CHAPTER ONE

1.0 Introduction

This chapter presents the background of the study, statement of problem, objectives, Research questions, significance of the study, scope of the study, theoretical/conceptual framework and definition of terms.

1.1 Background of the study

 Unwanted pregnancies followed by unsafe abortion is one of the major worldwide health problems.  It has many negative health consequences on the health and well-being of women in the reproductive age group.

Youths are prone to unplanned and undesired early sexual experiences that result in unwanted pregnancies for a variety of reasons. As a result, they are vulnerable to seeking induced abortion and becoming candidates for its consequences. Youths who have an induced abortion face major health risks such as bleeding, genital damage, infection, and mortality (Mbonye, 2000; Mirembe et al., 2010).

According to WHO (2021), unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards or both. An unsafe abortion is a life threatening procedure. Each year approximately 73 million unsafe abortions are performed each year. Six out of 10 (61%) of all unintended pregnancies, 3 out of 10 (29%) of all pregnancies end in induced abortion WHO (2021). All over the world, women experience unwanted pregnancy. Some of these women seek to terminate the pregnancy by safe medical means, if possible but often by whatever available. Techniques implemented are highly varied, as are circumstances under which it is practiced. Global estimates from 2010-2014 demonstrates that 45% of all induced abortions are unsafe. Of all unsafe abortions, one third were performed under the least safe conditions i.e., by untrained persons using dangerous and invasive methods.   Abortion is not unique at any point in time or level of societal organization. It has existed before history started to be recorded and it still exists till today. To some people in the society particularly the religious, it is a vice affecting every corner of the world (Jeje, 2001). World Health Organization WHO estimates revealed that about 25% of all pregnancies globally end in induced abortion which means approximately 73 million each year. Unsafe abortions impose a heavy burden on women and society by virtue of serious health consequences that often ensue. Globally, the commonly reported reason for having induced abortion is to post pone child birth, other socio economic concerns were disruption of education or employment, lack of support from family, poverty, unemployment, just to name a few. Cadmus and Owoaje (2011) In most African countries, abortion remains both unauthorized and unsafe and is the leading cause of maternal deaths accounting for a global average of 13% of pregnancy related fatalities. It has been documented that young adults are more likely to delay seeking termination, employ the use of unqualified and unskilled providers and also use dangerous methods to induce abortion.

The proportion of abortions worldwide that occur in developing regions rose from 76% to 88% between 1990-1994 and 2010-2014 with an average of 3 out of 4 unsafe abortions. (WHO, 2016) Mortality from unsafe abortion disproportionately affects women in Africa. While the continent accounts for 29% of all unsafe abortions, it sees 62% of unsafe abortion related deaths. During 2010-2014, an estimated 8.2 million induced abortions occurred each year in Africa, this number represents an increase from 4.6 million annually during 1990-1994 mainly because of the number of women of reproductive age (Lancet, 2016). Africa is the world region with the highest number of abortion-related deaths. In 2016, at least 11% of maternal deaths (17000 deaths) in Africa were from unsafe abortion (Guttmacher institute, 2018). In Cameroon, the prevalence of induced abortion is about 25%; in 2016, the estimated maternal mortality ratio attributed to unsafe abortion in Cameroon was 90 to 100000 live births. Unsafe abortion is responsible for 25% of maternal deaths in Cameroon. Consequently, abortion is fourth leading causes of maternal mortality in Cameroon (Kongnyuy et al., 2006).

 The youths who undergo an induced abortion expose themselves to serious health risks such as hemorrhage, genital injuries, sepsis, (Mbonye 2000) and death (Silberschmidt, 2001). In general, in many African countries women younger than 20 years of age represent up to 70% of women treated for abortion complications (Mbonye 2000: Ahman and Shah, 2011). Complications from unsafe abortion accounted for estimated 13% of all maternal deaths worldwide. Deaths as a result of unsafe abortion in developing countries are estimated 80,000 annually, that 400deaths per 100,000 abortions (Mirembe et al.,2011).

Following unsafe abortion, women may experience a range of harms that affect their quality of life and wellbeing with some women experiencing life threatening complications.

 According to a study by Justin Lussy Paluku et al published on February 6 March, 2013 on the Knowledge and attitudes about induced abortions among female youths attending Naguru Teenage Information and Health Centre, Kampala, Uganda. The results revealed most (93.1%) of the youths knew at least one medical complication of an induced abortion. Death (91.3%) was the most commonly cited complication. Few (16%) participants would encourage their colleagues to procure an abortion, while 83.7% would counsel others about perceived dangers of induced abortions. Participants who knew at least one complication were more likely to counsel their colleagues about the dangers of an induced abortion.  Thus, knowledge of complications of induced abortions was high among female youths attending Naguru Teenage Information and Health Centre (NTIHC). The majority of the youths were willing to counsel others about the medical complications of induced abortions.

1.2 Problem statement

Each year approximately 73 million unsafe abortions are performed worldwide with a number of negative consequences. (Paluku et al, 2013). World Health Organization (WHO, 2010) estimates revealed that about 25% of all pregnancies globally end in induced abortion which means approximately 73 million each year. Unsafe abortions impose a heavy burden on women and society by virtue of serious health consequences that often ensue. Globally, the commonly reported reason for having induced abortion is to post pone child birth, other socio economic concerns were disruption of education or employment, lack of support from family, poverty, unemployment, just to name a few (Cadmus and Owoaje (2011). In most African countries, abortion remains both unauthorized and unsafe and is the leading cause of maternal deaths accounting for a global average of 15% of pregnancy related fatalities (WHO, 2007). It has been documented that young adults are more likely to delay seeking termination, employ the use of unqualified and unskilled providers and also use dangerous methods to induce abortion. Abortion rates following unintended pregnancies is increasing in developing countries like Africa;

 As many as 76,000 women in the world die annually as a result of unsafe abortion and 48% of all abortions deemed unsafe. In 2008, 33 million (16%) of about 208 million pregnancies worldwide resulted in unintended births and 41 million (20%) in induced abortion. Everyday 192 women die because of complications arising from unsafe abortion due to different reasons (WHO, 2009).

 In Cameroon, the prevalence of induced abortion is about 25%, in 2000, the estimated maternal mortality ratio attributed to unsafe abortion in Cameroon was 90 to 100,000 live births. Unsafe abortion is responsible for 25% of maternal deaths in Cameroon making it the second leading cause of maternal mortality in Cameroon (Bongfen et al., 2019). Also the researcher on clinical experience witnessed a good number of cases of young girls who came seeking for their pregnancies to be terminated. Most of these young girls ends up with suffering from internal bleeding, damage to Internal organs, infections and possible death. This pushed the researcher to pursue a research on assessing youth’s knowledge on the effects of self-induced abortions.

1.3 Objectives

1.3.1 General objectives

 To ASSESSING YOUTH’S KNOWLEDGE ON THE EFFECTS OF SELF-INDUCED ABORTION IN BOTA COMMUNITY, MILE II LIMBE.

1.3.2 Specific objectives

Specifically, the study sought to,

1. Assess the youth’s knowledge, attitude, and practice on self-induced abortion in Bota Community, Mile II Limbe.
2. Identify the factors associated with self-induced abortion in Bota Community, Mile II Limbe.
3. Explore youth’s knowledge on the complications of self-induced abortion in Bota Community, Mile II Limbe.
4. Examine strategies use by the youths to prevent self-induced abortion

1.4 Research questions

1. What are the youth’s knowledge, attitude, and practice on self-induced abortion in Bota Community, Mile II Limbe?
2. What factors are associated with self-induced abortion in Bota Community, Mile II Limbe?
3. What knowledge do youths have on the complications of self-induced abortion in Bota Community, Mile II Limbe?
4. What strategies are employed by the youths to prevent self-induced abortion?