Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approach
Abstract Background Abortion is one of the leading causes of maternal death in developing countries, particularly in sub-Saharan Africa (sSA,). In this region, abortion is responsible for 38,000 maternal deaths, making the area with the highest rate of abortion-related mortality in the world. This s...
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2025-06-01
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| Online Access: | https://doi.org/10.1186/s13690-025-01656-7 |
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| author | Setegn Muche Fenta Haile Mekonnen Fenta Seyifemickael Amare Yilema Maru Mekie Denekew Bitew Belay Amsalu Worku Mekonin Ding-Geng Chen |
| author_facet | Setegn Muche Fenta Haile Mekonnen Fenta Seyifemickael Amare Yilema Maru Mekie Denekew Bitew Belay Amsalu Worku Mekonin Ding-Geng Chen |
| author_sort | Setegn Muche Fenta |
| collection | DOAJ |
| description | Abstract Background Abortion is one of the leading causes of maternal death in developing countries, particularly in sub-Saharan Africa (sSA,). In this region, abortion is responsible for 38,000 maternal deaths, making the area with the highest rate of abortion-related mortality in the world. This study aimed to examine the prevalence and associated factors of induced abortion in 33 countries in the region. Method We used data from the most current Demographic and Health Surveys (DHS) conducted in 33 sSA countries between 2012 and 2022. A total 367,881 of women were included in the analysis. The Bayesian multilevel logistic regression model was used to determine the factors associated to induced abortion because of the hierarchical nature of the DHS data. Results The overall prevalence of induced abortion was 16.50% in sSA. The random effects model revealed that about 75% of the variation in the induced abortion was caused by community and individual-level factors. Based on the Bayesian multilevel logistic regression model, women who smoke cigarettes(AOR = 1.044; 95%CI: 1.020, 1.070), 24-month and above birth interval(AOR = 5.747; 95%CI: 5.595, 5.889), rich women(AOR = 1.470, 95%CI: 1.436, 1.510), secondary and above-educated women (AOR = 2.640, 95%CI: 2.567, 2.707), being exposed to the media (AOR = 1.099, 95%CI: 1.083, 1.115), rural women (AOR = 1.025, 95%CI: 1.004, 1.047) and having pregnancy complications (AOR = 1.095, 95%CI: 1.067, 1.124) were associated with higher odds of induced abortion. But, the odds of an induced abortion were lower for women 35–49 years of age(AOR = 0.019, 95% CI: 0.018, 0.019), having 2–3 birth history(AOR = 0.105, 95%CI: 0.102, 0.107), having family size of 4–6 (AOR = 0.747; 95%CI: 0.735, 0.760), using contraception (AOR = 0.747; 95%CI: 0.735, 0.760), being married (AOR = 0.642; 95%CI: 0.628, 0.654), and being a working woman(AOR = 0.673; 95%CI: 0.658, 0.687). Conclusion The prevalence of induced abortion was high in the sSA countries with a significant country-specific variations. Therefore, public health programs shall focus on sexual and reproductive health education for young women, rural women, unmarried women, and rich women, in order to address this problem. Furthermore, it is crucial to formulate policies and initiatives that consider regional disparities in the prevalence of induced abortion and to actively pursue their implementation. |
| format | Article |
| id | doaj-art-c19f02568cf543f8a1f8a6c819f23f0c |
| institution | Kabale University |
| issn | 2049-3258 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | Archives of Public Health |
| spelling | doaj-art-c19f02568cf543f8a1f8a6c819f23f0c2025-08-20T03:47:24ZengBMCArchives of Public Health2049-32582025-06-0183111310.1186/s13690-025-01656-7Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approachSetegn Muche Fenta0Haile Mekonnen Fenta1Seyifemickael Amare Yilema2Maru Mekie3Denekew Bitew Belay4Amsalu Worku Mekonin5Ding-Geng Chen6Department of Statistics, College of Natural and Computational Sciences, Debre Tabor UniversityCenter for Environmental and Respiratory Health Research, Population Health, University of OuluDepartment of Statistics, College of Natural and Computational Sciences, Debre Tabor UniversityDepartment of Midwifery, College of Health Sciences, Debre Tabor UniversityCenter for Environmental and Respiratory Health Research, Population Health, University of OuluDepartment of Obstetric and Gynecology, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Statistics, University of PretoriaAbstract Background Abortion is one of the leading causes of maternal death in developing countries, particularly in sub-Saharan Africa (sSA,). In this region, abortion is responsible for 38,000 maternal deaths, making the area with the highest rate of abortion-related mortality in the world. This study aimed to examine the prevalence and associated factors of induced abortion in 33 countries in the region. Method We used data from the most current Demographic and Health Surveys (DHS) conducted in 33 sSA countries between 2012 and 2022. A total 367,881 of women were included in the analysis. The Bayesian multilevel logistic regression model was used to determine the factors associated to induced abortion because of the hierarchical nature of the DHS data. Results The overall prevalence of induced abortion was 16.50% in sSA. The random effects model revealed that about 75% of the variation in the induced abortion was caused by community and individual-level factors. Based on the Bayesian multilevel logistic regression model, women who smoke cigarettes(AOR = 1.044; 95%CI: 1.020, 1.070), 24-month and above birth interval(AOR = 5.747; 95%CI: 5.595, 5.889), rich women(AOR = 1.470, 95%CI: 1.436, 1.510), secondary and above-educated women (AOR = 2.640, 95%CI: 2.567, 2.707), being exposed to the media (AOR = 1.099, 95%CI: 1.083, 1.115), rural women (AOR = 1.025, 95%CI: 1.004, 1.047) and having pregnancy complications (AOR = 1.095, 95%CI: 1.067, 1.124) were associated with higher odds of induced abortion. But, the odds of an induced abortion were lower for women 35–49 years of age(AOR = 0.019, 95% CI: 0.018, 0.019), having 2–3 birth history(AOR = 0.105, 95%CI: 0.102, 0.107), having family size of 4–6 (AOR = 0.747; 95%CI: 0.735, 0.760), using contraception (AOR = 0.747; 95%CI: 0.735, 0.760), being married (AOR = 0.642; 95%CI: 0.628, 0.654), and being a working woman(AOR = 0.673; 95%CI: 0.658, 0.687). Conclusion The prevalence of induced abortion was high in the sSA countries with a significant country-specific variations. Therefore, public health programs shall focus on sexual and reproductive health education for young women, rural women, unmarried women, and rich women, in order to address this problem. Furthermore, it is crucial to formulate policies and initiatives that consider regional disparities in the prevalence of induced abortion and to actively pursue their implementation.https://doi.org/10.1186/s13690-025-01656-7Induced abortionSub-Saharan AfricaDemographic and Health SurveyBayesian multilevel model |
| spellingShingle | Setegn Muche Fenta Haile Mekonnen Fenta Seyifemickael Amare Yilema Maru Mekie Denekew Bitew Belay Amsalu Worku Mekonin Ding-Geng Chen Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approach Archives of Public Health Induced abortion Sub-Saharan Africa Demographic and Health Survey Bayesian multilevel model |
| title | Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approach |
| title_full | Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approach |
| title_fullStr | Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approach |
| title_full_unstemmed | Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approach |
| title_short | Pooled prevalence of induced abortion and associated factors among reproductive age women in sub-Saharan Africa: a Bayesian multilevel approach |
| title_sort | pooled prevalence of induced abortion and associated factors among reproductive age women in sub saharan africa a bayesian multilevel approach |
| topic | Induced abortion Sub-Saharan Africa Demographic and Health Survey Bayesian multilevel model |
| url | https://doi.org/10.1186/s13690-025-01656-7 |
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