Data and Sources
The study uses data from a multi-country study entitled “the Relationship Between the use of Misoprostol and the Type and Severity of Abortion Symptoms”. This paper uses data from the study conducted in Ghana. The study was a facility quantitative cross-sectional. A total of three hospitals rendering abortion services – Marie Stopes International Clinics – Ashaiman and Kokomlemle and La-General Hospitals all in the Greater Accra region, Ghana were selected for the study.
The facilities were selected from a list of all providers with at least three years of post-abortion services provision. Selection from the sampling frame was done by simple random sampling from the sampling frame stratified by length of service. Random sampling was preferred over purposive sampling to limit the possibility of bias in the selection of respondents. These facilities were selected because at the time of the study, they had large post-abortion care caseloads.
A total of 800 women aged 18 years and over coming with symptoms of an abortion who were examined in the obstetrics and gynaecology wards of the selected hospitals were recruited over a period of six months for the study after being examined by a physician. Data from a total of 698 women is used for this study given a response rate of 82 percent. A record of examination form was completed by the physician at the end of the examination. All women aged 18 and over who presented with symptoms of an abortion were asked by the provider at the end of initial examination if she was interested in being interviewed for a research study. If interested she was introduced to an interviewer, who was a female doctor or nurse in the obstetrics and gynaecology ward of the participating hospital. Research assistants were trained over a 5 – day period on how to ask questions and code answers. The interviewer obtained informed consent from the woman and if she was agreeable, the interview was carried out in a private setting. Care was taken to ensure that the interviewer did not provide care to the women admitted.
The interview focused on: brief social and demographic characteristics; method of abortion; history of attempts (for current abortion); knowledge of method; where they obtained the method; source of information; expectation of treatment after using the method and the cost of method.
The questionnaire was pre tested prior to the actual data collection. Data collection was constantly checked by the investigator at each hospital to ensure accuracy and completeness of data collected from each woman. To ensure data quality, completeness, accuracy and consistency all collected data was checked every day by the investigator and supervisor during the entire data collection period. Any quest related to clarity, ambiguity, incompleteness, misunderstanding, was solved on the following day before the next day’s activities.
All questionnaires completed by the interviewer were kept in a locked filing cabinet at the hospital. At monthly intervals the completed questionnaires were transported to the office of the principal investigator. At this stage no questionnaire contained an individual identifier. All data was entered using Epi Info Version 3.5.3 and later exported to STATA for further analysis. Data quality checks were performed and any inconsistency errors were resolved by reviewing the questionnaire. Data quality checks were done during the data cleaning.
Study variables
Outcome variable was misoprostol use. It was a dichotomous variable derived from the question “Did you use misoprostol to stop this most recent pregnancy? The answers were Yes = 1 and No = 0. The independent variables in the study included aged(18–24, 25–34,35–49), standard of living (Often do not have sufficient food, enough to survive, can save some money, more than sufficient), Educational level (no formal education, Primary, Junior High School, Senior High School, higher), marital status (never Married, Currently married, Cohabiting/separated), Number of children/parity (0, 1, 2 or more), Number of miscarriages (0, 1, 2 or more), Pregnancy intention (wanted, mistimed, unwanted) and contraceptive use (no, yes).