Perceived health facility-related barriers and post-abortion care-seeking intention among women of reproductive age in Osun state, Nigeria

Tosin Olajide Oni; Stephen Ayo Adebowale; Anuoluwapo Adeyimika Afolabi; Akanni Ibukun Akinyemi; Olufunmilayo Olufunmilola Banjo

doi:10.1186/s12905-023-02464-3

Perceived health facility-related barriers and post-abortion care-seeking intention among women of reproductive age in Osun state, Nigeria

BMC Womens Health. 2023 Jun 16;23(1):311. doi: 10.1186/s12905-023-02464-3.

Authors

Tosin Olajide Oni¹, Stephen Ayo Adebowale^{2

3}, Anuoluwapo Adeyimika Afolabi⁴, Akanni Ibukun Akinyemi⁵, Olufunmilayo Olufunmilola Banjo⁵

Affiliations

¹ Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria. tosinooni@gmail.com.
² Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria.
³ Population and Health Research Entity, North-West University, Mafikeng, South Africa.
⁴ Department of Community Medicine, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
⁵ Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.

Abstract

Background: Post-abortion care (PAC) prevents death and complications caused by unsafe abortion which is widespread in Nigeria. Yet, there is sparse community-based evidence on women's intention to seek PAC should they have an abortion. This study examined the influence of perceived health facility-related barriers (HFRB) on post-abortion care-seeking intention (PACSI) among women of reproductive ages in Osun state, Nigeria.

Methods: The study focused on women in a sexual relationship and who were residents of Osun state. A community-based survey was implemented using a multi-stage sampling technique. The calculated sample size (with attrition) was 1200 and data were collected from women aged 15-49 years, using open data kit (ODK). However, 1,065 complete responses were received on the ODK server, indicating an 88.8% response rate. Models were estimated using ordered logistic regression (Ologit) (α_0.05) and data analysis was performed using Stata 14.0.

Results: Mean age of the women was 29.3±7.6 years and 34.01% had the intention to seek PAC in health facilities. Lack of service confidentiality and unavailability of equipment specific to abortion were the two most reported barriers that would prevent women from seeking PAC. The adjusted Ologit model showed that respondents with perceived low HFRB had higher odds (aOR=1.60; CI=1.12-2.11) of seeking PAC in the health facility. Also, women who were employed and skilled were more likely (aOR=1.51; CI=1.13-2.01) while women who had PAC support from spouses/partners had higher odds of healthy PACSI (aOR=2.03; CI=1.48-2.78). Other identified predictors of PAC seeking intention included level of education, employment status, and spousal/partner support.

Conclusion: Perceived lack of trust in service provision and necessary equipment specific to abortion care had a negative influence on women's PACSI in Osun state. Reassuring health interventions that focus on improving the public perception of healthcare services and confidence to use the facility will likely improve the patronage of health facility for post-abortion care in Osun sate.

Keywords: Care-seeking intention; Health facility barriers; Nigeria; Osun state; Post-abortion care.

MeSH terms

Abortion, Induced*
Adult
Attitude of Health Personnel
Confidentiality
Female
Health Facilities
Health Services Accessibility
Humans
Intention*
Nigeria
Patient Acceptance of Health Care
Pregnancy
Young Adult