Title : Demographic and clinical influence on unsafe abortions as a major cause of maternal mortality in Jirapa municipality, Ghana
Introduction: While there is abound literature on unsafe abortions globally, reliability of data and information on the demographic and clinical influence on unsafe abortion and consequently maternal and neonatal deaths in Jirapa, Ghana is questionable. Most maternal deaths particularly in Jirapa, Ghana can be avoidable if the right procedures and protocol in child birth are observed by the patient and the medical practitioners. Unsafe abortions has contributed significantly to the rise in maternal deaths which need to be addressed if Ghana is to achieve the Sustainable Development Goals on health for all. WHO defines unsafe abortion “as a procedure for terminating an unintended pregnancy carried out either by a person lacking the necessary skills or in an environment that does not conform to minimum medical standards or both” (Ganatra, 2014).Most maternal deaths are preventable and the complication can be managed if early treatment or intervention is applied. Jirapa Municipality of Ghana is predominantly a Christian’s community with about 80% of the population practicing the Christian faith. There is only one district hospital of the Roman Catholic mission-Government co-ownership and co-management, six health centres, one polyclinic with a number of supporting CHPS Compounds. While the law permits abortion on certain conditions in Ghana, women who are known to terminate pregnancies voluntarily are stigmatized. At the level of the health facility and health care providers, there are very strict rules prohibiting the safe termination of pregnancies in facilities which are church co-owned. The combination of these factors can be seen to underpin a social barrier obstructing access to safe abortion care services in Jirapa. Therefore, many adolescent girls and women resort to the services of unorthodox and quack doctors or traditional medical practitioners for induced abortion and consequently, a high rate of maternal deaths due to unsafe abortions in Jirapa, Ghana.
Objective: The main of the study is to provide an analysis of the demographic and clinical factors influencing unsafe abortions and the resultant maternal related deaths in the Jirapa municipality of the Upper West Region of Ghana.
Methodology and Data. The study is intended to use the mixed method research design (quantitative and qualitative) by combining both primary and secondary of data. Data from the Ghana Maternal Health Survey Verbal Autopsy data, 2017 will be used as secondary data along with primary data to be collected using variety of tools such as; interviews with various stakeholders; expectant mothers, medical personnel connected to childbirth in the hospital and clinics, interview with traditional birth attendants who still play an important role in childbirth. Visual and audio documentaries on maternal mortality cases in the St. Joseph’s Hospital, Jirapa will be done at least six month to support the dissemination and advocacy workshops. Site visits will also be conducted to confirm information gathered using the various research tools. The Empirical analysis will be done using various regression models depending on the nature of the data and expected outcome of the project. The researcher expect to used experienced researchers in health research, experienced medical practitioner in Gynaecology and other practioners into unsafe abortion and maternal and neonatal care.
Expected Results. The project is expected to produce in parts the following output;
- Prevalence and causes of unsafe abortions in the Jirapa Municipality of Ghana.
- Contribution of unsafe abortions to maternal mortality in Jirapa as well as their clinical implications for maternal and child health outcomes in Jirapa, Ghana.
- Empirical analysis of the demographic and clinical factors influencing unsafe abortion practices.
- Provide visual and audio documentaries of maternal deaths and cases in the Hospitals and Clinics to aid the dissemination of research output and advocacy.
- Recommendation for reducing the incidence of unsafe abortions and provide suggested ways to reducing maternal and neonatal mortality in Jirapa, Ghana.
Conclusion: The research processes aimed to provide an educational platform, empirical evidenced using science and data to support claims. This study is expected to provide support stakeholders in health to address the high incidence of unsafe abortions in Jirapa, Ghana and contribute to the national policy discourse and influence clinical procedures aimed at providing last solution to addressing the high incidence of unsafe abortions and maternal and neonatal deaths in Ghana.