UNSAFE ABORTION

73 Pages·2014·2.53 MB·English

UNSAFE ABORTION; KNOWLEDGE AND PERCEPTIONS
AMONG IN - SCHOOL FEMALE ADOLESCENTS IN KAPIRI
MPOSHI

KALUBA LOMBE
(Computer #512806960)

A DISSERTATION SUBMITTED IN PARTIAL FULFILMENT OF THE
REQUIREMENTS FOR THE DEGREE OF MASTER OF PUBLIC HEALTH

THE UNIVERSITY OF ZAMBIA

SCHOOL OF MEDICINE

2014
ABSTRACT

This study aimed to investigate unsafe abortion, which is more prevalent in most third world
countries and contributes significantly to maternal morbidity and mortality. Majority of patients
treated for induced abortion are adolescents, yet their knowledge and perceptions on unsafe abortion
are understudied. A cross sectional descriptive and explorative study with a mixed method
approach was carried out among school girls aged 15 to 19 years in Kapiri Mposhi , Central
province of Zambia. The study aimed to assess schoolgirls’ knowledge on unsafe abortion and also
their perceptions on induced abortion. A sample of 340 schoolgirls was subjected to a pre-tested
self-administered questionnaire that captured data on knowledge on unsafe abortion and perceptions
on induced abortion. For triangulation purposes, 16 schoolgirls were purposively selected to
participate in two sessions of focus group discussions. Pearsons’ chi-square test was used to
determine association between independent and dependent variables. Nvivo version 10 was used to
assist the researcher in sorting and organising the qualitative data.
Mean age of respondents was 16.6 years and at the time of the study 35% of the respondents
had experienced their sexual debut. Out of these, 36.1% had ever been pregnant. Less than half
(41.9%) of the adolescents that had been pregnant before reported having aborted. All the abortions
were induced using methods that were ineffective and unsafe. The majority of respondents (92%)
had negative perceptions towards abortion and 50.6% of the respondents had good knowledge on
unsafe abortion. Factors associated with perceptions on abortion were age (P value>0.00) and ever
had sex (p- value 0.02). Knowledge on unsafe abortion was associated with age (p-value 0.00), ever
had sex (p- value 0.04) and ever used family planning (p-value 0.02). Qualitative findings showed
that majority of the participants did not support abortion based on moral grounds.
In order to increase adolescent girls’ knowledge on unsafe abortion and its related
consequences, there is need for comprehensive sexuality and reproductive health education focusing
on dangers of early pregnancy, unsafe abortion. Youth friendly medical services attending to their
reproductive health needs should be made available, affordable and accessible.

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DECLARATION

I Kaluba Lombe, declare that this dissertation is my own original work and that it has not been
submitted and will not be presented to any other university for a similar or any other degree award.

Signature…………………………… Date………………………………

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COPYRIGHT
©2014
All rights reserved. No part of this dissertation may be produced or transmitted in any
manner without permission in writing from the researcher or the University of Zambia.

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DEDICATION

To God who is my strength
To my mother Matilda Kasumpa Lombe, my siblings Kabaso, Kateule, Lombe, Sampa and
Chileshe. Lastly I dedicate this dissertation to the living memory of my late father
Emmanuel Chota Lombe,

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CERTIFICATE OF COMPLETION OF DISSERTATION

The undersigned certify that they have read this dissertation and are satisfied that this is the
original work of the author under whose name it is being presented.

…...…………………………… ………………………………….
Dr. Rosemary Likwa Mrs Doreen Sitali
(Principal Supervisor) (Co- Supervisor)

Head of department: ..............................................
Date: .............................................
Department: .............................................

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CERITIFCATE OF APPROVAL
The University of Zambia approves this dissertation of Kaluba Lombe in partial fulfilment
of the requirements for the award of the degree in Master of Public Health – Health
Promotion.

Examiners’ signatures Date

Examiner 1 ............................................. ...................

Examiner 2 ............................................. ...................

Examiner 3 ............................................... ....................

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ACKNOWLEDGEMENTS
This research would not have been possible without the help of several people who in one way
or another played a great role.
 First and foremost I wish to thank the Ministry of Community Development Mother and
Child Health for sponsoring my research

 Special thanks also go to my supervisors Dr Rosemary Likwa and Mrs Doreen Sitali for
their invaluable feedback, mentoring and support.

 The Ministry of Education for allowing me to carry out the research in Kapiri Mposhi.

 I also wish to thank Dr. Charles Mwinuna and the entire Kapiri Mposhi District Health
Management team for their moral support during the research.

 My mother for being a role model and raising me into a strong woman.

May The Almighty God bless you all.

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TABLE OF CONTENTS
ABSTRACT.………………………………………………………………………………..i
DECLARATION……………………………………………………………………………ii
COPYRIGHT………………………………………………………………………………..iii
DEDICATION ……………………………………………………………………………...iv
CERTIFICATE OF COMPLETION ……………………………………………………….v
CERTIFICATE OF APPROVAL …………………………………………………………..vi
ACKNOWLEDGMENTS …………………………………………………………………..vii
List of Abbreviations ……………………………………………………………………….x
Operational Definitions………………………………………………………………………xi
List of Tables ………………………………………………………………………………xii
List of Figures………………………………………………………………………………xiii
List of Annexes …………………………………………………………………………… xiii

CHAPTER ONE - INTRODUCTION
1.1 Background ………………………………………….......................................................14
1.2 Problem Statement ………………………………………................................................15
1.3 Rationale. .…………………………………………….....................................................16
1.4 Significance …………………………………………......................................................17
1.5 Objectives ………………………………………….........................................................17

CHAPTER TWO - LITERATURE REVIEW
2.1 Reasons why a pregnancy may be unwanted among adolescents....................................18
2.2 Consequences of Unsafe Abortion...................................................................................18

2.3 Review of Previous Studies on Adolescents and Unsafe Abortion .................................19
CHAPTER THREE - METHODOLOGY
3.1 Study Setting ……………………………………………................................................23
3.2 Study Population ………………………………………..................................................24
3.3 Study Design …………………………………………………........................................24
3.4 Variables ……………………………………………………..........................................24
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3.5 Sample Size Estimation ……………………………………….......................................25
3.6 Sampling Procedure ………………………………………….........................................26
3.7 Data Collection Tools ………………………………………..........................................26
3.8 Inclusion Criteria …………………………………………….........................................26
3.9 Exclusion Criteria ……………………………………………........................................26
3.10. Procedure for Data Collection ……………………......................................................27
3.11. Pre-testing …………………………………………….................................................27
3.12. Data Analysis …………………………………………................................................28
3.13 Disposal Plan …………………………………………….............................................28
3.14 Ethical Considerations ……………………………………...........................................28

CHAPTER FOUR - RESULTS
4.1 Quantitative Data…………………………………………..............................................30
4.3 Qualitative Data…………………………………………................................................42

CHAPTER FIVE - DISCUSSION
5.1 Discussion of Study Findings .........................................................................................46
5.2 Limitations ……………………………………………..................................................48

CHAPTER SIX – CONCLUSIONS AND RECCOMENDATIONS
6.1 Conclusions ……………………………………………..................................................49
5.5 Recommendations ……………………………………....................................................49

Bibliography…………………………………………………………...................................51

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