Community Health

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    Abortion statistics in Zambia: ‘implications for unsafe abortion, reproductive health programming, policy and research approaches’.
    (Zambia medical journal, 2010) Likwa, Ndonyo, Rosemary; Biddlecom, Ann; Ball, Haley
    Zambia has a liberal abortion law for termination of pregnancy on medical and social grounds for over three decades. Yet, it still faces serious consequences of increased morbidity and mortality associated with unsafe abortion. The extent of its national incidence remains unknown. There are substantial differences evident between legal abortions and illegal (unsafe) abortions demonstrating gaps in under reporting of abortion incidence which may require further estimation. Compiling Zambian abortion statistics as “research in brief” was essentially needed to provide direction to national abortion incidence measurements in Zambia, more strengthening of reproductive health services, possible review of policies and seek opportunities for further research approaches for understanding the magnitude of abortion problem and the means to prevent unsafe abortion occurrences. Thus contributing to reduction in abortion related morbidity and mortality in the country. An explorative descriptive survey was carried out in five (5) major hospitals to collect abortion statistics using a checklist tool for record review by the principal investigator with the assistance of five Ministry of Health professionals designated in these hospitals. Analysis employed aggregation compilation of annual abortion statistics collected from three (3) major tertiary hospitals and two (2) general hospitals for a period of nine years, 2000-2008 in five urban districts of four (4) provinces of Zambia. Analysis further involved application of descriptive statistics and significant tests, trend analysis and incidence rates A total number of 115886 abortions collected from five major hospitals in four provinces of Zambia over a period of nine (9) years, 2000-2008, show a varied distribution of 616 (0.5 %) for safe induced abortion, legally terminated pregnancy cases and 66687 (57.5%) abortion admissions with complications. Out of this figure, 474885 cases received post abortion care involving manual vacuum aspiration procedure (MVA) translating to over 70 percent of abortion complications had MVAs which reflect the extent of unsafe abortion exposure to Zambian women. Abortion morbidity and consequences of mortality are high and increasing in trend giving six per thousand women die of abortion complications, most likely due to unsafe, induced abortion. Access to safe induced abortion in major hospitals is quite low, yet Zambia has a liberal law for a termination of pregnancy on health and social grounds. IMPICATIONS: Abortion statistics show their relevancy for developing research priorities, policy review, reproductive health services to intensify abortion advocacy on its consequences, access to safe abortion care and contraception to prevent unwanted pregnancy. KEY WORD (S): Abortion statistics/ unsafe abortion/ abortion complications/ mortality/ post abortion care/ legal abortion/law/Zambia
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    Abortion statistics in Zambia: ‘implications for unsafe abortion, reproductive health programming, policy and research approcahes’.
    (Zambia medical journal, 2010) Likwa, Ndonyo, Rosemary
    Zambia has a liberal abortion law for termination of pregnancy on medical and social grounds for over three decades. Yet, it still faces serious consequences of increased morbidity and mortality associated with unsafe abortion. The extent of its national incidence remains unknown. There are substantial differences evident between legal abortions and illegal (unsafe) abortions demonstrating gaps in under reporting of abortion incidence which may require further estimation. Compiling Zambian abortion statistics as “research in brief” was essentially needed to provide direction to national abortion incidence measurements in Zambia, more strengthening of reproductive health services, possible review of policies and seek opportunities for further research approaches for understanding the magnitude of abortion problem and the means to prevent unsafe abortion occurrences. Thus contributing to reduction in abortion related morbidity and mortality in the country. An explorative descriptive survey was carried out in five (5) major hospitals to collect abortion statistics using a checklist tool for record review by the principal investigator with the assistance of five Ministry of Health professionals designated in these hospitals. Analysis employed aggregation compilation of annual abortion statistics collected from three (3) major tertiary hospitals and two (2) general hospitals for a period of nine years, 2000-2008 in five urban districts of four (4) provinces of Zambia. Analysis further involved application of descriptive statistics and significant tests, trend analysis and incidence rates A total number of 115886 abortions collected from five major hospitals in four provinces of Zambia over a period of nine (9) years, 2000-2008, show a varied distribution of 616 (0.5 %) for safe induced abortion, legally terminated pregnancy cases and 66687 (57.5%) abortion admissions with complications. Out of this figure, 474885 cases received post abortion care involving manual vacuum aspiration procedure (MVA) translating to over 70 percent of abortion complications had MVAs which reflect the extent of unsafe abortion exposure to Zambian women. Abortion morbidity and consequences of mortality are high and increasing in trend giving six per thousand women die of abortion complications, most likely due to unsafe, induced abortion. Access to safe induced abortion in major hospitals is quite low, yet Zambia has a liberal law for a termination of pregnancy on health and social grounds. IMPICATIONS: Abortion statistics show their relevancy for developing research priorities, policy review, reproductive health services to intensify abortion advocacy on its consequences, access to safe abortion care and contraception to prevent unwanted pregnancy. KEY WORD (S): Abortion statistics/ unsafe abortion/ abortion complications/ mortality/ post abortion care/ legal abortion/law/Zambia