By Lincoln G. Peters
Amid increased teenage and unwanted pregnancies across the country, Liberia is recording 38,779 induced abortion cases per year.
The Liberia National Abortion Study, which focuses on measuring abortion, magnitude of complication, cost and quality of post-abortion care released the report in Monrovia on Thursday, April 13, 2023, after two years of methodology abortion incidence and severity of related-complication study.
However, all data collection and study were done between September and March 2022.
The study used the Abortion Incidence and Complication Methodology (AICM) approach to estimate the induced abortion incidence and severity of complications.
According to the report titled evidence brief, data was collected, using three surveys, including the Health Facilities Survey (HFS), Knowledgeable Informant Survey (KIS) and the Prospective Morbidity Survey (PMS).
The launch was attended by health authorities, including county health officials.
The study was released jointly by the Clinton Health Access Initiative, the African Population and Health Research Center and Gutta Macher and presented to the Ministry of Health through Chief Medical Officer and Deputy Minister, Dr. Francis N. Kateh.
It details that 38,779 induced abortion cases occurred in Liberia, translating to an induced abortion rate of 30.7/1,000 women and girls (15-45 years) and induced abortion ratio of 229/1,000 live births, respectively.
“There were regional variations in the regional abortion rates, with North Central having the lowest abortion rates (6.6/1000) and South-Central having the highest 49.7/1000. Also, 14555 women received care for abortion-related complications in facilities. 67% went to public facilities and 74% went to primary level facilities’’, says the report.
However, with the findings, the study concludes that induced abortion is common in the country with most of the cases linked to unintended pregnancies.
It adds that most women go to health facilities with severe and near-miss complications that are life-threatening and can potentially result in death. Such complications tend to demand attendance by highly skilled providers such as physicians and gynecologists under long hospital admission.
“Liberia needs advanced legal and policy reforms that address the causes of unsafe abortion and unintended pregnancies, and provide an enabling environment for access to sexual and reproductive health services for all women”, the study recommends.
It further suggests expanding access to quality post-abortion care, including post-abortion contraception counseling and method provision at all health system levels, including strengthening capacity of lower-level health facilities and mid-level providers to ensure quality care.
The report stresses full dissemination and implementation of the Revised Public Health Law in all communities, health facilities, and policymakers as well as ensure community education and awareness on the danger of unsafe abortion, while considering existing legal status of abortion and current access point, like hospitals, stigma reduction, and awareness on a wild range of available family planning methods.
Receiving the Liberia National Abortion Study, Deputy Health Minister and Chief Medical Officer, Dr. Francis N. Kateh extolls the group for the initiative, promising to take the report to the Minister of Health to work with it.
“Today, I am excited that we have come to officially launch this initiative. This is a milestone achievement because it now gives Liberia a comprehensive data on abortion. Despite this being long overdue, but we can say now that we have recorded,” Dr. Kateh notes.
He says Liberia has been grappling with the lack of scientific abortion records because it’s illegal, so most abortions are done at home but adds that with the findings, it will help the Ministry and partners to plan properly.
Clinton Health Access Initiative country director (CHAI) Dr. Moses Massaquoi, defines unsafe abortion as the procedure for terming a pregnancy that is performed by persons lacking the necessary skills or in an environment, not in conformity with minimal medical standards or both.
According to him, unsafe abortion is among top causes of maternal illnesses and deaths, and that treatment of abortion complications drains significant health system resources.
Dr. Massaquoi explains there is limited scientific information available on the context in which women seek unsafe abortion, magnitude of the unsafe abortion problem and resulting complications from such practice.
“This evidence brief summarizes the findings of a 2021 nationwide abortion study in Liberia that aims to estimate the incidence and severity of related complications. The study used the Abortion Incidence and Complication Methodology (AICM) approach to estimate the induced abortion incidence and severity of complications”, the CHAI country director adds. Editing by Jonathan Browne