Induced abortion in Africa: A systematic review and meta-analysis

Introduction

Abortion, defined as the intentional termination of pregnancy before the 28th week of gestation, is a major public health problem worldwide, with over 44 million abortions occurring annually, according to the World Health Organization (WHO). The majority of these abortions are unsafe, leading to increased maternal morbidity and contributing to 13% of maternal deaths. This review aims to estimate the pooled prevalence of induced abortion and its associated factors in Africa.

Methods

A systematic search of electronic databases, including PubMed/MEDLINE, African Journals Online, and Google Scholar, was conducted to identify studies on the prevalence of induced abortion and its associated factors in Africa. The search was limited to articles published from March 1999 to May 1, 2023. Two reviewers independently screened the titles and abstracts of the identified studies, and full-text articles were assessed for eligibility. Data were extracted using a structured method of data collection and analyzed using STATA 14 software. Potential publication bias was assessed using a funnel plot and Egger regression test, and heterogeneity was measured using I2 statistics and Cochrane's Q.

Results

976 studies were identified through the initial search, and 46 full-text abstract papers were included in this study. The estimated pooled prevalence of induced abortion was 16% (95% CI: 13%-19%). According to the sub-group analysis, most studies were conducted in Ethiopia, and the pooled prevalence was 19% (95% CI: 10%'-30%). Similarly, the subgroup analysis by year of study showed that the prevalence of induced abortion was 39% (95% CI: 17%'-64%) among studies conducted in 2019.

Conclusion

The results of this study indicate that the pooled prevalence of induced abortion is higher than that of earlier studies published in some nations. These data are needed to support reproductive and adolescent health programmers and policymakers and to formulate recommendations for future clinical practice and guidelines.

Read more