangladesh (A Hossain, Bangladesh Association for Prevention of Septic Abortion, personal communication) 22 to account for cross-border exports of medication abortion drugs to these countries.…”

Section: Methodsmentioning

confidence: 99%

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The incidence of abortion and unintended pregnancy in India, 2015

Singh

Shekhar

Acharya

et al. 2018

The Lancet Global Health

202

208

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Summary Background Reliable information on the incidence of induced abortion in India is lacking. Official statistics and national surveys provide incomplete coverage. Since the early 2000s, medication abortion has become increasingly available, improving the way women obtain abortions. The aim of this study was to estimate the national incidence of abortion and unintended pregnancy for 2015. Methods National abortion incidence was estimated through three separate components: abortions (medication and surgical) in facilities (including private sector, public sector, and non-governmental organisations [NGOs]); medication abortions outside facilities; and abortions outside of facilities and with methods other than medication abortion. Facility-based abortions were estimated from the 2015 Health Facilities Survey of 4001 public and private health facilities in six Indian states (Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu, and Uttar Pradesh) and from NGO clinic data. National medication abortion drug sales and distribution data were obtained from IMS Health and six principal NGOs (DKT International, Marie Stopes International, Population Services International, World Health Partners, Parivar Seva Santha, and Janani). We estimated the total number of abortions that are not medication abortions and are not obtained in a health facility setting through an indirect technique based on findings from community-based study findings in two states in 2009, with adjustments to account for the rapid increase in use of medication abortion since 2009. The total number of women of reproductive age and livebirth data were obtained from UN population data, and the proportion of births from unplanned pregnancies and data on contraceptive use and need were obtained from the 2015–16 National Family Health Survey-4. Findings We estimate that 15·6 million abortions (14·1 million–17·3 million) occurred in India in 2015. The abortion rate was 47·0 abortions (42·2–52·1) per 1000 women aged 15–49 years. 3·4 million abortions (22%) were obtained in health facilities, 11·5 million (73%) abortions were medication abortions done outside of health facilities, and 0·8 million (5%) abortions were done outside of health facilities using methods other than medication abortion. Overall, 12·7 million (81%) abortions were medication abortions, 2·2 million (14%) abortions were surgical, and 0·8 million (5%) abortions were done through other methods that were probably unsafe. We estimated 48·1 million pregnancies, a rate of 144·7 pregnancies per 1000 women aged 15–49 years, and a rate of 70·1 unintended pregnancies per 1000 women aged 15–49 years. Abortions accounted for one third of all pregnancies, and nearly half of pregnancies were unintended. Interpretation Health facilities can have a greater role in abortion service provision and provide quality care, including post-abortion contraception. Interventions are needed to expand access to abortion services through better equipping existing facilities, ensuring adequate and continuous suppl...

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Section: Discussionmentioning

confidence: 64%

Section: Methodsmentioning

confidence: 99%

The incidence of abortion and unintended pregnancy in India, 2015

Singh

Shekhar

Acharya

et al. 2018

The Lancet Global Health

202

208

View full text Add to dashboard Cite

show abstract

“…Pregnant women and women experiencing postpartum amenorrhea and who gave birth within 2 years prior to the survey are classified as having unmet need if they indicated that their current or recent pregnancy was unintended [8]. Women with unmet need fall into two groups: spacers and limiters [9]. …”

Section: Introductionmentioning

confidence: 99%

“…In six African countries, including Ethiopia about one-third of married women aged 15 to 49 years have an unmet need for a FP method [14]. About one in every three births is unintended in Ethiopia as consequence of unmet need [9]. These high levels of unintended pregnancies can pose serious health risks to mothers and their infants [15].…”

Section: Introductionmentioning

confidence: 99%

Unmet need for family planning and associated factors among currently married reproductive age women in Tiro Afeta District, South West Ethiopia, 2017: cross-sectional study

Tesfaye¹,

Nigatu

Gebrehiwot

et al. 2019

BMC Women's Health

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BackgroundUnmet need for family planning in Oromia region was very high (28.9%) compared to other regions in Ethiopia. To address problems associated with unmet need for family planning locally available evidences are essential, however, there were no clear evidences on unmet need for family planning in Tiro Afeta district. This study aims to assess the magnitude and associated factors of unmet need for family planning among currently married women in Tiro Afeta district, South West Ethiopia, 2017.MethodsCommunity based cross sectional study was conducted in April, 2017. A total of 348 currently married women of reproductive age were enrolled from eight villages selected by simple random sampling and using proportional to size allocation. Data were entered using EpiData 3.1 and analyzed by SPSS version 22. Adjusted odds ratios at 95% confidence interval with p-value of < 0.05 were considered as significant variables.ResultsUnmet need for family planning among currently married women in Tiro Afeta was 26.1%. Factors significantly associated with unmet need for family planning were: never use of family planning before survey (AOR: 5.09, 95% CI: 2.73–9.50); multiparity (AOR: 3.02, 95% CI: 1.56–5.85); perceived husband’s attitude as disapproval (AOR: 2.75, 95% CI: 1.43–5.26); lack of counseling from health workers (AOR: 2.07, 95% CI: 1.11–3.85); and unavailability of Radio and/or Television in the house (AOR: 2.05, 95% CI: 1.15–3.66).ConclusionUnmet need for family planning in Tiro Afeta was higher than national average but lower than Oromia region. Never use of family planning, women’s parity, husband’s attitude towards contraceptives, women counseling and unavailability of Radio and/or Television in the respondent’s home were significantly associated factors with unmet need for family planning. Therefore, the service providers and the district health office should strengthen counseling and partner involvement to reduce unmet need for family planning.

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“…The HFS needed to be expanded to obtain counts of legal abortions and PAC caseload, and the HPS needed to obtain additional information on the proportion obtaining abortions from approved or legal providers separately from the proportion obtaining abortions from non-approved or illegal providers. Researchers have used this adaptation to estimate the incidence of abortions in Nepal, Ethiopia and Bangladesh (Puri et al 2016;Moore et al 2016;Singh et al 2017). Estimating Abortion Incidence: Assessment of a Widely Used……”

Section: Mixed Legal Settingsmentioning

confidence: 99%

Estimating Abortion Incidence: Assessment of a Widely Used Indirect Method

Singh

Juárez

Prada³

et al. 2019

Popul Res Policy Rev

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Induced abortion is a reproductive behavior that remains difficult to measure in countries where the procedure is highly restricted by law. Additionally, in some countries where abortion is broadly legal, a high proportion of abortions are carried out by illegal and untrained providers. In these contexts, official statistics are non-existent or highly incomplete. Measurement of the incidence of induced abortion is essential to inform sexual and reproductive health policies and programs. Researchers have developed diverse methodologies over the years. Direct methods, such as population-based surveys that ask women about their abortion experience, generally are subject to high levels of underreporting. A range of indirect methods have been developed to obtain more accurate estimates. Created in the early 1990s, the Abortion Incidence Complications Method (AICM) is a widely applied indirect method that has produced robust estimates of abortion incidence in a range of contexts. This paper presents the original AICM methodology used in countries where abortion is highly restricted. It also highlights modifications made for two situations, one of which is newly emerging. First, the methodology has been adapted recently for countries where, despite the restrictive abortion laws, a new, relatively safe method-medication abortion (mainly misoprostol alone)-is increasingly used. Second, it has been adapted for countries where abortion is broadly legal but unsafe abortion remains common. The paper also assesses performance of the methodology to the extent available data permit. The paper provides guidance to researchers who want to conduct abortion incidence studies using the AICM and to further advance the measurement of abortion incidence.

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The Incidence of Menstrual Regulation Procedures and Abortion in Bangladesh, 2014

Abstract: Given declines in MR provision, more attention needs to be paid to building capacity, including hiring and training more providers of MR. Harm-reduction approaches should be pursued to increase the safety of clandestine use of misoprostol in Bangladesh.

Cited by 43 publications

References 0 publications

The incidence of abortion and unintended pregnancy in India, 2015

The incidence of abortion and unintended pregnancy in India, 2015

Unmet need for family planning and associated factors among currently married reproductive age women in Tiro Afeta District, South West Ethiopia, 2017: cross-sectional study

Estimating Abortion Incidence: Assessment of a Widely Used Indirect Method

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