Behavioural shift, communication can raise awareness about safe abortions in India

Over 56% of the estimated 6.4 million abortions that are performed in India every year, are unsafe, claim researchers.

Adopting interactive communication can improve knowledge about safe abortions, a major public health problem in India, claims a new study.

Complications during abortions account for nearly 8-9% of maternal deaths in India.(Images: Shutterstock)

Complications during abortions account for nearly 8-9% of maternal deaths in the country where every year an estimated 6.4 million abortions are performed and over half (56%) are estimated to be unsafe.

To increase abortion knowledge, interventions should focus on multiple exposures to Behaviour change communication (BCC) activities in order to ensure accurate knowledge, the study by Ipas Development Foundation (IDF) said.

“Even today, unsafe abortion is a significant public health problem in India. Many women in the country remain uninformed about safe abortion practices, the fact the abortion is legal and the various government-certified public health facilities where abortion services are provided.

“However, BCC interventions can help in improving knowledge of safe abortion, especially complex issues such as legal gestational age limit. To increase abortion knowledge, interventions should focus on multiple exposures to BCC activities to ensure accurate knowledge,” the study said.

It said that BCC interventions have already shown to have the potential of improving knowledge of contraceptive use, immunisation and HIV/AIDS. The study was conducted among married women aged 15–49 years.

IDF, in collaboration with Bihar and Jharkhand governments piloted two models of BCC interventions in four selected districts, two each in Bihar and Jharkhand – High Intensity Model (HIM) and Low Intensity Model (LIM).

The HIM intervention consisted of communication activities including interpersonal communication through group meetings and interactive games, wall signs, street dramas and distribution of low-literacy reference materials.

The LIM intervention was focused on increasing access to safe abortion services through community intermediaries (ASHA, AWW, ANM) and wall signs.

The HIM intervention was found to be more effective than the LIM intervention in increasing comprehensive knowledge about safe abortion services, the study said.

The study also found evidence of a dose–response relationship between level of exposure to abortion-related messages and accurate knowledge about abortion (higher dose = more accurate knowledge).

Though the HIM intervention requires a greater investment of resources, it is likely to result in better outcomes than the LIM intervention, the study authored by Sushanta K Banerjee, Kathryn Andersen, Erin Pearson, Janardan Warvadekar, Danish U Khan and Sangeeta Batra said.

“Today, unsafe abortion is still a significant public health problem in India, with complications of abortion accounting for 8–9% of maternal deaths. Every year an estimated 6.4 million abortions are performed in India, and over half (56%) are estimated to be unsafe.

“Many women are not aware that abortion is legal, nor are they aware of facilities that are certified by the government to provide abortion services,” the IDF said.

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