Background Unsafe abortion among adolescent girls has emerged as a significant public health issue. This study employed an analytical cross-sectional survey to assess adolescent misconceptions and unsafe practices toward abortion in Rural Tanzania. Methods This study was guided by a pragmatic public-health perspective and employed a school-based analytical cross-sectional survey of a randomized controlled trial (Clinical Trial Registration Number: Pan African Clinical Trial Registry identifier: PACTR20200965616077) design using a quantitative research approach. A structured questionnaire was administered to 331 respondents who were randomly selected and completed it under the guidance of an interviewer. This approach was based on previous studies. IBM SPSS software, version 25, was used to analyze the data with a 95% confidence interval (CI) and a 5% significance level. Results The respondents’ mean age was 13 ± 0.917 years. Findings indicate that 37.9% of respondents reported having had an abortion in their lifetime. Among those who had experienced abortion, 39.2% utilized non-medically approved methods or materials, followed by 39.0% who used Postinor-2(P2) for pregnancy prevention, and 21.8% used medically approved methods/materials. Intrinsic factors significantly associated with abortion included 13–16 years of age (AOR = 1.914, probability (p) value = 0.014; 95% CI 1.019–4.675), 17–19 years of age (AOR = 1.801; p = 0.021; 95% CI 1.032–4.334), and having no disability (AOR = 1.161; p = 0.033; 95% CI 1.005–3.462). Extrinsic factors included living off-campus (AOR = 2.324; p = 0.017; 95% CI 1.766–6.091), engaging in gambling activities (AOR = 2.773; p = 0.017; 95% CI 1.792–6.813), and lack of sexual and reproductive health training (AOR = 2.663; p = 0.022; 95% CI 1.863–6.992). Conclusion a significant number of adolescent girls undergo both safe and unsafe abortions, often performed by untrained individuals using methods and materials that lack clear safety, ethical, or legal classifications and approval. Therefore, large-scale, context-specific, culturally sensitive, and age-appropriate educational initiatives, along with the provision of friendly and supportive abortion care services, are essential to protect adolescent girls and promote their health and productivity in adulthood. Plain English This study was grounded in a rights-based ethical framework by adapting a critical realistic stance framed by a social determinants approach to assess variations in abortion practices as outcomes of interactions between social structures (relationships, economy, and cultural norms), individual agency, and service-related factors, among adolescent girls in rural Tanzania. The research involved 331 respondents, with 37% reporting having had an abortion in their lifetime, of which 39.2% of them used non-medically approved methods/materials, 39.0% Postinor-2 (P2) for pregnancy prevention, and 21.8% used medically approved methods/materials. Factors associated with abortion included extrinsic factors, such as not limited to, partner’s denial of the pregnancy; traditional Birth attendant’s advice, and poverty. On the other side of the coin, other study respondents underwent abortions due to intrinsic factors, including fear of dropping out of school, fear of being isolated by the family, not being prepared to be a parent, and fear of disruption of physical appearance. The study concludes that most girls undergo unsafe abortions by untrained individuals using unapproved methods. Large-scale multifaceted educational initiatives and adolescent- and youth-friendly abortion care, which are context-specific, culturally sensitive, and age-appropriate, are essential for their healthy and productive adulthood.

A cross sectional survey to measure misconceptions and unsafe practices toward abortion among adolescents in Rural Tanzania

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2025年12月27日

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Walter C. Millanzi

摘要

Background

Unsafe abortion among adolescent girls has emerged as a significant public health issue. This study employed an analytical cross-sectional survey to assess adolescent misconceptions and unsafe practices toward abortion in Rural Tanzania.

Methods

This study was guided by a pragmatic public-health perspective and employed a school-based analytical cross-sectional survey of a randomized controlled trial (Clinical Trial Registration Number: Pan African Clinical Trial Registry identifier: PACTR20200965616077) design using a quantitative research approach. A structured questionnaire was administered to 331 respondents who were randomly selected and completed it under the guidance of an interviewer. This approach was based on previous studies. IBM SPSS software, version 25, was used to analyze the data with a 95% confidence interval (CI) and a 5% significance level.

Results

The respondents’ mean age was 13 ± 0.917 years. Findings indicate that 37.9% of respondents reported having had an abortion in their lifetime. Among those who had experienced abortion, 39.2% utilized non-medically approved methods or materials, followed by 39.0% who used Postinor-2(P2) for pregnancy prevention, and 21.8% used medically approved methods/materials. Intrinsic factors significantly associated with abortion included 13–16 years of age (AOR = 1.914, probability (p) value = 0.014; 95% CI 1.019–4.675), 17–19 years of age (AOR = 1.801; p = 0.021; 95% CI 1.032–4.334), and having no disability (AOR = 1.161; p = 0.033; 95% CI 1.005–3.462). Extrinsic factors included living off-campus (AOR = 2.324; p = 0.017; 95% CI 1.766–6.091), engaging in gambling activities (AOR = 2.773; p = 0.017; 95% CI 1.792–6.813), and lack of sexual and reproductive health training (AOR = 2.663; p = 0.022; 95% CI 1.863–6.992).

Conclusion

a significant number of adolescent girls undergo both safe and unsafe abortions, often performed by untrained individuals using methods and materials that lack clear safety, ethical, or legal classifications and approval. Therefore, large-scale, context-specific, culturally sensitive, and age-appropriate educational initiatives, along with the provision of friendly and supportive abortion care services, are essential to protect adolescent girls and promote their health and productivity in adulthood.

Plain English

This study was grounded in a rights-based ethical framework by adapting a critical realistic stance framed by a social determinants approach to assess variations in abortion practices as outcomes of interactions between social structures (relationships, economy, and cultural norms), individual agency, and service-related factors, among adolescent girls in rural Tanzania. The research involved 331 respondents, with 37% reporting having had an abortion in their lifetime, of which 39.2% of them used non-medically approved methods/materials, 39.0% Postinor-2 (P2) for pregnancy prevention, and 21.8% used medically approved methods/materials. Factors associated with abortion included extrinsic factors, such as not limited to, partner’s denial of the pregnancy; traditional Birth attendant’s advice, and poverty. On the other side of the coin, other study respondents underwent abortions due to intrinsic factors, including fear of dropping out of school, fear of being isolated by the family, not being prepared to be a parent, and fear of disruption of physical appearance. The study concludes that most girls undergo unsafe abortions by untrained individuals using unapproved methods. Large-scale multifaceted educational initiatives and adolescent- and youth-friendly abortion care, which are context-specific, culturally sensitive, and age-appropriate, are essential for their healthy and productive adulthood.