Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study

Abstract Background Between 2010 and 2014, approximately 25 million unsafe abortions were performed annually across the globe. Africa alone accounted for 29% of all unsafe abortions, and 62% of the related deaths. Women living in poverty, especially adolescents, lack information about where and how...

Full description

Bibliographic Details
Main Authors: Lawrence Rugema, Marie Ange Uwase, Athanase Rukundo, Vianney Nizeyimana, Theobald Mporanyi, Aflodis Kagaba
Format: Article
Language:English
Published: BMC 2023-04-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-023-02366-4
_version_ 1797836258904375296
author Lawrence Rugema
Marie Ange Uwase
Athanase Rukundo
Vianney Nizeyimana
Theobald Mporanyi
Aflodis Kagaba
author_facet Lawrence Rugema
Marie Ange Uwase
Athanase Rukundo
Vianney Nizeyimana
Theobald Mporanyi
Aflodis Kagaba
author_sort Lawrence Rugema
collection DOAJ
description Abstract Background Between 2010 and 2014, approximately 25 million unsafe abortions were performed annually across the globe. Africa alone accounted for 29% of all unsafe abortions, and 62% of the related deaths. Women living in poverty, especially adolescents, lack information about where and how to access safe abortion services. They often lack adequate insight to make informed decisions. The purpose of this study was to explore the empowered perspectives of women leaders in Rwanda about the recent policy change for safe abortion. The study identifies women leaders’ perceived barriers and their attitudes about resulting consequences toward safe abortion. Method In this qualitative study, seven focus group discussions and eight key informant interviews were performed in October 2019. A total of 51 women leaders participated, their age ranging from 38 to 60 years. Participants were drawn from three districts, namely Gasabo, Kicukiro, and Nyarugenge. For variability of data, participants came from parliament, government ministries, government parastatals, and civil society organizations. All interviews were conducted in Kinyarwanda and later translated into English. Data were analyzed using qualitative content analysis. Results The emerging theme Strong barriers and numerous consequences of safe abortion illustrates how women leaders perceive barriers to safe abortion and its related consequences in Rwanda. The theme is divided into two categories: (1) Perceived barriers of safe abortion and (2) Consequences of providing safe abortion. The sub-categories for the first category are Reluctance to fully support safe abortion due to perceived unjustified abortions”, Abortion-related stigma, Abortion is against cultural and religious beliefs, Emotional attachment to the unborn and Lack of awareness of abortion. The sub-categories for the second category are Perceived physiological trauma, Cause for barrenness/infertility, Increase in services abuse by adolescents/women, Increase of workload for healthcare providers, “Increase in sexual activities and STIs, and Abortion-related physiological trauma. Conclusion The subject of safe abortion evokes mixed reactions among participants, and is entangled with unsafe abortion in most cases. Participants stress that the word ‘abortion’ disturbs, regardless of whether it relates to being safe or unsafe. Participants believe the word ‘abortion’ outweighs the word ‘safe’. Societal expectations play a major role in the decision-making process of any adolescent or a family member faced with a pregnant adolescent regardless of the existing safe abortion law. Community mobilization and sensitization are crucial if safe abortion in accordance with abortion law is to be embraced. Messages that reinforce safe abortion as acceptable and address stigma, fears of trauma, and barrenness should be developed to educate adolescents, parents, and women leaders about safe abortion, to mitigate unsafe abortion-related complications.
first_indexed 2024-04-09T15:05:50Z
format Article
id doaj.art-0bc8da06cb6048a7b2d285fc80292674
institution Directory Open Access Journal
issn 1472-6874
language English
last_indexed 2024-04-09T15:05:50Z
publishDate 2023-04-01
publisher BMC
record_format Article
series BMC Women's Health
spelling doaj.art-0bc8da06cb6048a7b2d285fc802926742023-04-30T11:27:01ZengBMCBMC Women's Health1472-68742023-04-0123111110.1186/s12905-023-02366-4Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative studyLawrence Rugema0Marie Ange Uwase1Athanase Rukundo2Vianney Nizeyimana3Theobald Mporanyi4Aflodis Kagaba5School of Public Health, University of RwandaHealth Development InitiativeHealth Development InitiativeHealth Development InitiativeHealth Development InitiativeHealth Development InitiativeAbstract Background Between 2010 and 2014, approximately 25 million unsafe abortions were performed annually across the globe. Africa alone accounted for 29% of all unsafe abortions, and 62% of the related deaths. Women living in poverty, especially adolescents, lack information about where and how to access safe abortion services. They often lack adequate insight to make informed decisions. The purpose of this study was to explore the empowered perspectives of women leaders in Rwanda about the recent policy change for safe abortion. The study identifies women leaders’ perceived barriers and their attitudes about resulting consequences toward safe abortion. Method In this qualitative study, seven focus group discussions and eight key informant interviews were performed in October 2019. A total of 51 women leaders participated, their age ranging from 38 to 60 years. Participants were drawn from three districts, namely Gasabo, Kicukiro, and Nyarugenge. For variability of data, participants came from parliament, government ministries, government parastatals, and civil society organizations. All interviews were conducted in Kinyarwanda and later translated into English. Data were analyzed using qualitative content analysis. Results The emerging theme Strong barriers and numerous consequences of safe abortion illustrates how women leaders perceive barriers to safe abortion and its related consequences in Rwanda. The theme is divided into two categories: (1) Perceived barriers of safe abortion and (2) Consequences of providing safe abortion. The sub-categories for the first category are Reluctance to fully support safe abortion due to perceived unjustified abortions”, Abortion-related stigma, Abortion is against cultural and religious beliefs, Emotional attachment to the unborn and Lack of awareness of abortion. The sub-categories for the second category are Perceived physiological trauma, Cause for barrenness/infertility, Increase in services abuse by adolescents/women, Increase of workload for healthcare providers, “Increase in sexual activities and STIs, and Abortion-related physiological trauma. Conclusion The subject of safe abortion evokes mixed reactions among participants, and is entangled with unsafe abortion in most cases. Participants stress that the word ‘abortion’ disturbs, regardless of whether it relates to being safe or unsafe. Participants believe the word ‘abortion’ outweighs the word ‘safe’. Societal expectations play a major role in the decision-making process of any adolescent or a family member faced with a pregnant adolescent regardless of the existing safe abortion law. Community mobilization and sensitization are crucial if safe abortion in accordance with abortion law is to be embraced. Messages that reinforce safe abortion as acceptable and address stigma, fears of trauma, and barrenness should be developed to educate adolescents, parents, and women leaders about safe abortion, to mitigate unsafe abortion-related complications.https://doi.org/10.1186/s12905-023-02366-4Women leadersUnsafe abortionSafe abortionAdolescent sexual and reproductive health (SRH)Qualitative researchContent analysis
spellingShingle Lawrence Rugema
Marie Ange Uwase
Athanase Rukundo
Vianney Nizeyimana
Theobald Mporanyi
Aflodis Kagaba
Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study
BMC Women's Health
Women leaders
Unsafe abortion
Safe abortion
Adolescent sexual and reproductive health (SRH)
Qualitative research
Content analysis
title Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study
title_full Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study
title_fullStr Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study
title_full_unstemmed Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study
title_short Women leaders perceived barriers and consequences of safe abortion in Rwanda: a qualitative study
title_sort women leaders perceived barriers and consequences of safe abortion in rwanda a qualitative study
topic Women leaders
Unsafe abortion
Safe abortion
Adolescent sexual and reproductive health (SRH)
Qualitative research
Content analysis
url https://doi.org/10.1186/s12905-023-02366-4
work_keys_str_mv AT lawrencerugema womenleadersperceivedbarriersandconsequencesofsafeabortioninrwandaaqualitativestudy
AT marieangeuwase womenleadersperceivedbarriersandconsequencesofsafeabortioninrwandaaqualitativestudy
AT athanaserukundo womenleadersperceivedbarriersandconsequencesofsafeabortioninrwandaaqualitativestudy
AT vianneynizeyimana womenleadersperceivedbarriersandconsequencesofsafeabortioninrwandaaqualitativestudy
AT theobaldmporanyi womenleadersperceivedbarriersandconsequencesofsafeabortioninrwandaaqualitativestudy
AT aflodiskagaba womenleadersperceivedbarriersandconsequencesofsafeabortioninrwandaaqualitativestudy