KNOWLEDGE.
ATTITUDE AND PRACTICE OF UNSAFE ABORTION AMONG INSCHOOL ADOLESCENTS IN OYO WEST LOCAL GOVERNMENT AREA
PENGETAHUAN.
SIKAP.
DAN PRAKTIK ABORSI TIDAK AMAN DI KALANGAN
REMAJA SEKOLAH DI WILAYAH PEMERINTAHAN LOKAL OYO WEST
Esohe G.
Ehondor,1.
Oluwunmi A.
Obisesan2.
Salawudeen A.
Waheed2.
Emmanuel E.
Uye4* 1,3,& 4 Department of Psychology.
University of Ibadan.
Nigeria Department of Psychology.
Lead City University.
Ibadan.
Nigeria *Corresponding author: emmanuel.
uye@gmail.
ARTICLE HISTORY
Received .
August 2.
Revised .
August 2.
Accepted .
September 2.
KEYWORDS Knowledge.
Attitude.
Practice.
Abortion.
Inschool adolescents ABSTRAK Aborsi adalah salah satu penyebab utama kematian maternal, terutama di negara berkembang di mana metode-metode kasar sering digunakan.
Penelitian tentang tingkat pengetahuan, sikap, dan praktik aborsi tidak aman di kalangan remaja sekolah masih terbatas.
Penelitian ini dilakukan untuk mengisi kekurangan pengetahuan tersebut.
Desain survei potong lintang digunakan, sementara teknik pengambilan sampel acak sederhana digunakan untuk memilih lima sekolah menengah di wilayah Pemerintah Lokal Oyo West.
Data dikumpulkan dari 200 peserta perempuan menggunakan kuesioner yang telah divalidasi dan dianalisis dengan statistik deskriptif dan Chi-square (N.
untuk menjawab tiga pertanyaan penelitian dan menguji dua hipotesis, masingmasing.
Hasil penelitian menunjukkan bahwa 83% remaja sekolah memiliki pengetahuan yang baik tentang aborsi, 80% memiliki sikap positif terhadap aborsi, sementara 65% mengindikasikan bahwa mereka pernah melakukan Selain itu, hasil penelitian menunjukkan bahwa sikap berpengaruh signifikan terhadap praktik aborsi tidak aman (N2 = 30.
307, p < 0.
, sementara usia tidak berpengaruh (N2 = 4.
830, p > 0.
Penelitian ini menyimpulkan bahwa remaja sekolah perempuan dengan rentang usia 13-19 tahun memiliki pengetahuan yang baik dan sikap positif terhadap aborsi serta telah melakukan aborsi lebih dari sekali.
Penelitian ini merekomendasikan konseling yang efektif dan kampanye kesehatan yang ditargetkan untuk menyampaikan bahaya melakukan aborsi tidak aman di kalangan remaja sekolah.
ABSTRACT
This is an open access article under the CCAe BY-SA license Abortion is one of the leading causes of maternal mortality especially in developing countries where crude methods are frequently used.
Studies on the level of knowledge, attitude and practice of unsafe abortion among in-school adolescents are sketchy.
This study was conducted to fill these gaps in Cross-sectional survey design was adopted while simple random sampling technique was used to select five secondary schools in Oyo West Local Government Area.
Data were collected from 200 female participants using validated questionnaires and analyzed with descriptive and Chi-square (N.
statistics to answer three research questions and test two hypotheses.
The result revealed that 83% of in-school adolescents had good knowledge of abortion, 80% had a positive attitude toward abortion, while 65% indicated that they had carried out abortion.
Furthermore, the result revealed that attitude significantly influenced the practice of unsafe abortion (N2 = 30.
p < 0.
, while age did not (N2 = 4.
830, p > 0.
The study concluded that female in-school adolescents .
age bracket had good knowledge and positive attitude toward abortion and had practiced abortion more than once.
The study recommended effective counseling and targeted health campaigns on the danger of engaging in unsafe abortion among in-school adolescents.
INTRODUCTION
The World Health Organization (WHO, 2.
defines unsafe abortion as Authe termination of an unintended pregnancy either by a person lacking the necessary skills or in an environment lacking the minimal medical standard or bothAy.
Globally, abortion is one of the leading causes JURNAL SAINTIFIK (Multi Science Journa.
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347 of maternal mortality where 65.
4 million women committed abortion each year and 47.
6 million of these happened in developing countries (WHO, 2.
In Nigeria, between 6,000 and 10,000 women aged 16-49 years engaged in abortion annually of which about 70% are performed by non-physician, and 75% of them are done among females less than 24 years of age (Alabi et , 2.
And the most worrisome aspect of it all is that, about 24.
7% of these cases of unsafe abortions are done among in-school adolescents (Atuhaire, 2.
The question arises: What is the level of knowledge, attitude and practice of unsafe abortion among in-school adolescents? This is the question this study seeks to provide answers.
Knowledge of unsafe abortion.
In a study carried out by Upuli and Chrishantha .
among undergraduates in Sri Lanka, it was found that the majority .
3%) of the participants had 'good' knowledge of unsafe abortion while the minority .
3%) had 'poor' knowledge of unsafe abortion.
Another study reported that the majority .
3%) of female students of senior secondary schools had good knowledge of abortion (Abiola et al.
, 2016.
Bobo et al.
, 2025.
Espinoza et al.
, 2.
Furthermore, in Uganda and Ethiopia, female adolescents were found to have good knowledge of unsafe abortion (Thomas et al.
, 2.
However, one Ethiopian study reported that the knowledge level on medical abortion among undergraduates was relatively low (Thomas et al.
, 2.
Attitude towards unsafe abortion.
Attitude has to do with the positive or negative evaluations of ideas, objects or persons.
Attitude tends to affect behavior.
The way an individual would evaluate unsafe abortion would determine their behavior (Espinoza et al.
, 2020.
Yorulmaz, 2.
In terms of in-school adolescentsAo attitude towards unsafe abortion.
Perera et .
2% of their participants agreed that pregnant women should have the right to decide whether they want abortion or not, and that induced abortions should be restricted to save mother's life .
7%).
Furthermore, the participants agreed that providing abortion services through the government health facilities would increase inappropriate sexual behavior among people including adolescents.
Similarly, one Sri Lankan study reported that about 96% of the women seeking termination of pregnancy were not aware of adverse outcomes of abortion(Perera et al.
, 2.
Practice of unsafe abortion.
In a study carried out by Barnett .
, approximately one in ten of their participants had considered illegal abortion in the past.
In addition, the study showed that more than double .
4% vs 10.
7%) of participants .
vs 35 participant.
of study participants who have considered abortion before would again consider it if they were pregnant These findings suggest that the number of in-school adolescents who would consider abortion is on the increase.
Ghazaleh and Kathryn .
found several reasons why adolescents engaged in un.
abortion to include their desire to continue education or to protect future aspirations.
to avoid the stigma of teenage pregnancy.
incest or transactional sex.
Furthermore, in a South African and Zambian study, adolescents sought abortion due to experience of sexual violence .
, rape or inces.
and fears of physical trauma due to childbirth (Ramakuela et al.
, 2.
Moreover, a study of unmarried pregnant adolescents in Uganda found that many girls who sought abortion felt they had to do it to Ausave faceAy for their parents.
and in some contexts, such as in Mexico, girls reported that parents forced them to seek abortions (Schiavon et al.
, 2.
Finally, in Nigeria, lack of access to adequate medical personnel, facilities and equipment were reasons for engaging in unsafe abortion among girls ages 14-21 years.
High cost of safe abortion service fees and distrust in the health care providers were also cited as barriers to accessing safe abortion in Ghana (Tunde, 2.
Abortion is one of the serious issues in reproductive health especially among female adolescents in particular.
While the government and other stakeholders have been involved in the prevention and reduction of unsafe abortion especially among in-school adolescents, the levels of knowledge, attitude and practice of abortion among female teenagers has received little investigation leaving gaps in knowledge to be filled.
Therefore, the purpose of this study is to examine the levels of knowledge, attitude and practice of abortion among in-school JURNAL SAINTIFIK (Multi Science Journa.
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348 adolescents in Oyo State.
Nigeria.
The study aims to answer the question: What is the level of knowledge, attitude and practice of abortion among in-school adolescents? The study would provide baseline data on the knowledge, attitude and practice of abortion among study participants.
In addition, the study would help parents, teachers and policy makers to plan appropriate reproductive health education for the in-school adolescents on the danger of engaging in abortion.
Theoretical construct This study is guided by the social learning theory (SLT.
Bandura, 1.
The theory suggests that individuals learn through observation, and then they consciously decide to imitate That the underlying emotions such as peer pressure and desires to fit in affects the behavior of interest.
In the context of this study, the theory holds that abortion is a learned behavior, that teenagers indulge in abortion because they have seen their peers, neighbors, and other people either talked about it or have done it in order to cover their shame not minding the risk involved (Bell et al.
, 2020.
Ushie et al.
, 2.
RESEARCH METHODOLOGY
Research Design Cross-sectional survey design was employed while data were collected using validated questionnaires on the knowledge, attitude and practice of abortion among in-school adolescents in Oyo-West Local Government Area (LGA).
Oyo State.
Nigeria.
Sampling Technique Purposive sampling technique was used to select the LGA, simple random sampling technique was used to select the schools while convenience sampling technique was used to distribute questionnaires to the study participants.
Five out of 11 public secondary schools in the LGA were randomly selected and 40 female in-school adolescents were sampled from each school to obtain 200 participants.
Sample size Based on the 15.
3% prevalence of attitude toward abortion practice (Perera et al.
, 2.
sample size was calculated using the formula: N = za2p.
/y2.
Where: N=sample size.
Za=standard score or critical value .
, p = prevalence of abortion practice from a previous study .
3%), e2=desired level of precision .
, 1.
962 * 0.
Ae 0.
/0.
052, =199.
To accommodate for non-response, a 10% mark-up was calculated to arrive at 210 sample size.
Instrument The instrument used for data collection was a semi-structured questionnaire developed and validated by the researchers.
The questionnaires contained questions related to knowledge of abortion .
AuAbortion is the termination of pregnancy before 28 weeks of gestationAy and AuAbortion is not legally allowed in the country except to prevent death of a motherA.
, attitude towards abortion .
AuA pregnant woman should have the right to decide whether she wants an abortion or notAy and Au Making abortion services through the government health facilities could increase the inappropriate sexual behavior among teenage girlsA.
, and practice of abortion ( e.
AuHave you committed abortion before? and AuWhat means did you use for the abortion?).
The items in the questionnaire have response formats of AuYesAy.
AuNoAy, or AuI donAot knowAy options.
Content validity of the scale was established by experts in psychometrics.
CronbachAos alpha() for knowledge items was 0.
86, attitude items ( = 0.
and for practice items ( = 0.
addition, demographic data of age, class in school, family structure and religious affiliations were collected.
Procedure JURNAL SAINTIFIK (Multi Science Journa.
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349 Formal letter of introduction was obtained from the Department of Psychology.
University of Ibadan.
Nigeria which was presented to the respective principals.
Based on the evaluation of the study questionnaires by the respective principals or the school counsellors as was the case, the potential participants were assembled in a designated classroom for the researchers to address them.
The potential participants were briefed on the purpose of the study and their consent were sought.
They were duly informed that participation in the study was voluntary and if they so desired to participate, their responses would be treated confidentially.
Only those who agreed to participate in the study were given the questionnaires to fill which took less than 12 A total of 200 questionnaires .
for eac.
were distributed and collected on the spot and were used in the analysis.
Data Analysis Data collected were analyzed using IBMR SPSS version 26.
Descriptive and inferential statistics were computed.
Descriptive statistics of mean, standard deviation and percentages were used to explore the research questions.
Hypotheses 1 & 2 were tested using Chi-square statistics and accepted at p < .
05 level significance.
RESULTS AND DISCUSSION
The study first presents the demographic data of the study participants.
The descriptive statistics showed that 80 .
%) of the participants were between the ages of 13 and 15 years while 120 .
%) were between the ages of 16 and 19 years.
In terms of the participants' years in the school, 86 .
%) were in Junior Secondary School (JSS) 1 to 3 while 114 .
%) were in Senior Secondary School .
1 to 3.
Furthermore, the result revealed that 140 .
%) of the participants were from monogamous backgrounds while 60 .
%) were from the polygamous backgrounds.
Finally, in terms of their religious affiliations, 112 .
%) of the participants were Christians, 71 .
%) were Muslims, while 17 .
%) did not indicate their religious affiliations.
Table 1: Knowledge of Teenager toward Unsafe Abortion
Variable Response I donAot
N = 200
Yes
Item
N = 200
Abortion is the termination of pregnancy before 28 weeks of Abortion can result in death Abortion can lead to abnormal pain Abortions can lead to sub fertility Abortions can lead to uterine Abortion is not legally allowed in the country except to prevent death of a mother Are there illegal places where abortions are carried out in your JURNAL SAINTIFIK (Multi Science Journa.
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350 Table 1 showed that 165 .
%) of the participants have knowledge of what abortion is, 70 .
%) said they knew abortion can lead to death, and 170 .
%) agreed that abortion can lead to abdominal pain.
Moreover, 86 .
%) of the participants confirmed that abortion can lead to infertility, while 90 .
%) agreed that abortion is not allowed in the country except in the event of the death of the mother.
Finally, 160 .
%) of the participants said they knew places where abortions were carried out in their area.
Table 2 : Attitude of Teenagers towards Unsafe Abortion
Variables Response I donAot
N = 200
Yes Item A pregnant woman should have the right to decide whether she wants an abortion or not.
I will abort if I get pregnant before marriage.
Induced abortions should not be allowed under any of the circumstances.
Making abortion services through the government health facilities could increase the inappropriate sexual behavior among teenage girls.
Induced abortion should be freely available in the country on demand to anyone who needs it.
Abortion could be considered as a more convenient form of family planning just as Legal restrictions drive people to unsafe abortions and fall into Table 2 revealed that 160 .
%) of the participants confirmed that pregnant women should have the right to decide whether they want abortion or not, 118 .
%) of the participants were of the opinion that they would abort if they get pregnant before marriage, and 130.
%) said that induced abortions should be allowed under any circumstances.
Furthermore, 70 .
%) of the teenagers said that making abortion services available through the government health facilities would increase the inappropriate sexual behavior among teenage girls, 150 .
%) of the teenagers said induced abortions should be freely available in the country on demand to anyone who needs it, and 165 .
%) of the teenagers reported that abortion could be considered as a more convenient method of family planning just as contraceptives.
Finally, 149 .
%) of the teenagers said that legal restrictions drive individuals to unsafe abortions and fall into trouble.
This implies that in-school adolescents in the study population have a positive attitude towards abortion for their own good.
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351 Table 3: Practice of Unsafe Abortion among Teenagers Variables Response Yes Item Have you committed abortion before? If yes to the question above , how many times have you aborted? Once Twice More than two times No response What means did you use for the abortion? Took some abortion pills Surgical means Use of herbs No response Table 3 showed that 130 .
%) of the respondents reported that they have carried out abortion while 70 .
%) of them said they have never aborted before.
Among the teenagers that have committed abortion before , 45.
5%) of them said they have done it only once, 65 .
5%) reported twice and 20 .
%) reported more than twice while 70 .
%) of the teenagers did not respond to the question.
Moreover, 85.
%) of the teenagers who have committed abortion reported that they took abortion pills during the process, 15 .
%) went through surgical procedures, 30 .
%) used herbs while 70 .
%) did not respond to this question.
DISCUSSION
This study reveals that in-school adolescents in the study population and sample have a robust knowledge of what abortion is, the consequences of unsafe abortion in terms of causing pain, infertility and where unsafe abortion could be carried out.
This high level of knowledge among in-school adolescents tends to be worrisome considering the likely effects in their academic and future lives.
This finding was supported by Cadmus and Woaje .
who found 83% of their study participants to have good knowledge of unsafe abortion and the possible consequences of engaging in unsafe abortion.
Similarly, the study by Upuli and Chrishantha .
lent credence to the present finding where 53% of undergraduates in Sri Lanka have "good" knowledge of unsafe abortion.
Conclusively.
Balogun et al.
supported the present finding that in-school adolescents had good knowledge of abortion in Nigerian samples.
However, the present results contradicted that of Thomas et al.
and Perera et .
who reported in their studies that about 96% of their study participants were not aware of adverse effects of un.
In terms of attitude towards unsafe abortion, the result confirms a positive attitude towards unsafe abortion such that pregnant women should have the right to decide whether they want abortion and if they get pregnant before marriage.
Their result further indicates that women should induce abortions whenever they want to.
However, they disagree in allowing abortion services to be readily available to prevent inappropriate sexual behavior among teenage girls.
This finding supported Perera et al.
who found a positive attitude toward abortion whenever it is necessary for the safety of the mother and the babies.
However, this study did not support unsafe abortion by in-school adolescents.
Finally, the result of this study demonstrates that a significant number of study participants had practiced unsafe abortion more than once in their life in school given several reasons that include desire to further their studies, avoiding stigmatization, parental pressure, to save face, etc.
Several of them had used pills, herbs and surgical procedures to carry out abortion.
This finding aligned with that of Ghazaleh and Kathryn .
who found several reasons why adolescents engaged in un.
Other studies (Alabi et al.
, 2024.
Ramakuela et al.
Schiavon et al.
, 2013.
Tunde, 2.
supported the findings of the present study on the reasons for practicing .
safe abortion among study participants.
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CONCLUSION
The study investigates knowledge, attitude and practice of abortion among in-school adolescents in a rural setting in Oyo State.
Nigeria.
The study concludes that teenage girls .
-19 year.
have good knowledge of unsafe abortion and its implications.
They equally have a negative attitude towards abortion from the point of the law guiding unsafe abortion practice in the country and high rate of practice of unsafe abortion among themselves.
The study proffers the following recommendations: The government should intensify their effort to enforce the law against illegal abortion practice in the country by empowering the law enforcement agencies all-round the country.
In addition, adequate implementation of appropriate health interventions such as free counselling and distribution of effective contraceptive materials to prevent the incidence of unintended pregnancies.
Finally, parents should be enlightened on how to guide their teenage children as regards sexuality education aimed at discouraging unhealthy sexual behavior.
The study suffers some limitations which need to be addressed in subsequent studies.
To begin with, the study utilized self-reported questionnaires which were not free of response bias.
Further study would benefit by using key informant interviews and documentary evidence from the school counsellors to triangulate data collected from self-reported questionnaires.
In addition, only one LGA in Oyo State was selected with 200 participants which technically hinders generalization of study findings.
Further study should include more LGAs with increased sample size.
Finally, the study variables of knowledge, attitude and practice were not exhaustive.
Further study should include variables such as self-esteem, parenting styles and social support available to the in-school adolescents.
REFERENCES