Community perception of abortion, women who abort and abortifacients in Kisumu and Nairobi counties, Kenya

PLoS One. 2019 Dec 12;14(12):e0226120. doi: 10.1371/journal.pone.0226120. eCollection 2019.

Abstract

Background: Abortion draws varied emotions based on individual and societal beliefs. Often, women known to have sought or those seeking abortion services experience stigma and social exclusion within their communities. Understanding community perception of abortion is critical in informing the design and delivery of interventions that reduce the gaps in access to safe abortion for women.

Objective: We explored community perceptions and beliefs relating to abortion, clients of abortion services, and abortifacients in Kenya.

Methods: We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) in Kisumu and Nairobi counties in Kenya among a mix of adult men and women, pharmacists, nurses, and community health volunteers.

Results: Community perspectives around abortion were heterogeneous, reflecting a myriad of opinions ranging from total anti-abortion to more pro-choice positions, and with rural-urban differences. Notably, negative views on abortion became more nuanced and tempered, especially among young women in urban areas, as details of factors that motivate women to seek abortion became apparent. Participants were mostly aware of the pathways through which women and girls access abortion services. Whereas abortion is commonplace, multiple structural and socioeconomic barriers, as well as stigma, are prevalent, thus impeding access to safe and quality services.

Conclusion: Community perceptions on abortion are heterogeneous, varying by gender, occupation, level of education, residence, and position in society. Stigma and the hostile abortion environment limit access to safe abortion services, with several negative consequences. There is urgent need to strengthen community-based approaches to mitigate predisposing and enabling factors for unsafe abortions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortifacient Agents / supply & distribution
  • Abortifacient Agents / therapeutic use*
  • Abortion, Induced / psychology*
  • Abortion, Induced / statistics & numerical data
  • Adult
  • Attitude of Health Personnel
  • Cross-Sectional Studies
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Kenya / epidemiology
  • Perception / physiology*
  • Pregnancy
  • Residence Characteristics
  • Rural Population / statistics & numerical data
  • Social Stigma*
  • Surveys and Questionnaires
  • Urban Population / statistics & numerical data
  • Young Adult

Substances

  • Abortifacient Agents

Grants and funding

This work was supported by the Hewlett and Packard Foundation under Grant number 2015: 3063 to the African Population and Health Research Center (APHRC), https://hewlett.org/. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.