Contextualizing medication abortion in seven African nations: A literature review

Abstract

We conducted a comprehensive literature review on abortion in seven African countries to synthesize and analyze the landscape of abortion-related scientific knowledge, with the aim of informing abortion-access related research and programs in the region. We find that that abortion is common, despite legal restrictions, and often occurs outside of the formal health care system. Use of medication abortion was reported to be low, potentially due to legal restrictions and insufficient provider training across the continent. Creative interventions that could improve people’s knowledge of and access to safe medication abortion were identified and described.

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Acknowledgment

The authors would like to thank Daniel Zoetewey (University of Calgary, Calgary, Alberta, Canada) for their help with identifying and synthesizing relevant literature.

Notes

1 A note about language: to be consistent with the language used in the articles included in this review, we refer to “women”, although we acknowledge that people who do not identify as “women” are capable of pregnancy, and have abortions, too.

2 “Safe” abortions are those that were performed with a method which is recommended by the World Health Organization (WHO) that was appropriate to the duration of the pregnancy, and was provided by a trained provider. “Less safe” abortions are those where either misoprostol is used outside of the formal health system, often without access to a trained health care worker and/or appropriate information; or those where the abortion was carried out by trained providers but using outdated methods (for instance, sharp curettage). “Least safe” abortions are provided by untrained individuals using dangerous methods, such as the insertion of foreign bodies, use of traditional concoctions, or the ingestion of caustic substances (Ganatra et al., 2017).

Additional information

Funding

This research was supported by a grant from The William and Flora Hewlett Foundation.