Social Network-Based Measurement of Abortion Incidence: Promising Findings from Population-Based Surveys in Nigeria, Cote d’Ivoire, and Rajasthan, India

Suzanne Bell , Johns Hopkins Bloomberg School of Public Health
Mridula Shankar, Johns Hopkins Bloomberg School of Public Health
Elizabeth F. Omoluabi, Centre for Research Evaluation Resources and Development (CRERD)
Anoop Khanna, Indian Institute of Health Management (IIHMR)
Andoh Kouakou Hyacinthe, Programme National de Santé de la Mère et de l'Enfant
Funmilola OlaOlorun, University of Ibadan
Danish Ahmed, Indian Institute of Health Management (IIHMR)
Georges Guiella, Université de Ouagadougou
Saifuddin Ahmed, Johns Hopkins University
Caroline Moreau, INSERM/INED and Johns Hopkins School of Public Health

In this study, we aim to test the confidante methodology for estimating abortion incidence rates in Nigeria, Cote d’Ivoire, and Rajasthan, India and develop methods to adjust for violations of assumptions. In population-based surveys in each setting, female respondents of reproductive age reported separately on their two closest confidantes’ experience with pregnancy removal, in addition to reporting about their own experiences. We used descriptive analyses, design-based F tests, and Poisson regression to test for violations of method assumptions. Using post-hoc analytical techniques we corrected for biases in the confidante sample to improve the validity and precision of the abortion incidence estimates produced from these data. Findings indicate incomplete transmission of confidante abortions to respondents, a biased confidante sample, but reduced social desirability bias when reporting on confidantes after adjusting for assumption violations. The respondent one-year pregnancy removal was 18.7 abortions per 1,000 women of reproductive age in Nigeria, 18.8 in Cote d’Ivoire and 7.0 in Rajasthan. After adjustment for violations of method assumptions, the one-year abortion incidence rates for the first confidantes were 35.1 in Nigeria, 31.5 in Cote d’Ivoire, and 15.2 in Rajasthan, India. The confidante two rates were closer to confidante one incidences than respondent incidences. The adjusted confidante one and two incidence estimates were significantly higher than respondent incidences in all three countries. Findings suggest that the confidante approach may present an opportunity to address some abortion-related data deficiencies but require modeling approaches to correct for biases due to violations of social network-based method assumptions.

See paper

 Presented in Session P1. Poster Session Fertility, Family and the Life Course