Abstract:
The Ghanaian abortion law was amended in 1985 to ensure more availability and
accessibility of safe abortion services as permitted by law. Contrary to the legal
provision for abortion in Ghana, anecdotal evidence suggest the use of abortion
as a family planning option in Ghana hence this exploratory study. Using a crosssectional
and descriptive design, data was obtained from 50 health facilities
comprising private (42) and Non-Governmental Organizations (NGO) (8). Ten indepth
interviews were also held with midwife providers (6) and medical officers
(4) between January 2010 and December 2017 in Accra and Kumasi Metropolises.
Findings show that patronage of abortion services in health facilities within Accra
and Kumasi Metropolises increase steadily each year. Abortion services in NGO
facilities were however reported as target driven and providers’ performances/
bonuses were tied to meeting set targets thereby encouraging abortion on
demand. Whereas NGO facilities provide both abortion and full contraception
method mix, majority (38 out of 42) of private facilities provide only abortion
services. Those providing contraception focus mainly on short term methods (pills
and injections) due to lack of interest and/or trained providers. There is more
midwife lead abortion providing facilities in Accra (40) than in Kumasi (10). Where
midwives provided abortion services, contraceptives were readily available and
clients encouraged to take a method following abortion. This practice was very
common in NGO facilities as post abortion contraception was reported to be a
mandatory package. Increasing numbers of abortions in the study area coupled
with reported target setting for abortion services suggest abortion on demand and
its being used as a family planning option. A nationwide facility based assessment
of abortion and contraception service delivery is recommended to inform policy.
