Correlates of individual-level abortion stigma among women seeking elective abortion in Nigeria

Ayodeji Oginni,1 Sikiratu Kailani Ahmadu,2 Nkiruka Okwesa,1 Isaac Adejo,3 Hauwa Shekerau3 1Research and Evaluation Unit, Ipas Nigeria, 2Maternal, Newborn, and Child Health Program (MNCH2), Ipas Nigeria, 3Program Unit, Ipas Nigeria, Abuja, Nigeria Objective: This study aimed to measure individual-level abortion stigma (ILAS) and determine its correlates among women receiving safe elective abortion services. Patients and methods: Data were collected from a cross-section of women who received safe elective abortion services in select intervention health facilities. Respondents were recruited through a self-selection sampling. ILAS was assessed using a 16-item scale (Cronbach’s alpha =0.9122). Respondents were categorized as high (summed score >40) or low ILAS (summed score ≤40) on a spectrum of a summed minimum score of 16 to a maximum score of 64. A log-binomial regression model was constructed to determine the ILAS correlates. Results: Among 382 respondents, 43% expressed high ILAS. Women’s age and education, provider’s cadre and type of abortion procedure were significant correlates in the model. Older women (age 25–34 and age ≥35) were less likely (prevalence ratio [PR]=0.60 and 0.39, p<0.001) to express high ILAS than the younger women (age ≤24); those with higher educational status were more likely to express (PR=1.64, p<0.05) high ILAS than those with None/Primary education; those who had medical abortion were less likely (PR=0.54, p<0.01) to express high ILAS than those who had surgical abortion; and lastly, those who received care from midlevel providers were more likely (PR=1.31, p<0.05) to express high ILAS than those who received care from physicians. Conclusion: High ILAS still exists among women accessing safe elective abortion care in Nigeria. Therefore, interventions at all levels of the socioecological model of abortion stigma need to be considered to address this societal problem that affects and impacts women. Keywords: abortion, stigma, individual-level, women, factor