CHAPTER ONE

INTRODUCTION

1.1 Background

Unsafe abortion is of public health concern because of its dire reproductive health consequences and impact on maternal morbidity and mortality. The World Health Organization (WHO) defines unsafe abortion as a procedure for terminating a pregnancy performed by persons lacking the necessary skills or in an environment not in conformity with minimal medical standards, or both (Ganatra, et al., 2014).Young adults terminate unplanned pregnancies for various reasons; these include fear of expulsion from school, unstable relationships, financial instability and lack of support from the partner (Cadmus & Owoaje, 2019). In cases where early marriage or single mothers are unaccepted, the pregnancy not only represents an unwanted responsibility but also the end of hope of further education, financial advancement and improved social opportunities in life. Coupled with their lack of, or poor knowledge of contraception, quite a few usually end up with unwanted pregnancies and are quite often faced with the predicament of dealing with the problem thereof (Cadmus & Owoaje, 2019). In Cameroon, abortion is not allowed on socio-economic grounds, even though these play a key role in women’s decision for abortion. Induced abortion is only permitted when a woman’s life is at risk, to preserve her physical and mental health, and on grounds of rape or incest. Illegal abortions are punishable by a fine of up to two million CFA and imprisonment of up to five years for the abortionist, one year for the woman herself, and two years for anyone supplying drugs or instruments to induce abortion (Ganatra, et al., 2014). Globally, unsafe abortions claim the lives of 68,000 women each year; 43% of these women are African (Worku & Binyam, 2014). The overall abortion rate in Africa, where the vast majority of abortions are illegal and unsafe, showed no decline between 2003 and 2008, holding at 29 abortions per 1,000 women of child-bearing age. The Southern African sub-region, dominated by South Africa, where abortion was legalized in 1997, has the lowest abortion rate of all African sub-regions, at 15 per 1,000 women in 2008. East Africa has the highest rate, at 38, followed by Middle Africa at 36, West Africa at 28 and North Africa at 18 (WHO, 2008). In Cameroon, the prevalence of unsafe abortion is about 25%. Furthermore, in 2017, the estimated maternal mortality ratio attributed to unsafe abortion in Cameroon was 90 to 100,000 live births. This is a huge number which could be controlled if abortions were done safely (WHO, 2008).Where access to safe abortion is restricted, complications from unsafe abortion lead to morbidity and are a major cause of maternal deaths. Unsafe abortions can endanger women’s reproductive health and lead to serious, often life-threatening complications. Furthermore, unsafe abortions impose a heavy burden on women and society by virtue of the serious health consequences that often ensue (Cadmus & Owoaje, 2019). Globally, it has been estimated that some 68,000 women die each year as a consequence of unsafe abortion, and 5.3 million suffer temporary or permanent disability. The public health burden is greatest in the developing world. Tackling this problem will go a long way towards achieving one of the Millennium Developmental Goals, which aims to reduce overall maternal mortality by two thirds by the year 2035. This study therefore aimed at assessing knowledge on unsafe abortion among teenage girls (13 to 19 years) at the Muea Community, Buea. The findings are hoped to provide evidences for policymakers regarding efforts to reduce risks associated with unsafe abortions in teenage girls.

 1.2 Problem Statement

The root cause of women seeking an abortion is the persistence of unintended pregnancies, which in turn reflects the failure of family planning programmes to meet the contraceptive needs of all women at risk of an unintended pregnancy. For the growing number of women and men of reproductive age who wish to regulate their fertility and have fewer children, there is a need for correct and consistent use of effective contraceptive methods. However, problems such as difficulties in access to preferred methods of contraception, incorrect or inconsistent use of contraceptive methods, and potential contraceptive method failure are not easily resolved and may lead to unintended pregnancies. Other reasons for unwanted pregnancies include forced or unwanted sexual intercourse and a lack of women’s empowerment over sexual and reproductive matters. Unplanned pregnancy leads to unsafe abortion which has the following as consequences; hemorrhage, sepsis, uterine perforation, bowel perforation, trauma to the cervix, acute renal failure, tetanus and death from anaesthesia amongst others (Rehan, 2011). In response to this, this study sought to assess knowledge on the consequences of unsafe abortion among teenage girls (13 to 19 years) at Muea Community, Buea.

1.3 Research Questions

1. What are the causes of unsafe abortion among teenage girls at Muea Community, Buea?
2. What knowledge do teenage girls have on the prevention of unsafe abortion at Muea Community, Buea?
3. What knowledge do teenage girls have on the consequences of unsafe abortion at Muea Community, Buea?

1.4 Research Objectives

1.4.1 General Objective

The main aim of this study was to assess knowledge on the consequences of unsafe abortion among teenage girls (13 to 19 years) at Muea Community, Buea.

1.4.2 Specific Objective

• To identify the causes of unsafe abortion among teenage girls at Muea Community, Buea
• Examine the knowledge of teenage girls on the prevention of unsafe abortion at Muea Community,
• To assess teenage girls knowledge on the consequences of abortion at Muea Community, Buea.