A recently released study has revealed that maternal mortality arising from unsafe abortion has reduced to 5.1 percent.
The countrywide study, “A Critical Analysis of Abortion Related Deaths in Zambia: A National Survey” conducted by the Zambia Association of Gynaecologists and Obstetricians (ZAGO) with financial support from the International Federation of Gynaecology and Obstetrics (FIGO) – show that abortion related deaths have drastically reduced.
“We used total sampling methodology of maternal deaths occurring countrywide. We identified for follow up abortion related deaths occurring in both health facilities and the community as captured by the weekly Maternal Perinatal Death Surveillance Review (MPDSR)meetingsof the Ministry of Health to see if they met the inclusion criteria of being abortion related. All relevant information related to these deaths were captured through a purpose designed questionnaire in line with the World Health Organization (WHO) Maternal Mortality ICD 10 death certification, and administered electronically to the lead health providers involved in the care of the deceased,” ZAGO President Dr Swebby Macha shares with a packed conference as he disseminates the study findings.” “Where gaps or explanations were found to be deficient, a physical visit was undertaken to the sites for file reviews and conduct physical interviews. Descriptive statistics using SPSS version 26 were generated to study abortion related maternal mortality. Prevalence of the problem was calculated, root causes and risk factors identified and targeted interventions suggested to further reduce abortion related deaths.”
Dr Macha says the study shows significant reduction in abortion related deaths from 9% in 2020 to 5.1% in 2022.
He says the findings give hope that abortion related mortalities can be eradicated with continued implementation of known strategies.
“The study took six (6) months and recorded a total number of 349 maternal deaths of which 18 were abortion-related,” he continues. “This represents 9 percent decline compared to what was reported in the 2020 Maternal Mortality Death Surveillance Response (MPDSR). More deaths occurred in patients from rural areas 10 (55.6%) compared to urban areas 8 (44.4%). Majority were unmarried 11(61.1%) compared to married 7(38.9%). In addition, majority were unemployed 15 (83.3%) compared to employed 3(16.7%). The commonly affected age group was adolescents 5(27.8%). Majority of the patients were attended to by a medical officer 16(88.9%) while the rest were seen by a clinical officer/medical licentiate 2 (11.1%) with similar frequencies of having been referred or not 88.9% against 11.1%. The highest number of these patients were seen at level 2 of health care 7(38.9%) followed by level 1 of care 6(33.3% and 5 (27.8%) were seen at level 3. Majority of patients stayed for less than 24 hours in hospital 10 (55.6 %), followed by 7(38.9 %) who were admitted for one to seven days and only 1 (5.6%) was admitted for more than a week. Copperbelt and Lusaka provinces recorded highest number of deaths with each recording 4(16.7%)”
He notes that although previous research indicated that adolescents and uneducated rural women were mostly affected by unsafe abortion, abortion related death among these demographics are on the decline.
“This is good step in the right direction. In view of this positive trajectory, there is need to escalate sensitization on the legal framework on termination of pregnancy and improve access to safe abortion services and contraception targeting adolescents and uneducated rural women in order to reduce further these mortalities. Awareness on the availability and legality of safe abortion services should be increased and possibly mainstreamed across the board.”
Dr Macha looks forward to continued collective sensitisation effort on in order sustain the gains achieved the project has achieved so far.
“The findings in this study showed that a prevalence of 5.1% abortion related maternal mortality. [This reduction] is indicative that some targeted interventions aimed at curbing such deaths are working. Over 15 years ago, in 2006 abortion related deaths were 30% and this figure came down threefold to 9 % in 2020. Further, the findings show a reduction in abortion related deaths by almost half. These reductions occurred at a time when FIGO was implementing the Safe Abortion Advocacy project which had activities among them reaching out to adolescents on Safe Choices campaign explaining reproductive health choices that include credible reproductive health messages, contraception choices and access to safe abortion service in case of unwanted pregnancy,” he explains.