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Using Respondent-Driven Sampling to measure abortion safety in restrictive contexts: Results from Kaya (Burkina Faso) and Nairobi (Kenya)

Author

Listed:
  • Lonkila Moussa Zan

    (Université de Genève)

  • Onikepe Owolabi

    (Vital Strategies)

  • Adama Baguiya

    (Institut de Recherche en Sciences de la Santé)

  • Ramatou Ouedraogo

    (African Population and Health Research Center (APHRC))

  • Martin Bangha

    (Institut de Recherche en Sciences de la Santé)

  • Caron Kim

    (World Health Organization)

  • Clémentine Rossier

    (Université de Genève)

Abstract

Background: Due to restrictive laws and limited service provision, globally the majority of induced abortions are unsafe and remain largely undocumented, despite their negative impact on women’s health. Objective: The purpose of this study is to test Respondent-Driven Sampling – used previously in HIV research – for abortion, and to measure abortion safety characteristics in the small town of Kaya and surrounding villages (Burkina Faso) and in the slums of Nairobi (Kenya). Methods: A preliminary qualitative study confirmed that women disclose to network members when seeking an abortion. Using RDS, we recruited 481 abortion-seekers from 12 seeds in Kaya (in max. 10 waves) and 551 abortion-seekers from 8 seeds in Nairobi (in max. 5 waves) in 2021. These respondents reported 487 (Kaya) and 595 (Nairobi) abortions in the previous 3 years. Results: Standard diagnostics showed that the safety characteristics of the abortions of the recruited women were independent of those of the seeds, but sample-wide convergence was reached at relatively high sample sizes (around 300 in Kaya and 400 in Nairobi). More advanced checks indicated convergence (or tendency towards convergence) across seeds, except for one indicator in one site. In Kaya, most women used plant-based methods (50%) and unidentified pills (Medical Abortion (MA) in appearance) (33%). In Nairobi, women used unidentified pills (likely MA) (38% of abortions), followed by plant-based (21%) and known harmful methods (19%); pharmacists were frequent providers (45%). In Kaya, abortions occurred in the first trimester (98%), but less so in Nairobi (70%). The level of reported likely infected complications was similar across sites (6.2% in Kaya versus 9.6% in Nairobi). Conclusions: While the RDS misses non-networked abortion-seekers (an arguably small share of abortion-seekers in the sites), the different available quality checks yielded positive signals as to the possibility of using RDS to obtain data representative of networked abortions. The data revealed contrasting safety characteristics and abortion-seeker profiles across sites. Contribution: RDS is cheap, yields large and diverse samples of abortion-seekers, and is equipped with built-in quality tests: it is a promising avenue for collecting data on abortions in restrictive settings where abortion-seekers are highly networked, although a number of limitations remain and further development is needed.

Suggested Citation

  • Lonkila Moussa Zan & Onikepe Owolabi & Adama Baguiya & Ramatou Ouedraogo & Martin Bangha & Caron Kim & Clémentine Rossier, 2024. "Using Respondent-Driven Sampling to measure abortion safety in restrictive contexts: Results from Kaya (Burkina Faso) and Nairobi (Kenya)," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 50(47), pages 1387-1422.
  • Handle: RePEc:dem:demres:v:50:y:2024:i:47
    DOI: 10.4054/DemRes.2024.50.47
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    References listed on IDEAS

    as
    1. Agnès Guillaume & Clémentine Rossier, 2018. "Abortion Around the World. An Overview of Legislation, Measures, Trends, and Consequences," Population (english edition), Institut National d'Études Démographiques (INED), vol. 0(2), pages 217-306.
    2. Yeatman, S. & Trinitapoli, J., 2011. "Best-friend reports: A tool for measuring the prevalence of sensitive behaviors," American Journal of Public Health, American Public Health Association, vol. 101(9), pages 1666-1667.
    3. Sophia Chae & Sheila Desai & Marjorie Crowell & Gilda Sedgh & Susheela Singh, 2017. "Characteristics of women obtaining induced abortions in selected low- and middle-income countries," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-19, March.
    4. Laura Lindberg & Kathryn Kost & Isaac Maddow-Zimet & Sheila Desai & Mia Zolna, 2020. "Abortion Reporting in the United States: An Assessment of Three National Fertility Surveys," Demography, Springer;Population Association of America (PAA), vol. 57(3), pages 899-925, June.
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    More about this item

    Keywords

    induced abortion; respondents-driven samples; sub-Saharan Africa; social networks;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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