Estimating induced abortion incidence and the use of non-recommended abortion methods and sources in two provinces of the Democratic Republic of the Congo (Kinshasa and Kongo Central) in 2021: results from population-based, cross-sectional surveys of reproductive-aged women

References

• Bearak J, Popinchalk A, Ganatra B, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Glob Health. 2020;8(9):e1152–e1161. doi:10.1016/S2214-109X(20)30315-6.
   PubMed Web of Science ®Google Scholar
• Ganatra B, Gerdts C, Rossier C, et al. Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. Lancet. 2017;390(10110):2372–2381. doi:10.1016/S0140-6736(17)31794-4.
   PubMed Web of Science ®Google Scholar
• Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–e333. doi:10.1016/s2214-109x(14)70227-x.
   PubMed Web of Science ®Google Scholar
• Bell SO, Shankar M, Moreau C. Global epidemiology of induced abortion. In Oxford Research Encyclopedia of Global Public Health; 2021.
   Google Scholar
• Journal Officiel de la République Démocratique du Congo. Code pénal congolais, Décret du 30 janvier 1940 tel que modifié et complété à ce jour. edited by Presidence de la République; 2004.
   Google Scholar
• Chae S, Kayembe PK, Philbin J, et al. The incidence of induced abortion in Kinshasa, democratic Republic of Congo, 2016. PLOS ONE. 2017;12(10):e0184389. doi:10.1371/journal.pone.0184389.
   PubMed Web of Science ®Google Scholar
• Ishoso DK, Tshefu AK, Delvaux T, et al. Extent of induced abortions and occurrence of complications in Kinshasa, democratic republic of the Congo. Reprod Health. 2019;16(1):1–8.
   PubMedGoogle Scholar
• Ishoso DK, Tshefu AK, Coppieters Y. Analysis of induced abortion-related complications in women admitted to referral health facilities in Kinshasa, Democratic Republic of the Congo. PLOS ONE. 2018;13(8):e0203186. doi:10.1371/journal.pone.0203186.
   PubMed Web of Science ®Google Scholar
• African Commission on Human and People’s Rights (ACHPR). Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa. African Union; 2003 [cited 2022 Aug 31]. Available from: https://au.int/en/treaties/protocol-african-charter-human-and-peoples-rights-rights-women-africa.
   Google Scholar
• Official Gazette of the DRC, and Cabinet of the President of the Republic. Special Issue, March 14, 2018.. Available from: https://www.ilo.org/dyn/natlex/docs/SERIAL/84846/94671/F861828376/ratification%20protocole%20droits%20de%20la%20femme.pdf.
   Google Scholar
• Prata N, Bell S, Gessessew A. Comprehensive abortion care: evidence of improvements in hospital-level indicators in tigray, Ethiopia. BMJ Open. 2013;3(7):e002873. doi:10.1136/bmjopen-2013-002873. http://bmjopen.bmj.com/content/3/7/e002873.abstract
   PubMed Web of Science ®Google Scholar
• Moore AM, Gebrehiwot Y, Fetters T, et al. The estimated incidence of induced abortion in Ethiopia, 2014: changes in the provision of services since 2008. Int Perspect Sex Reprod Health. 2016;42(3):111–120. doi:10.1363/42e1816.
   PubMed Web of Science ®Google Scholar
• Casey SE, Steven VJ, Deitch J, et al. “You must first save her life”: community perceptions towards induced abortion and post-abortion care in north and south kivu, democratic republic of the Congo. Sexual Reproductive Health Matters. 2019;27(1):106–117.
   Web of Science ®Google Scholar
• Burtscher D, Schulte-Hillen C, Saint-Sauveur J-F, et al. “Better dead than being mocked”: an anthropological study on perceptions and attitudes towards unwanted pregnancy and abortion in the democratic Republic of Congo. Sexual Reproductive Health Matters. 2020;28(1):1852644.
   PubMedGoogle Scholar
• Izugbara CO, Egesa C, Okelo R. ‘High profile health facilities can add to your trouble’: women, stigma and un/safe abortion in Kenya. Soc Sci Med. 2015;141:9–18.
   PubMed Web of Science ®Google Scholar
• Erdman JN. Harm reduction, human rights, and access to information on safer abortion. Int J Gynaecol Obstet. 2012;118(1):83–86.
   PubMed Web of Science ®Google Scholar
• Singh S, Prada E, Juarez F. The abortion incidence complications method: a quantitative technique. New York: Guttmacher Institute; 2010.
   Google Scholar
• Keogh SC, Otupiri E, Chiu DW, et al. Estimating the incidence of abortion: a comparison of five approaches in Ghana. BMJ Global Health. 2020;5(4):e002129.
   Web of Science ®Google Scholar
• Singh S, Shekhar C, Acharya R, et al. The incidence of abortion and unintended pregnancy in India, 2015. Lancet Glob Health. 2018;6(1):e111–e120.
   PubMed Web of Science ®Google Scholar
• Sully E, Giorgio M, Anjur-Dietrich S. Estimating abortion incidence using the network scale-up method. Demogr Res. 2020;43:1651–1684.
   Web of Science ®Google Scholar
• Giorgio M, Sully E, Chiu DW. An assessment of third-party reporting of close ties to measure sensitive behaviors: The confidante method to measure abortion incidence in Ethiopia and Uganda. Stud Fam Plann. 2021;52(4):513–538. doi:10.1111/sifp.12180.
   PubMed Web of Science ®Google Scholar
• Rossier C, Guiella G, Ouedraogo A, et al. Estimating clandestine abortion with the confidants method–results from Ouagadougou, Burkina Faso. Soc Sci Med. 2006;62(1):254–266.
   PubMed Web of Science ®Google Scholar
• Jones RK, Kost K. Underreporting of induced and spontaneous abortion in the United States: An analysis of the 2002 national survey of family growth. Stud Fam Plann. 2007;38(3):187–197.
   PubMed Web of Science ®Google Scholar
• Sedgh G, Keogh SC. Novel approaches to estimating abortion incidence. Reprod Health. 2019;16(1):44.
   PubMedGoogle Scholar
• Bell SO, Shankar M, Omoluabi E, et al. Methodological Advances in Survey-Based Abortion Estimation: Promising Findings from Nigeria, India, and Cote d’Ivoire. Population Association of America Annual Meeting, Austin, Texas; 2019.
   Google Scholar
• Yeatman S, Trinitapoli J. Best-friend reports: A tool for measuring the prevalence of sensitive behaviors. Am J Public Health. 2011;101(9):1666–1667.
   PubMed Web of Science ®Google Scholar
• Bell SO, Omoluabi E, OlaOlorun F, et al. Inequities in the incidence and safety of abortion in Nigeria. BMJ Global Health. 2020;5(1):e001814. doi:10.1136/bmjgh-2019-001814. https://gh.bmj.com/content/bmjgh/5/1/e001814.full.pdf.
   PubMed Web of Science ®Google Scholar
• Bell SO, Sheehy G, Hyacinthe AK, et al. Induced abortion incidence and safety in Côte d’Ivoire. PLoS One. 2020;15(5):e0232364.
   PubMed Web of Science ®Google Scholar
• Ahmad D, Shankar M, Khanna A, et al. Induced abortion incidence and safety in Rajasthan, India: evidence that expansion of services is needed. Stud Fam Plann. 2020;18(1):1–15.
   Google Scholar
• Stillman M, Leong E, Utomo B, et al. An application of the confidante method to estimate induced abortion incidence in java, Indonesia. Int Perspect Sexual Reproductive Health. 2020;46:199–210.
   PubMed Web of Science ®Google Scholar
• Bell SO, Guiella G, Byrne ME, et al. Induced abortion incidence and safety in Burkina Faso in 2020: results from a population-based survey using direct and social network-based estimation approaches. PLoS One. 2022;17(11):1–17. doi:10.1371/journal.pone.0278168.
   Web of Science ®Google Scholar
• Bell SO, Guiella G, Anjur-Dietrick S, et al. Social network-based abortion incidence estimation in Burkina Faso: Examining the impact of the network generating question. Population Assocation of America, Atlanta, GA; 2022.
   Google Scholar
• Performance Monitoring for Action (PMA). Performance Monitoring for Action (PMA); 2021 [cited 2021 u 15]. Available from: https://www.pmadata.org/.
   Google Scholar
• Bell SO, Shankar M, Omoluabi E, et al. Social network-based measurement of abortion incidence: promising findings from population-based surveys in Nigeria, cote d’Ivoire, and rajasthan, India. Popul Health Metr. 2020;18(1):1–15.
   PubMed Web of Science ®Google Scholar
• World Health Organization. WHO Abortion care guidelines: Chapter 3: Recommendations and best practice statements across the continuum of abortion care - Self-management Recommendation 50: Self-management of medical abortion in whole or in part at gestational ages < 12 weeks (3.6.2). World Health Organization; 2022 [cited 2022 Apr 21]. Available from: https://srhr.org/abortioncare/chapter-3/service-delivery-options-and-self-management-approaches-3-6/self-management-recommendation-50-self-management-of-medical-abortion-in-whole-or-in-part-at-gestational-ages-12-weeks-3-6-2/.
   Google Scholar
• StataCorp. Stata statistical software: release 17. College Station (TX): StataCorp, LLC; 2021.
   Google Scholar
• Sana M, Stecklov G, Weinreb AA. A test of the stranger-interviewer norm in the Dominican Republic. Popul Stud. 2016;70(1):73–92.
   Google Scholar
• Safi S, Greenleaf A, Hawes M, et al. Resident Interviewers and Repeat Surveys: Effects on Measures of Reproductive Health. Population Association of America, Chicago, IL, April 27–29, 2017; 2017.
   Google Scholar
• Smith E, Purdy C, Radding M, et al. Private sector’s potential to deliver sexual reproductive health: increasing access to contraception and safe abortion. Int J Arts Human Soc Stud. 2022;4(1):66–74.
   Google Scholar
• Chae S, Desai S, Crowell M, et al. Characteristics of women obtaining induced abortions in selected low-and middle-income countries. PloS One. 2017;12(3):e0172976.
   PubMed Web of Science ®Google Scholar
• Tulane University School of Public Health, University of Kinshasa School of Public Health, The Bill & Melinda Gates Institute for Population and Reproductive Health at The Johns Hopkins Bloomberg School of Public Health, and Jhpiego. Performance Monitoring for Action (PMA) Democratic Republic of Congo (Kinshasa & Kongo Central) phase 2: household and female survey, PMA2020/CD-P2-HQFQ. DRC and Baltimore (MD); 2021.
   Google Scholar
• Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité - MPSMRM/Congo, Ministère de la Santé Publique - MSP/Congo, and ICF International. Enquête Démographique et de Santé en République Démocratique du Congo 2013-2014. MPSMRM, MSP, and ICF International, Rockville, Maryland, USA; 2014.
   Google Scholar
• Glover AL, Kayembe P, Kaba D, et al. Assessing readiness to provide comprehensive abortion care in the democratic republic of the Congo after passage of the Maputo protocol. Int Perspectives Sexual Reproductive Health. 2020;46(Supplement 1):3–12. doi:10.1363/46e0420. https://www.jstor.org/stable/10.136346e0420.
   PubMedGoogle Scholar
• Aantjes CJ, Gilmoor A, Syurina EV, et al. The status of provision of post abortion care services for women and girls in eastern and Southern Africa: a systematic review. Contraception. 2018;98(2):77–88.
   Web of Science ®Google Scholar
• Singh S, Remez L, Sedgh G, et al. Abortion Worldwide 2017: Uneven Progress and Unequal Access. 2018.
   Google Scholar
• Shekhar C, Sundaram A, Alagarajan M, et al. Providing quality abortion care: findings from a study of six states in India. Sex Reprod Healthc. 2020;24:100497.
   PubMed Web of Science ®Google Scholar
• Ansari N, Zainullah P, Kim YM, et al. Assessing post-abortion care in health facilities in Afghanistan: a cross-sectional study. BMC Pregnancy Childbirth. 2015;15:6–6. doi:10.1186/s12884-015-0439-x. https://pubmed.ncbi.nlm.nih.gov/25645657. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320442/.
   PubMed Web of Science ®Google Scholar
• Yegon EK, Mwaniki PK, Echoka E, et al. Abortion-related stigma and unsafe abortions: perspectives of women seeking abortion care in Machakos and Trans-Nzoia Counties, Kenya. East Afr Med J. 2016;93(8):327–332.
   Google Scholar
• Footman K, Keenan K, Reiss K, et al. Medical abortion provision by pharmacies and drug sellers in Low-and middle-income countries: A systematic review. Stud Fam Plann. 2018;49(1):57–70.
   PubMed Web of Science ®Google Scholar
• Stillman M, Owolabi O, Fatusi AO, et al. Women’s self-reported experiences using misoprostol obtained from drug sellers: a prospective cohort study in Lagos State, Nigeria. BMJ Open. 2020;10(5):e034670.
   PubMed Web of Science ®Google Scholar
• WHO, UNICEF, UNFPA, World Bank Group and UNPD (MMEIG). UNICEF Data - DRC Maternal Mortality Ratio; 2019 [cited 2022 Dec 19]. Available from: https://data.unicef.org/resources/data_explorer/unicef_f/?ag=UNICEF&df=GLOBAL_DATAFLOW&ver=1.0&dq=COD.MNCH_MMR.&startPeriod=1970&endPeriod=2022.
   Google Scholar
• Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9947):980–1004. doi:10.1016/s0140-6736(14)60696-6.
   PubMed Web of Science ®Google Scholar
• University of Kinshasa School of Public Health, The Bill & Melinda Gates Institute for Population and ReproductiveHealth at The Johns Hopkins Bloomberg School of PublicHealth, and Jhpiego. Performance Monitoring for Action (PMA) République Démocratique du Congo (Kinshasa): results from the COVID-19 phone survey (Kinshasa): results from the COVID-19 phone survey. Kinshasa, DRC and Baltimore (MD); 2020. https://www.pmadata.org/sites/default/files/data_product_results/DRC%20Kinshasa%20Phase%201-FU_Results%20Brief_English_final_0.pdf.
   Google Scholar
• Ho LS, Bertone MP, Mansour W, et al. Health system resilience during COVID-19 understanding SRH service adaptation in north kivu. Reprod Health. 2022;19(1):135. doi:10.1186/s12978-022-01443-5.
   PubMed Web of Science ®Google Scholar
• Polis CB, Biddlecom A, Singh S, et al. Impacts of COVID-19 on contraceptive and abortion services in low- and middle-income countries: a scoping review. Sexual Reproductive Health Matters. 2022;30(1):2098557. doi:10.1080/26410397.2022.2098557.
   PubMedGoogle Scholar
• Social Sciences Analytics Cell (CASS). The impacts of the COVID-19 outbreak response on women and girls in the democratic republic of the Congo. Kinshasa: UNICEF (Kinshasa, DRC); 2020; https://www.unicef.org/drcongo/media/5416/file/COD-CASS-impacts-COVID-response-women-girls.pdf.
   Google Scholar
• World Health Organization. Democratic Republic of the Congo COVID-19 Situation. World Health Organization; 2022 [cited 2022 Dec 14]. Available from: https://covid19.who.int/region/afro/country/cd.
   Google Scholar
• Sheehy G, Omoluabi E, OlaOlorun FM, et al. A mixed-methods study exploring women’s perceptions of terminology surrounding fertility and menstrual regulation in côte d’Ivoire and Nigeria. Reprod Health. 2021;18(1):251. doi:10.1186/s12978-021-01306-5.
   PubMed Web of Science ®Google Scholar
• Bell SO, Fissell ME. A little Bit pregnant?: productive ambiguity and fertility research. Popul Dev Rev. 2021.
   Web of Science ®Google Scholar
• Gerdts C, Bell SO, Shankar M, et al. Beyond safety: the 2022 WHO abortion guidelines and the future of abortion safety measurement. BMJ Global Health. 2022;7(6):e009557.
   PubMed Web of Science ®Google Scholar