Effect of socioeconomic inequalities and contextual factors on induced abortion in Ghana: A Bayesian multilevel analysis

• Published in: PloS one Vol. 15; no. 7; p. e0235917
• Main Authors: Nyarko, Samuel H, Potter, Lloyd
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.07.2020; Public Library of Science (PLoS)
• Subjects: Abortion; Abortion, Induced - statistics & numerical data; Adolescent; Adult; Age; Bayes Theorem; Bayesian analysis; Biology and Life Sciences; Demography; Economic aspects; Education; Educational Status; Female; Ghana - epidemiology; Health Surveys; Households; Humans; Insurance Coverage; Level (quantity); Levels; Logistic Models; Marital Status; Maternal & child health; Medicine and Health Sciences; Middle Aged; Multilevel; Parity; People and Places; Poverty; Pregnancy; Prevalence; Regression analysis; Social aspects; Social factors; Social Sciences; Socio-economic aspects; Socioeconomic data; Socioeconomic Factors; Socioeconomics; Studies; Variables; Womens health; Young Adult; Ghana; United States > US
• DOI: 10.1371/journal.pone.0235917
• ISSN: 1932-6203

There is a dearth of information on induced abortion in Ghana, possibly owing to the sensitive nature of the subject. In this study, we examine the effect of socioeconomic and contextual factors on induced abortion in Ghana. This study draws on data from the 2017 Ghana Maternal Health Survey. The study used a Bayesian multilevel logistic regression analysis to estimate both individual- and contextual-level factors affecting induced abortion levels in Ghana. The results show a total induced abortion prevalence of 19.6% coupled with considerable district-level disparities. Induced abortion is significantly associated with socioeconomic factors such as educational attainment, wealth status, and marital status at the individual-level. The risk of induced abortion is considerably higher among the educated, wealthy, and cohabiting women. The current age of women, age at first sex, religious affiliation, parity, and type of residence are the demographic factors having an association with induced abortion levels. At the contextual-level, district health insurance coverage and poverty rate have a significant association with induced abortion. Induced abortion appears to be prevalent in Ghana and is underpinned by both individual-level socioeconomic and aggregate-level factors. Addressing induced abortion levels in Ghana may require policies that take a multilevel approach by focusing on the socioeconomic status of women and district-level contextual factors.