Women’s Awareness of Liberalization of Abortion Law and Knowledge of Place for Obtaining Services in Nepal

Abstract

In Nepal, following the liberalization of the abortion law, expansion and scaling up of services proceeded in parallel with efforts to create awareness of the legalization status of abortion and provide women with information about where services are available. This article assesses the effectiveness of these programmatic interventions in the early years of the country's abortion program. Data from a 2006 national survey are analyzed with 2 outcome measures-awareness of the legal status of abortion and knowledge of places to obtain abortion services among women ages 15 to 44 years. The variations in the outcomes are analyzed by ecological-development subregion, residence, education, household wealth quintile, age, and number of living children. Bivariate and multivariate logistic regression techniques are used. Overall 32.3% (95% confidence interval = 31.4% to 33.2%) of the respondents were aware of the legal status of abortion and 56.5% (95% confidence interval = 55.5% to 57.4%) knew of a place where they could obtain an abortion. Both outcome measures showed considerable variations by the covariates. Women with secondary or higher level of education had the highest odds ratio of being aware of the law and having knowledge of a source for abortion services. Ecological-development subregions showed the second highest levels of odds ratios. Significant disparities among the population subgroups existed in the diffusion of awareness of the legal status of abortion and having knowledge of a place for abortion services in Nepal. The results point to which population subgroups to focus on and also serve as a baseline for assessing future progress in the diffusion process.

Women’s Awareness and Knowledge of Abortion Laws: A Systematic Review

“…Sampling strategies and questions posed to participants to determine awareness/knowledge showed considerable variation across studies. Four of the studies are nationally based samples [ 16 , 22 , 25 , 26 ], and five are sub-national population samples of women [ 10 , 11 , 13 , 17 , 31 ]. For 10 of the studies, the study sample was taken from a health facility setting (hospital or clinic) [ 7 , 8 , 18 , 20 , 21 , 23 , 24 , 27 , 29 , 30 ].…”

“…In terms of setting, 11 studies were carried out in urban settings [ 7 – 9 , 12 , 14 , 18 – 20 , 27 , 28 , 30 ], 11 in mixed urban/rural locations [ 13 , 15 – 17 , 21 – 26 , 29 ], and only 2 studies were based entirely in rural areas [ 10 , 11 ]. Two of the studies used data from a Demographic and Health Survey (DHS) and a Maternal Health Survey [ 16 , 22 ] and two were secondary data analyses using the DHS [ 25 , 26 ].…”

“…These studies conducted 4 to 8 years after legalization, measured the percentage of women who correctly knew the change in legal status ( Fig 4 ). In South Africa, Nepal, and Ethiopia, where the laws were changed in 1996, 2002, and 2005 respectively, it appears knowledge of the legalization/liberalisation is relatively low, ranging between 32.3% to 68.2% [ 9 , 15 , 23 , 25 , 29 , 31 ]. The proportion of women with correct awareness and knowledge of the law change in Ethiopia reported in three studies conducted 5 to7 years after the legal reform showed no major difference ranging from 35.7–57.2% [ 9 , 15 , 31 ].…”

“…While most of the studies were small and many were facility based and non-representative samples, it was encouraging to see national level data on this included in the Demographic Health Surveys or Maternal Health Surveys in three countries—Nepal in 2006 and 2011, South Africa in 1998 and Ghana in 2009 [ 22 , 25 , 26 ]. There is a greater need for abortion related national level representative data to be collected.…”

Abortion Law awareness and Abortion Services Utilization among reproductive age women of Inarwa municipality of Eastern Nepal

“…In total, 375 of 391 respondents who were eligible participated in this study: reasons for non-participation were that women were not healthy to participate (n=6), women were busy with household chores (n=8) and women refused (n=2). Sample size calculation was based on the reference taken by study done by Thapa S and Sharma SK 16 where 32% of women were aware about the legalization of abortion law using single proportion…”