Abortion: perception and behaviour of adolescents in two districts in Kenya
Rogo Khama O.
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This study, done between July 1995 and June 1996, was to determine the adolescents' perceptions and behaviour regarding induced abortion and its risks. It was a descriptive cross-sectional study. Adolescents aged 10-19 years, from schools in Kiambu and Nairobi districts, were interviewed. A multi-stage random sampling procedure was used in the selection of the adolescents. A second group of adolescents from two hospitals and two clinics in Nairobi were interviewed in the immediate post-abortion period. Both groups were subjected to a self-administered, anonymous questionnaire. Demographic and health data, as well as perceptions and behaviour regarding induced abortion, was collected. Focus group discussions with adolescents in schools were conducted to gather complimentary data. A total of 1820 adolescents (1048 school girls, 580 school boys and 192 postabortion girls) were interviewed. More than 90010 of the adolescents were aware of induced abortion. The most important reported source of this information was the media, followed by friends and teachers. Knowledge of induced abortion correlated -positively with the level of education (p<0.01). Seventy one percent (71%), 84%, and 50% of the .school girls, post-abortion girls and school boys respectively, were aware of abortion-related complications. The most common reported complications were infections, death and infertility. Those who (whose girlfriends) had abortion encounter showed significantly higher levels of awareness of other girls with abortionrelated health problems than the others (p<0.01). The findings further reveal that 3.4%, 9.3% and 100% of the school girls, school boys' girlfriends and post-abortion girls respectively, had an abortion prior to the interview. Repeat abortions were common. Non-medical people (including self) were abortionists for a large number of adolescents. About 27%, 45% and 16% of the school girls, school boys' girlfriends and post-abortion girls respectively, developed health problems, some quite severe, due to. abortion. Direct and indirect costs of abortion and its complications were heavy on the girls. Most of the post-abortion girls (83%) and a quarter of the school adolescents felt that abortion complications were preventable through seeking abortionservices from a qualified doctor. Although the -majority of the adolescents (56%, 69% and 12:% of the-post-abortion girls, school boys and school girls respectively) felt that abortion ,was preventable, less than 40% proposed abstinence from sex as a primary strategy. Inspite of the high levels of awareness about abortion and its risks, many of the adolescents would procure it or recommend it for their peers. There is therefore need for information, education and communication to adolescents on fertility matters including abortion, as well as formulation and implementation of dedicated, adolescent-friendly reproductive health programmes, and advocacy for policy guidelines and policy change to address issues of abortion as a priority adolescent reproductive health concern in Kenya.