From 1990 to 1994, there were 79 unintended pregnancies and 40 abortions per 1,000 women of reproductive age, compared to 64 unintended pregnancies and 40 abortions per 1,000 women from 2015-2019. Although the global unintended abortion rate has decreased from 1990 to 2019, the abortion rate remains more or less the same. This statistic illustrates the unintended pregnancy and abortion rates worldwide from 1990 to 2019.

This statistic shows estimated abortion rates worldwide from 1990 to 1994 and 2015 to 2019, by region. From 2015 to 2019, there were an estimated ** abortions per 1,000 women aged 15-49 years worldwide.

From 2015 to 2019, there were 93 unintended pregnancies and 38 abortions per 1,000 women of reproductive age in low-income countries, compared to 34 unintended pregnancies and 15 abortions per 1,000 women in high-income countries. This statistic illustrates the unintended pregnancy and abortion rates worldwide from 2015 to 2019, by income group.

From 2015 to 2019, there were 58 unintended pregnancies and 40 abortions per 1,000 women of reproductive age in countries where abortion is broadly legal, compared to 80 unintended pregnancies and 40 abortions per 1,000 women in countries where abortion is prohibited altogether. The abortion rate for both groups is identical despite the wide difference in restriction levels. This statistic illustrates the unintended pregnancy and abortion rates worldwide from 2015 to 2019, by abortion legality.

Abortions in the Soviet Union became much more accessible under the Khrushchev administration in 1953, and the USSR's abortion rate subsequently developed into the highest in the world. The Soviet government did not begin releasing official statistical data until the 1970s, however it is believed that around six or seven million abortions were carried out each year in the 1950s and 1960s; a figure that remained fairly consistent until the late 1980s**. This high rate was, in-part, due to rapid urbanization and a desire for smaller families, as well as the lack of quality contraceptives produced by the Soviet government, and the widespread belief that abortion was safer than the side-effects of hormonal regulation via the pill. Relative to population size, there were between 97 and 106 abortions carried out per 1,000 women aged between 15 and 49 in the given years, which is roughly equal to one in ten women of childbearing age having an abortion each year (estimates for Russia alone suggest that this number was one in six in the 1960s). There were however regional disparities across the Soviet Union, as abortions were much more accessible and common in the European part of the country, and less available or socially acceptable in the Muslim-majority and rural regions of Asia. Abortion in the U.S. In the U.S. during this time, the abortion rate was much lower due to previous legal restrictions and lack of access, societal attitudes, and better access to contraceptives. Prior to 1973, abortions were either banned outright or only available under specific circumstances in all-but-four states. The Supreme Court case Roe v. Wade then saw the removal of most federal restrictions relating to abortion in the first trimester of pregnancy. This granted women across the country greater access to legal abortions; in 1975 there were over one million legal abortions performed in the U.S., and between 1.5 and 1.6 million in the 1980s. Proportional to population size, this equated to 29 abortions per 1,000 women aged between 15 and 45 in 1980, which is roughly equal to one in 34 women of childbearing age having an abortion in this year. Legacy During the decline and dissolution of the Soviet Union, the government began to promote the use of contraceptives, however the poor quality and supply of these reinforced former perceptions that they were more harmful than abortions. Additionally, medical institutions received much higher sums from the government when abortions were performed (relative to income from contraceptives), and these incentives delayed the drop in Russian and other post-Soviet states' abortion rates. While it is now generally accepted that contraception is safer than abortion, and awareness of the risks of infertility and maternal death has become more widespread, today, Soviet successor states have some of the highest abortion rates in the world by a considerable margin.

In the U.S., following the peak of almost 30 abortions per 1,000 women aged 15 to 44 in the 1980s, the abortion rate has gradually fallen with each decade, even dropping below the 1973 level in 2017. Although this is a side effect of improvements in contraception and education, a large part of this decline can be attributed to restricted access to abortion, particularly in rural and southern regions. While the majority of U.S. adults support Roe v. Wade, the Supreme Court overturned the ruling in June 2022, granting states the right to determine their own abortion laws.

BackgroundIn 2010–2014, approximately 86% of abortions took place in low- and middle-income countries (LMICs). Although abortion incidence varies minimally across geographical regions, it varies widely by subregion and within countries by subgroups of women. Differential abortion levels stem from variation in the level of unintended pregnancies and in the likelihood that women with unintended pregnancies obtain abortions.ObjectivesTo examine the characteristics of women obtaining induced abortions in LMICs.MethodsWe use data from official statistics, population-based surveys, and abortion patient surveys to examine variation in the percentage distribution of abortions and abortion rates by age at abortion, marital status, parity, wealth, education, and residence. We analyze data from five countries in Africa, 13 in Asia, eight in Europe, and two in Latin America and the Caribbean (LAC).ResultsWomen across all sociodemographic subgroups obtain abortions. In most countries, women aged 20–29 obtained the highest proportion of abortions, and while adolescents obtained a substantial fraction of abortions, they do not make up a disproportionate share. Region-specific patterns were observed in the distribution of abortions by parity. In many countries, a higher fraction of abortions occurred among women of high socioeconomic status, as measured by wealth status, educational attainment, and urban residence. Due to limited data on marital status, it is unknown whether married or unmarried women make up a larger share of abortions.ConclusionsThese findings help to identify subgroups of women with disproportionate levels of abortion, and can inform policies and programs to reduce the incidence of unintended pregnancies; and in LMICs that have restrictive abortion laws, these findings can also inform policies to minimize the consequences of unsafe abortion and motivate liberalization of abortion laws. Program planners, policymakers, and advocates can use this information to improve access to safe abortion services, postabortion care, and contraceptive services.

BackgroundDuring the 1970s the Nordic countries liberalized their abortion laws.ObjectiveWe assessed epidemiological trends for induced abortion on all Nordic countries, considered legal similarities and diversities, effects of new medical innovations and changes in practical and legal provisions during the subsequent years.MethodsNew legislation strengthened surveillance of induced abortion in all countries and mandated hospitals that performed abortions to report to national abortion registers. Published data from the Nordic abortion registers were considered and new comparative analyses done. The data cover complete national populations.Results and conclusionsAfter an increase in abortion rates during the first years following liberalization, the general abortion rates stabilized and even decreased in all Nordic countries, especially for women under 25 years. From the mid-1980s higher awareness about pregnancy termination led women to present at an earlier gestational age, which was accelerated by the introduction of medical abortion some years later. Most terminations (80–86%) are now done before the 9th gestational week in all countries, primarily by medical rather than surgical means. Introduction of routine ultrasound screening in pregnancy during the late 1980s, increased the number of 2nd trimester abortions on fetal anomaly indications without an overall increase in the proportion of 2nd relative to 1st trimester abortions. Further refinement of ultrasound screening and non-invasive prenatal diagnostic methods led to a slight increase in the proportion of early 2nd trimester abortions after the year 2000. Country-specific differences in abortion rates have remained stable over the 50 years of liberalized abortion laws.

In 2022, there were around 613 thousand legal abortions in the United States. The number of legal abortions in the United States has decreased significantly since the early 1990’s. This number will probably continue to decrease in the coming years since many states have severely limited or completely banned abortion after the overturning of Roe v. Wade by the Supreme Court in 2022. The states with the highest abortion rates In 2022, the rate of legal abortions per live births in the United States was 19.9 per 100. In comparison, in 1990 there were 34.4 abortions per 100 live births. The states with the highest rates of abortion per live births are New Mexico, Illinois, and Florida. In Florida, there were around 37 abortions per 100 live births in 2022. Florida had the highest total number of abortions that year, followed by New York and Illinois. Missouri and South Dakota had the lowest number of abortions in 2022. Out-of-state abortions Critics of the Supreme Court decision to overturn Roe v. Wade argue that while those who can afford it may be able to travel to other states for an abortion if their state bans the procedure, poorer residents will have no such choice. Even before the overturning of Roe v. Wade, out-of-state residents already accounted for a high share of abortions in certain states. In 2022, 69 percent of abortions in Kansas were performed on out-of-state residents, while out-of-state residents accounted for around 62 percent of abortions in New Mexico. Illinois had the highest total number of abortions performed on out-of-state residents that year, with around 16,849 procedures.

These four datasets were collected by the Guttmacher Institute. They consist of the Ethiopia Prospective Data Survey (2014), Nigeria Community-Based Survey (2002-2003), Nigeria Hospital-Based Survey (2002-2003), and the Philippines Community-Based Survey (CBS). We used these data to calculate the distribution of abortions by women's sociodemographic characteristics and abortion rates (Nigeria, Philippines).

Percentage distribution of abortions by wealth, by region and country.

ContextThe last decade witnessed growing differences in abortion dynamics in Belarus, Russia, and Ukraine despite demographic, social, and historical similarities of these nations. This paper investigates changes in birth control practices in the three countries and searches for an explanation of the diverging trends in abortion. MethodsOfficial abortion and contraceptive use statistics, provided by national statistical agencies, were analysed. Respective laws and other legal documents were examined and compared between the three countries. To disclose inter-country differences in prevalence of the modern methods of contraception and its association with major demographic and social factors, an analysis of data from national sample surveys was performed, including binary logistic regression. ResultsThe growing gap in abortion rate in Belarus, Russia, and Ukraine is a genuine phenomenon, not a statistical artefact. The examination of abortion and prevalence of contraception based on official statistics and three national sample surveys did not reveal any unambiguous factors that could explain differences in abortion dynamics in Belarus, Russia, and Ukraine. However, it is very likely that the cause of the inter-country discrepancies lies in contraceptive behavior itself, in adequacies of contraceptive knowledge and practices. Additionally, large differences in government policies, which are very important in shaping contraceptive practices of the population, were detected. ConclusionSince the end of the 1990s, the Russian government switched to archaic ideology in the area of reproductive health and family planning and neglects evidence-based arguments. Such an extreme turn in the governmental position is not observed in Belarus or Ukraine. This is an important factor contributing to the slowdown in the decrease of abortion rates in Russia.

BackgroundZimbabwe has the highest contraceptive prevalence rate in sub-Saharan Africa, but also one of the highest maternal mortality ratios in the world. Little is known, however, about the incidence of abortion and post-abortion care (PAC) in Zimbabwe. Access to legal abortion is rare, and limited to circumstances of rape, incest, fetal impairment, or to save the woman’s life.ObjectivesThis paper estimates a) the national provision of PAC, b) the first-ever national incidence of induced abortion in Zimbabwe, and c) the proportion of pregnancies that are unintended.MethodsWe use the Abortion Incidence Complications Method (AICM), which indirectly estimates the incidence of induced abortion by obtaining a national estimate of PAC cases, and then estimates what proportion of all induced abortions in the country would result in women receiving PAC. Three national surveys were conducted in 2016: a census of health facilities with PAC capacity (n = 227), a prospective survey of women seeking abortion-related care in a nationally-representative sample of those facilities (n = 127 facilities), and a purposive sample of experts knowledgeable about abortion in Zimbabwe (n = 118). The estimate of induced abortion, along with census and Demographic Health Survey data was used to estimate unintended pregnancy.ResultsThere were an estimated 25,245 PAC patients treated in Zimbabwe in 2016, but there were critical gaps in their care, including stock-outs of essential PAC medicines at half of facilities. Approximately 66,847 induced abortions (uncertainty interval (UI): 54,000–86,171) occurred in Zimbabwe in 2016, which translates to a national rate of 17.8 (UI: 14.4–22.9) abortions per 1,000 women 15–49. Overall, 40% of pregnancies were unintended in 2016, and one-quarter of all unintended pregnancies ended in abortion.ConclusionZimbabwe has one of the lowest abortion rates in sub-Saharan Africa, likely due to high rates of contraceptive use. There are gaps in the health care system affecting the provision of quality PAC, potentially due to the prolonged economic crisis. These findings can inform and improve policies and programs addressing unsafe abortion and PAC in Zimbabwe.

Eurostat’s annual data collections on demographic and migration statistics are structured as follows:

• NOWCAST: Annual data collection on provisional monthly data on live births and deaths covering at least six months of the reference year (Article 4.3 of the Commission implementing regulation (EU) No 205/2014).
• DEMOBAL (Demographic balance): Annual data collection on provisional data on population, total live births and total deaths at national level (Article 4.1 of the Commission implementing regulation (EU) No 205/2014).
• POPSTAT (Population statistics): The most in-depth annual national and regional demographic and migration data collection. The data relate to populations, births, deaths, immigrants, emigrants, marriages and divorces, and is broken down into several categories (Article 3 of Regulation (EU) No 1260/2013 and Article 3 of Regulation (EC) No 862/2007).

The aim is to collect annual mandatory and voluntary demographic data from the national statistical institutes. Mandatory data are those defined by the legislation listed under ‘6.1. Institutional mandate - legal acts and other agreements’.

The completeness of the demographic data collected on a voluntary basis depends on the availability and completeness of information provided by the national statistical institutes. For more information on mandatory/voluntary data collection, see 6.1. Institutional mandate - legal acts and other agreements’.

The following statistics on live births are collected from the National Statistical Institutes:

• Live births by month of occurrence;
• Live births by mother's age, year of birth and by:
  • region (NUTS 2) of residence
  • region (NUTS 3) of residence
  • mother's country of birth
  • mother's country of citizenship
  • live-birth order
  • sex of the new-born
  • mother's legal marital status
  • employment status of the mother
  • mother's educational attainment (ISCED 2011);
• Live births by birth weight and duration of gestation;
• Legally induced abortions by mother's age and parity;
• Late fœtal deaths by mother's age.

Statistics on fertility: based on the different breakdowns of data on live births and on legally induced abortions received, Eurostat produces the following:

• Statistics available in the online table Population change - Demographic balance and crude rates at national level (demo_gind):
  • natural change of the population, crude birth rate;
• Statistics available in the online table Fertility indicators (demo_find):
  • the proportion of live births outside marriage
  • total fertility rate
  • the mean age of women at childbirth
  • the mean age of women at the birth of first / second / third / fourth and higher child
  • the median age of women at childbirth
  • the percentage of first / second / third / fourth and higher live births Fertility rates by age (demo_frate);
• Fertility rates by age and NUTS 2 region (demo_r_frate2);
• Total fertility rate by NUTS 3 region (demo_r_frate3);
• Statistics available in the online table Abortion indicators (demo_fabortind):
  • abortion rate
  • abortion ratio

In 2022, there were roughly **** abortions per 1,000 women in France. The abortion rate in France remained pretty stable since the nineties, while the estimated abortion rate in Europe decreased significantly. Abortion in France France legalized abortion in 1975. If at that time the fight for legalization was intense, it appears that now the support for abortion right in France is widespread. In 2017, more than 80 percent of French people declared that abortion should be legal in all or most cases. France has a low rate of teenage pregnancy, but the abortion rate is not the same throughout the country. Overseas regions of France such as Guadeloupe or Mayotte have a higher abortion rate number of young women aged from 15 to 17 years, while in the rest of the country the majority of abortions concerned women aged between 20 and 29 years. The evolution of contraception in France Like in other European countries, French women seem to be more and more concerned about the consequences that may be related to their contraception method. In 2017, ** percent of women in France stated that they were rather worried about the cardiovascular risks of hormonal contraception like the pill. Consequently, the share of French women using contraceptive oral pills is decreasing and other methods like IUD or implant are becoming more common.

Abstract Objectives: this study intends to estimate the rates, associated factors and trends of selfreported abortion rates in the northeast of Brazil. Methods: series of population-based surveys realized in Ceará, northeast of Brazil, one of the poorest states in the country. A sample of about 27,000 women of reproductive age was used. Abortion was assessed according to women´s information and rates were calculated using official population estimates. The trends and the association among socioeconomic and reproductive factors were studied using regressive models. Results: a trend for reduction in rates was identified. For induced abortion, the determinants were: not having a partner, condom in the last sexual intercourse, first child up to 25years old (AOR= 5.21; ACI: 2.9 – 9.34) and having less than 13years old at first sexual intercourse (AOR= 5.88; ACI: 3.29 – 10.51). For spontaneous abortion were: having studied less than 8 years, knowledge and use of morning-after pill (AOR= 26.44; ACI: 17.9 – 39.05) and not having any children (AOR= 3.43). Conclusions: rates may have been low due to self-reporting. Young age and knowledge about contraceptive methods were associated to both kinds of abortion, while education level along with spontaneous and marital status with induced. Programs to reduce abortion rates should focus on single younger women with low education.

More than ******* abortions were performed in Russia in 2023. Starting from over *** millio* abortions recorded in the country in 2000, the number of terminated pregnancies has continuously decreased over time. The figures include induced abortions as well as miscarriages. The abortion rate in Russia stood at *** procedures per 1,000 live births in 2022. How is abortion regulated in Russia? Abortions are legal in Russia up to the 12th week of pregnancy and up to the 22nd week in cases of rape. They are conducted in state as well as private medical facilities. In 2022, approximately ********* of all pregnancy terminations in the country were conducted in commercial clinics. However, over the past decade, the laws regarding abortion have been tightened, allowing for fewer reasons for pregnancy termination. Moreover, there are proposals to ban abortions in private clinics. In a ranking of European policies by progressiveness and openness to abortion, Russia listed below most Western European countries. Contraception use in Russia Russia was one of the lowest-ranking countries in Europe by access to modern contraception. Approximately ** percent of Russian women aged 15 to 49 years used hormonal contraceptives, while ***** percent used an intrauterine device (IUD). In 2023, the country’s health ministry increased control over the sale and storage of mifepristone and misoprostol, medicines for pregnancy termination.

Prevalence and odds of reporting an abortion before age 20, among women who conceived before age 20, by parent socioeconomic group and individual level of education, 17–29 year olds, Britain and France.

Abstract

The 1996 Uzbekistan Demographic and Health Survey (UDHS) is a nationally representative survey of 4,415 women age 15-49. Fieldwork was conducted from June to October 1996. The UDHS was sponsored by the Ministry of Health (MOH), and was funded by the United States Agency for International Development. The Institute of Obstetrics and Gynecology implemented the survey with technical assistance from the Demographic and Health Surveys (DHS) program.

The 1996 UDHS was the first national-level population and health survey in Uzbekistan. It was implemented by the Research Institute of Obstetrics and Gynecology of the Ministry of Health of Uzbekistan. The 1996 UDHS was funded by the United States Agency for International development (USAID) and technical assistance was provided by Macro International Inc. (Calverton, Maryland USA) through its contract with USAID.

OBJECTIVES AND ORGANIZATION OF THE SURVEY

The purpose of the 1996 Uzbekistan Demographic and Health Survey (UDHS) was to provide an information base to the Ministry of Health for the planning of policies and programs regarding the health of women and their children. The UDHS collected data on women's reproductive histories, knowledge and use of contraception, breastfeeding practices, and the nutrition, vaccination coverage, and episodes of illness among children under the age of three. The survey also included, for all women of reproductive age and for children under the age of three, the measurement of the hemoglobin level in the blood to assess the prevalence of anemia and measurements of height and weight to assess nutritional status.

A secondary objective of the survey was to enhance the capabilities of institutions in Uzbekistan to collect, process and analyze population and health data so as to facilitate the implementation of future surveys of this type.

MAIN RESULTS

• Fertility Rates. Survey results indicate a total fertility rate (TFR) for all of Uzbekistan of 3.3 children per woman. Fertility levels differ for different population groups. The TFR for women living in urbml areas (2.7 children per woman) is substantially lower than for women living in rural areas (3.7). The TFR for Uzbeki women (3.5 children per woman) is higher than for women of other ethnicities (2.5). Among the regions of Uzbekistan, the TFR is lowest in Tashkent City (2.3 children per woman).
• Family Planning. Knowledge. Knowledge of contraceptive methods is high among women in Uzbekistan. Knowledge of at least one method is 89 percent. High levels of knowledge are the norm for women of all ages, all regions of the country, all educational levels, and all ethnicities. However, knowledge of sterilization was low; only 27 percent of women reported knowing of this method.
• Fertility Preferences. A majority of women in Uzbekistan (51 percent) indicated that they desire no more children. Among women age 30 and above, the proportion that want no more children increases to 75 percent. Thus, many women come to the preference to stop childbearing at relatively young ages when they have 20 or more potential years of childbearing ahead of them. For some of these women, the most appropriate method of contraception may be a long-acting method such as female sterilization, However, there is a deficiency of both knowledge and use of this method in Uzbekistan. In the interest of providing couples with a broad choice of safe and effective methods, information about this method and access to it should be made available so that informed choices about its suitability can be made by individual women and couples.
• Induced Aboration : Abortion Rates. From the UDHS data, the total abortion rate (TAR)--the number of abortions a woman will have in her lifetime based on the currently prevailing abortion rates--was calculated. For Uzbekistan, the TAR for the period from mid-1993 to mid-1996 is 0.7 abortions per woman. As expected, the TAR for Uzbekistan is substantially lower than recent estimates of the TAR for other areas of the former Soviet Union such as Kazakstan (1.8), Romania (3.4 abortions per woman), and Yekaterinburg and Perm in Russia (2.3 and 2.8, respectively).
• Infant mortality : In the UDHS, infant mortality data were collected based on the international definition of a live birth which, irrespective of the duration of pregnancy, is a birth that breathes or shows any sign of life (United Nations, 1992).
• Mortality Rates. For the five-year period before the survey (i.e., approximately mid- 1992 to mid- 1996), infant mortality in Uzbekistan is estimated at 49 infant deaths per 1,000 births. The estimates of neonatal and postneonatal mortality are 23 and 26 per 1,000.
• Maternal and child health : Uzbekistan has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. This system includes special delivery hospitals, the obstetrics and gynecology departments of general hospitals, women's consulting centers, and doctor's assistant/midwife posts (FAPs). There is an extensive network of FAPs throughout rural areas.
• Nutrition : Breastfeeding. Breastfeeding is almost universal in Uzbekistan; 96 percent of children born in the three years preceding the survey are breastfed. Overall, 19 percent of children are breastfed within an hour of delivery and 40 percent within 24 hours of delivery. The median duration of breastfeeding is lengthy (17 months). However, durations of exclusive breastfeeding, as recommended by WHO, are short (0.4 months).
• Prevalence of anemia : Testing of women and children for anemia was one of the major efforts of the 1996 UDHS. Anemia has been considered a major public health problem in Uzbekistan for decades. Nevertheless, this was the first anemia study in Uzbekistan done on a national basis. The study involved hemoglobin (Hb) testing for anemia using the Hemocue system. Women. Sixty percent of the women in Uzbekistan suffer from some degree of anemia. The great majority of these women have either mild (45 percent) or moderate anemia (14 percent). One percent have severe anemia.

Geographic coverage

National Seven raions were excluded from the survey because they were considered too remote and sparsely inhabited.

Analysis unit

• Household
• Women age 15-49

Universe

The population covered by the 1996 UDHS is defined as the universe of all women age 15-49 in Uzbekistan

Kind of data

Sample survey data

Sampling procedure

The UDHS employed a probability sample of women age 15 to 49, representative of 98.7 percent of the country. Seven raions were excluded from the survey because they were considered too remote and sparsely inhabited. These raions are: Kungradskiyi, Muyinakskiyi, and Takhtakupyrskiyi in Karakalpakstan; Uchkudukskiyi, Tamdynskiyi, and Kanimekhskiyi in Navoiiskaya; and Romitanskiyi in Bukharskaya. The remainder of the country was divided into five survey regions. Tashkent City constituted a survey region by itself, while the remaining four survey regions consisted of groups of contiguous oblasts. The five survey regions were defined as follows: Region 1: Karakalpakstan and Khoresmskaya. Region 2: Navoiyiskaya, Bukharskaya, Kashkadarinskaya, and Surkhandarinskaya. Region 3: Samarkandskaya, Dzhizakskaya, Syrdarinskaya, and Tashkentskaya. Region 4: Namanganskaya, Ferganskaya, and Andizhanskaya. Region 5: Tashkent City.

CHARACTERISTICS OF THE UDHS SAMPLE

The sample for the UDHS was selected in three stages. In the rural areas, the primary sampling units (PSUs) corresponded to the raions which were selected with probabilities proportional to size, the size being the 1994 population. At the second stage, one village was selected in each selected raion. A complete listing of the households residing in each selected village was carried out. The lists of households obtained were used as the frame for third-stage sampling, which is the selection of the households to be visited by the UDHS interviewing teams during the main survey fieldwork. In each selected household, women between the ages of 15 and 49 were identified and interviewed.

In the urban areas, the PSUs were the cities and towns themselves. In the second stage, one health block was selected from each town except in self-representing cities (large cities that were selected with certainty), where more than one health block was selected. The selected health blocks were segmented prior to the household listing operation which provided the household lists for the third-stage selection of households.

SAMPLE ALLOCATION

The regions, stratified by urban and rural areas, were the sampling strata. There were thus nine strata with Tashkent City constituting an entire stratum. A proportional allocation of the target number of 4,000 women to the 9 strata would yield the sample distribution.

The proportional allocation would result in a completely self-weighting sample but would not allow for reliable estimates for at least two of the five survey regions, namely Region 1 and Tashkent City. Results of other demographic and health surveys show that a minimum sample of 1,000 women is required in order to obtain estimates of fertility and childhood mortality rates at an acceptable level of sampling errors. Given that the total sample size for the UDHS could not he increased so as to achieve the required level of sampling errors, it was decided that the sample would be divided equally among the five regions, and within each region, it would be distributed proportionally to the urban and the rural areas. With this type of allocation, demographic rates (fertility and mortality) could not be produced for regions separately.

The number of sample points (or clusters) to be selected for each stratum was calculated by dividing the

The Ukraine Demographic and Health Survey (UDHS) is a nationally representative survey of 6,841 women age 15-49 and 3,178 men age 15-49. Survey fieldwork was conducted during the period July through November 2007. The UDHS was conducted by the Ukrainian Center for Social Reforms in close collaboration with the State Statistical Committee of Ukraine. The MEASURE DHS Project provided technical support for the survey. The U.S. Agency for International Development/Kyiv Regional Mission to Ukraine, Moldova, and Belarus provided funding.

The survey is a nationally representative sample survey designed to provide information on population and health issues in Ukraine. The primary goal of the survey was to develop a single integrated set of demographic and health data for the population of the Ukraine.

The UDHS was conducted from July to November 2007 by the Ukrainian Center for Social Reforms (UCSR) in close collaboration with the State Statistical Committee (SSC) of Ukraine, which provided organizational and methodological support. Macro International Inc. provided technical assistance for the survey through the MEASURE DHS project. USAID/Kyiv Regional Mission to Ukraine, Moldova and Belarus provided funding for the survey through the MEASURE DHS project. MEASURE DHS is sponsored by the United States Agency for International Development (USAID) to assist countries worldwide in obtaining information on key population and health indicators.

The 2007 UDHS collected national- and regional-level data on fertility and contraceptive use, maternal health, adult health and life style, infant and child mortality, tuberculosis, and HIV/AIDS and other sexually transmitted diseases. The survey obtained detailed information on these issues from women of reproductive age and, on certain topics, from men as well.

The results of the 2007 UDHS are intended to provide the information needed to evaluate existing social programs and to design new strategies for improving the health of Ukrainians and health services for the people of Ukraine. The 2007 UDHS also contributes to the growing international database on demographic and health-related variables.

MAIN RESULTS

- Fertility rates. A useful index of the level of fertility is the total fertility rate (TFR), which indicates the number of children a woman would have if she passed through the childbearing ages at the current age-specific fertility rates (ASFR). The TFR, estimated for the three-year period preceding the survey, is 1.2 children per woman. This is below replacement level.

- Contraception : Knowledge and ever use. Knowledge of contraception is widespread in Ukraine. Among married women, knowledge of at least one method is universal (99 percent). On average, married women reported knowledge of seven methods of contraception. Eighty-nine percent of married women have used a method of contraception at some time.

- Abortion rates. The use of abortion can be measured by the total abortion rate (TAR), which indicates the number of abortions a woman would have in her lifetime if she passed through her childbearing years at the current age-specific abortion rates. The UDHS estimate of the TAR indicates that a woman in Ukraine will have an average of 0.4 abortions during her lifetime. This rate is considerably lower than the comparable rate in the 1999 Ukraine Reproductive Health Survey (URHS) of 1.6. Despite this decline, among pregnancies ending in the three years preceding the survey, one in four pregnancies (25 percent) ended in an induced abortion.

- Antenatal care. Ukraine has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. Overall, the levels of antenatal care and delivery assistance are high. Virtually all mothers receive antenatal care from professional health providers (doctors, nurses, and midwives) with negligible differences between urban and rural areas. Seventy-five percent of pregnant women have six or more antenatal care visits; 27 percent have 15 or more ANC visits. The percentage is slightly higher in rural areas than in urban areas (78 percent compared with 73 percent). However, a smaller proportion of rural women than urban women have 15 or more antenatal care visits (23 percent and 29 percent, respectively).

- HIV/AIDS and other sexually transmitted infections : The currently low level of HIV infection in Ukraine provides a unique window of opportunity for early targeted interventions to prevent further spread of the disease. However, the increases in the cumulative incidence of HIV infection suggest that this window of opportunity is rapidly closing.

- Adult Health : The major causes of death in Ukraine are similar to those in industrialized countries (cardiovascular diseases, cancer, and accidents), but there is also a rising incidence of certain infectious diseases, such as multidrug-resistant tuberculosis.

- Women's status : Sixty-four percent of married women make decisions on their own about their own health care, 33 percent decide jointly with their husband/partner, and 1 percent say that their husband or someone else is the primary decisionmaker about the woman's own health care.

- Domestic Violence : Overall, 17 percent of women age 15-49 experienced some type of physical violence between age 15 and the time of the survey. Nine percent of all women experienced at least one episode of violence in the 12 months preceding the survey. One percent of the women said they had often been subjected to violent physical acts during the past year. Overall, the data indicate that husbands are the main perpetrators of physical violence against women.

- Human Trafficking : The UDHS collected information on respondents' awareness of human trafficking in Ukraine and, if applicable, knowledge about any household members who had been the victim of human trafficking during the three years preceding the survey. More than half (52 percent) of respondents to the household questionnaire reported that they had heard of a person experiencing this problem and 10 percent reported that they knew personally someone who had experienced human trafficking.

Abstract

Unsafe abortion was one of the major causes of complications, leading to Liberia's high maternal mortality ratio (1,072 deaths per 100,000 live births). The Ministry of Health highly prioritized reducing the high rates of maternal and neonatal deaths in the country. Among national efforts to improve access to and quality of reproductive, maternal, neonatal, child, and adolescent health (RMNCAH) services was the prevention of unsafe abortion and morbidity and mortality from unsafe abortions because nearly 6 out of 10 girls were mothers before age 19. In addition, adolescent pregnancy contributed to high maternal mortality and high neonatal mortality. Nevertheless, there was little information available on abortion incidence, burden and costs of managing complications from unsafe abortions, and the quality of post-abortion care. Data were critical for government and civil society stakeholders to design effective policies and guidance to reduce maternal morbidity and mortality from unsafe abortions and to advocate for increased access to comprehensive abortion care (inclusive of safe abortion for legal indications and post-abortion care) in Liberia.

Objectives: The overall aim of the study was to determine the incidence of induced abortions, severity and magnitude of abortion-related complications, quality of PAC, and cost burden of unsafe abortion on the health systems in Liberia.

Methodology: A mixed-method cross-sectional design was applied to determine the incidence of abortion in Liberia. This research design was employed using the Abortion Incidence Complication Method (AICM). This widely applied indirect method had produced robust estimates of abortion incidence in a range of contexts. The study comprised five (5) different surveys, namely: 1) Health Facility Survey (HFS), 2) Prospective Morbidity Survey, 3) Knowledgeable Informant Survey, 4) Quality of PAC survey, and 5) Post Abortion Care (PAC) Costing Survey. The Health Facility Survey was implemented at sampled public facilities using a nationally representative, stratified, random sampling approach to determine the incidence of induced abortion and abortion complications in Liberia. The Health Facility Survey also included a quality survey to assess the quality of post-abortion care. The Prospective Morbidity Survey was about women seeking PAC in health facilities and providers, including a patient chart review to assess the severity of complications. It also collected data on decision-making, care-seeking pathways, and awareness of the country's abortion law. For the Knowledgeable Informant Survey, a sample of health sector stakeholders who were knowledgeable about abortion/PAC in Liberia were interviewed. Data from this component generated the multiplier to inform the incidence of abortion. The PAC costing study targeted health facility administrators to estimate the costs of PAC at facilities and the national level.

Geographic coverage

National coverage

Analysis unit

professionals knowledgeable about the conditions of abortion and the provision of post-abortion care abortion around Liberia

Universe

The survey covered professionals knowledgeable about the conditions of abortion and the provision of post-abortion care abortion in Liberia, they included medical doctors and midwives in public and private practice, policymakers, advocates, researchers, NGO staff, community health workers, and community leaders

Sampling procedure

The KIS involved in-person structured interviews with a sample of purposively selected respondents with knowledge about the provision of abortion and PAC in the country (nationally or pertaining to specific regions). Informants were not restricted to clinicians providing direct CAC services to patients. Potential key informants were identified through purposeful and snowball sampling. A total of 89 key informants were interviewed on topics ranging from their perception regarding the type of providers women seek abortion from, the likelihood women will experience complications that require treatment in a facility according to the type of abortion provider used, to the likelihood that women who need treatment will receive it at a health facility. These questions were asked for four (4) major sub-groups of women within the population: rural poor, rural non-poor, urban poor, and urban non-poor. This information was used in the calculation of the multiplier. The multiplier is the number of women/girls who have induced abortion who either did not have complications, or had complications that were not treated in the formal health system, for everyone that received facility-based care. Other data sources used for calculating abortion incidence were the 2019/2020 Liberia Demographic and Health Survey (LDHS) (7), which provided information on fertility, contraceptive prevalence, unmet need for contraception, birth wantedness, and measures of access to health care. We also drew data from 2021 population projection for the number of women aged 15-49 in the different regions of Liberia. We used the Poverty & Equity Brief for Liberia 2021(15) and the Global Multidimensional Poverty Index (MPI) Country Briefing 2021: (16), to estimate the proportion of poor/non-poor in urban/rural settings in Liberia.

Sampling deviation

N/A

Mode of data collection

Face-to-face [f2f]

Research instrument

KIS was used to sample and recruit both health and non-health professionals (e.g., law, media, teachers, research, education, nursing, policymaking, advocacy, and family planning program implementation and management) who are nevertheless well-informed about the context of abortion (access, safety, care-seeking behavior) in their regions. Interviews were carried out at the respondents' place of work or location of the respondents' choice The questionnaire was written in English. It explored a number of questions that served to refine further an understanding and the opinion of abortion incidence and safety in Liberia.

Cleaning operations

the software used was survey CTO for data colllection, the data was later downloaded in STATA format.

Response rate

100%

Sampling error estimates

N/A