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Inequities in the incidence and safety of abortion in Nigeria
  1. Suzanne O Bell1,
  2. Elizabeth Omoluabi2,
  3. Funmilola OlaOlorun3,
  4. Mridula Shankar1,
  5. Caroline Moreau1
  1. 1Population Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2Centre for Research, Evaluation Resources and Development, Ile-Ife, Nigeria
  3. 3Department of Community Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
  1. Correspondence to Professor Suzanne O Bell; suzanneobell{at}


Background We know little about the frequency, correlates and conditions under which women induce abortions in Nigeria. This study seeks to estimate the 1-year induced abortion incidence and proportion of abortions that are unsafe overall and by women’s background characteristics using direct and indirect methodologies.

Methods Data for this study come from a population-based, nationally representative survey of reproductive age women (15–49) in Nigeria. Interviewers asked women to report on the abortion experiences of their closest female confidante and themselves. We adjusted for potential biases in the confidante data. Analyses include estimation of 1-year induced abortion incidence and unsafe abortion, as well as bivariate and multivariate assessment of their correlates.

Results A total of 11 106 women of reproductive age completed the female survey; they reported on 5772 confidantes. The 1-year abortion incidence for respondents was 29.0 (95% CI 23.3 to 34.8) per 1000 women aged 15–49 while the confidante incidence was 45.8 (95% CI 41.0-50.6). The respondent and confidante abortion incidences revealed similar correlates, with women in their 20s, women with secondary or higher education and women in urban areas being the most likely to have had an abortion in the prior year. The majority of respondent and confidante abortions were the most unsafe (63.4% and 68.6%, respectively). Women aged 15–19, women who had never attended school and the poorest women were significantly more likely to have had the most unsafe abortions.

Conclusion Results indicate that abortion in Nigeria is a public health concern and an issue of social inequity. Efforts to expand the legal conditions for abortion in Nigeria are critical. Simultaneously, efforts to increase awareness of the availability of medication abortion drugs to more safely self-induce can help mitigate the toll of unsafe abortion-related morbidity and mortality.

  • abortion
  • survey
  • measurement

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  • Handling editor Sanni Yaya

  • Correction notice This article has been corrected since it was published. The article type has been updated.

  • Contributors SB, CM and MS conceived the study and led development of the study instrument. EO and FO led in-country data collection and provided input on the study instrument. SB and MS led the data analysis with input from FO, EO and CM. All authors were involved in the manuscript writing and provided final approval of the manuscript.

  • Funding This study was funded by an Anonymous Donor (Grant number: 127941).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.