Determinants of abortion among women of reproductive age in Ghana: multilevel analysis evidence from the 2022 Ghana demographic and health survey

Abstract

INTRODUCTION: Due to data gaps in most countries, the factors that affect the prevalence of abortion among women from a variety of social and economic backgrounds, especially in Africa, are little understood. We investigated abortion and its determinants among women of reproductive age in this study with the aim of providing policymakers in Ghana specific information. METHODS: After obtaining authorization to analyze data on abortion among women of reproductive age, we looked at the data from the Ghana demographic health survey 2022 that we obtained from the DHS website. We used binary logistic regression, both bivariate and multilevel. A three-level binary logistic regression analysis was performed on community and individual-level abortion predictors, using p-values less than 0.05 and adjusted odds ratios (AOR) with 95% confidence intervals (CI). RESULTS: In the current study, the prevalence of abortion was 39.84%. Factors associated with abortion were age group 20-24 (AOR = 1.65, 95%CI = 1.05-2.61), 25-29 (AOR = 2.55, 95%CI = 1.60-4.08), 30-34 (AOR = 2.97, 95%CI = 1.54-4.81), 35-39 (AOR = 2.54, 95%CI = 1.54-4.17), 40-44 (AOR = 4.73, 95%CI = 2.74-8.15), 45-49 (AOR = 4.73, 95%CI = 2.21-9.45), married women (AOR = 1.48, 95%CI = 1.07-2.04), women living with their partner (AOR = 1.42, 95%CI = 1.02-1.98), intention to use contraceptives (AOR = 0.73, 95%CI = 0.61-0.88), smokers (AOR = 0.05, 95%CI = 0.06-0.43), Northern region (AOR = 0.50, 95%CI = 0.26-0.96), North East region (AOR = 0.26, 95%CI = 0.11-0.59), Upper East region (AOR = 0.33, 95%CI = 0.16-0.71), and Upper West region (AOR = 0.29, 95%CI = 0.12-0.67). CONCLUSION: The magnitude of abortion was relatively higher than that of other African countries including Mozambique, Ghana, Côte d'Ivoire and Ethiopia. Education status, age, intention of using contraceptives, smoking, and region were determinants of abortion in Ghana. Therefore, comprehensive and culturally acceptable sexual and reproductive health services for women must be provided by those in charge. It is important to establish programs that support women's livelihood and education so that they can make educated decisions about things like using contraception and avoiding unintended pregnancies.