(2015) Health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia

Subtitle: A systematic literature review of qualitative and quantitative data

Ulrika Rehnström Loi, Kristina Gemzell-Danielsson, Elisabeth Faxelid, and Marie Klingberg-Allvin
BMC Public Health (2015) 15:139
DOI 10.1186/s12889-015-1502-2

Partial Abstract:

Background: Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim of this study was to identify, summarise and synthesise available research addressing health care providers’ perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia.

Conclusions: Health care providers in sub-Saharan Africa and Southeast Asia have moral-, social- and gender-based reservations about induced abortion. These reservations influence attitudes towards induced abortions and subsequently affect the relationship between the health care provider and the pregnant woman who wishes to have an abortion. A values clarification exercise among abortion care providers is needed.

Relevant Excerpt:

Access to safe, legal induced abortion, postabortion care (which occurs after an unsafe abortion) and family planning is fundamental to reduce maternal mortality and morbidity related to unsafe abortions [64,65]. The conservative attitudes towards induced abortions among health care providers in sub-Saharan Africa and Southeast Asia might also affect access to post-abortion care and, consequently, post-abortion contraceptive counselling.

It is essential to highlight that the majority of the studies included in this review were conducted in South Africa, where it is known that many health care providers are conscientious objectors to the provision of safe abortions [17,66]. The refusal to assist in abortion services is frequently based on moral, religious, ethical or philosophical beliefs. As reported elsewhere, such conscientious objections to abortion provision are an abuse of women’s rights and potentially harmful to women’s health [67]. A recent study from Ghana indicates that a favourable attitude toward abortion among health care providers’ is not associated with safe abortion provision. On the other hand, it was noticed that the odds of providing safe abortions lowers by 57 percent when the health care provider is Catholic in comparison to other religions. Furthermore, the same study found that providers’ confidence in their capability to offer safe abortion is fundamental [68].

Source: BMC Public Health