Incidence of abortion and related complications in Brong Ahafo Region of Ghana, 2011-2015

Introduction : complications from abortion contribute significantly to maternal mortality in sub-Saharan Africa, including Ghana. Globally, at least 15 out of1000 women in their reproductive age experience induced abortion. This figure might be higher in Ghana since stigmatization leads to under reporting. Brong Ahafo Regional Reproductive and Child Health Unit (RCH) as part of the national strategy, routinely collects data on facility reported abortions but analysis of this data is limited. We analyzed five-year data on abortion in the region to determine trends and key indicators for programme planning. Methods : we reviewed 2011-2015 abortion surveillance data from midwifery form A. reports of the Brong Ahafo Regional Health Directorate. We extracted data on age, abortion method, type of abortion, abortion complication and family planning (FP) acceptors. Data was analyzed with Microsoft Excel and Epi Info 7 and expressed as frequencies and proportions. Results : a total of 25,818 abortions were recorded for 2011-2015, and this represented 5.2% of the expected pregnancies from the region. The mean age was 26 years with age group 20-24 reporting the highest incidence 6569 (25.4%). The teenage (10-19 years) abortion incidence was 5586 (21.6%). The proportion of spontaneous abortion was highest 12725 (51.5%), followed by induced 10388 (41.9%) and elective 1669 (6.7%). Method used by the health facilities were Dilation & Curettage (50.6%), Manual Vacuum Aspiration (48.7%) and medical (0.7%). Abortion clients that accepted FP was 57%. About 603 (2.4%) resulted in complications from haemorrhage (58%), sepsis (35%), and perforation (7%). Conclusion : the proportion of teenagers in the region who abort is high. Hemorrhage and sepsis are the major complications associated with these abortions. The high level of induced abortions suggests unmet needs for family planning and comprehensive abortion care and therefore place them at a high risk for maternal mortality. Targeted programs aimed at preventing unwanted pregnancies must be enhanced.