Experts at the Johns Hopkins Bloomberg School of Public Health (JHSPH) are leading a smartphone-based survey to gather representative data on abortion and post-abortion care (PAC) in three countries – Côte d’Ivoire, India (Rajasthan), and Nigeria. The study is being conducted by JHSPH researchers working with Performance Monitoring and Accountability (ǻ2020). ǻ2020 is also partnering with the Guttmacher Institute on a study led by the Institute on abortion incidence and the provision of post-abortion and safe abortion care in Uganda and Ethiopia.
ǻ2020, led by the Bill & Melinda Gates Institute for Population and Reproductive Health at JHSPH, is a data collection platform that measures individual, household and health facility metrics annually in 11 countries across Africa and Asia. Local universities and research organizations implement the project, deploying resident female enumerators to conduct rapid-turnaround population-based surveys. ǻ2020 currently collects data on family planning, maternal and newborn health, water and sanitation, schistosomiasis, nutrition, and primary health care.
An anonymous donor recently granted ǻ2020 funds to expand data collection activities in Côte d’Ivoire, India, and Nigeria to include questions on abortion. ǻ2020 is also collaborating on a study being led by the Guttmacher Institute that will generate new evidence on abortion in Ethiopia and Uganda. These studies are gathering data on women’s knowledge of abortion methods and sources, the incidence of induced abortion, how women terminate pregnancies, and the extent of unsafe abortion. In addition to direct questions on abortion, the female survey module includes questions about the respondents’ two closest friends and their experiences with abortion. Investigators will use these data to calculate national and sub-national abortion rates in Nigeria, Cote d’Ivoire, Uganda and Ethiopia, as well as state specific rates for Rajasthan, India. Service delivery point (SDP) surveys also feature new questions related to abortion. Data will determine the availability of basic and comprehensive abortion and PAC services, the uterine evacuation methods provided, abortion and PAC caseloads, and the number of PAC cases resulting in severe complications. The Guttmacher Institute, in collaboration with ǻ2020 and local universities in Uganda and Ethiopia, will use the data collected in the female and service delivery point surveys to additionally investigate potential impacts of the global gag rule—as reimposed and expanded by the Trump Administration—in Uganda and Ethiopia.
The data from both studies will expand upon the limited existing information on abortion and PAC in Côte d’Ivoire and Rajasthan, India, and provide updated estimates for Nigeria, Ethiopia and Uganda.
Dr. Suzanne Bell, Assistant Scientist at JHSPH and co-Principal Investigator of the studies explains, “The current research will generate important insight regarding the role of abortion in women’s fertility regulation. Results will enable us to identify the populations most at risk of experiencing morbidity or mortality as a result of unsafe abortion. Additionally, findings will highlight deficiencies in safe abortion and post-abortion care services.”
Results produced by these studies can inform the development of evidence-based comprehensive sexual and reproductive health policies and programs at the country and global level to ensure women’s reproductive needs are met.