In its sustained efforts to contributing to the scientific body of knowledge through research and Continuing Medical Education (CME), as well as remaining true to one of its fundamental values, “Scientific and evidence-based engagement” that interventions to policy must be based on sound, well-researched and established facts – the Zambia Association of Gynaecologists and Obstetricians (ZAGO) has over the past year or so accomplished four research studies. These studies looked at different interventions of human health.

One of its studies has been published by a reputable Journal, the International Journal for Gynaecology and Obstetrics. The study, “Magnitude and determinants of unsafe abortions among Zambian women presenting for abortion care services: A multilevel analysis” was conducted by ZAGO’s Gynaecologists and Obstetricians (OBGYNs) and academicians, with Dr Ketty M. Lubeya as the lead investigator.

This was a cross-sectional study aimed to establish the magnitude and determinants of unsafe abortion among women presenting for Comprehensive Abortion Care (CAC) in nine selected public health facilities in Zambia’s Lusaka and Copperbelt Provinces.

The study exhumes unspoken and hidden enclaves surrounding unsafe abortion, a major cause of maternal morbidity and mortality.

According to the study by Dr Lubeya et al (2022), unsafe abortion ‘vary across sub-Sahara Africa primarily due to unmet needs for modern contraceptives, lack of accessible and availability of comprehensive abortion care services and stigma’. In most sub-Saharan African countries for example, the study notes that secretly, women continue to seek unsafe abortions despite it being ‘legal’. The study attributes this behaviour to cultural and religious beliefs that are deeply-rooted with negative connotations towards abortion.

In Zambia, the picture is no different from that of the regional perspective. Although, the legal abortion law was legislated as far back as 1972, unsafe practices are still rampant, with evidence pointing to the fact that about 50% of Gynecological admissions and 30% of maternal deaths result from unsafe abortions.

“We collected data using a structured questionnaire,” authors explain about the research study. “We included women aged 15 to 49 years and those who responded to the question on who conducted the abortion and where it was initiated. Those who did not sign written informed consent were excluded. In total, 362 women were eligible for analysis and 77 (21.3% [95% confidence interval, 16.8–25.3]) had unsafe abortions being unaware that abortion is legal in Zambia; being unaware that hospitals offer free abortion care services. And [on the] Copperbelt Province, the magnitude of unsafe abortion is high, in keeping with previous studies in similar resource-poor settings.”

The study then explains details of some of the contributing factors to unsafe abortions in the country.

“The study reveals that the unmet need for modern contraceptive methods, lack of information [knowledge] that abortion [in Zambia] is legal, and regional differences in the CAC provision could have contributed to unsafe abortion,” the study highlights in part. “Findings suggest that modifiable factors contribute to unsafe abortion, and interventions should be implemented to reduce it. Priority should be given to unmarried women and residents from high-density areas while providing more education on modern contraceptive methods and advocating for legal abortion to avoid its consequences.”

This is one of the many research studies ZAGO has been conducting over the years which are yet to be published.

Full content of the research can be accessed here:  https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.14351