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*Corresponding Author: Abdul Rauf Alhassan, Department of Surgery, Tamale Teaching Hospital, P.O. Box TL 16; Tamale-Ghana.
Citation: Abdul R. Alhassan and John N. A. Adolipore. (2021). Prevalence and Predictive Factors of Induced Abortion among Women in Ghana: Data Analysis of Maternal Health Survey, 2017. J Clinical Research and Reports, 9(3); DOI:10.31579/2690-1919/204
Copyright: © 2021, Abdul Rauf Alhassan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 29 September 2021 | Accepted: 20 October 2021 | Published: 01 November 2021
Keywords: induced; abortion; prevalence; predictors; women; Ghana
Induced abortion is a common practice for women worldwide; nevertheless, the practice of unsafe abortion rate in Ghana is in height and is a constant issue of public health concern. Objective: The main aim of the study was to identify predictive factors associated with induced abortion among women in Ghana. Methods: Ghana Maternal Health Survey data was used for this study to do an analytic cross-section study. Data analysis was done using SPSS version 20. The association between dependent and independent variables was explored using chi-square and logistic regression. Statistical significance was set at p < 0.05. Results: In this study, the prevalence of induced among the respondents was 14.8%, the prevalence was higher (25.5%) in Greater Accra Region and lower (3.2%) in Northern Region. All under-studied independent variables through chi-square analysis were associated with induced abortion with significance. However, in advance analysis through binary logistics regression model predictor factors of induced abortion in Ghana identified were; the age of the respondents’, region of orientation, religious affiliation, marital status, ethnicity, exposure to mobile phone and newspaper, and age at first sex. The logistic regression model appropriately explained the outcome variable (induced abortion) since the Hosmer-Lemeshow goodness-of-fit test p-value was more than 0.05 (X2 (8) = 4.428, P = .817). Conclusion: The prevalence of abortion in Ghana is still high, hence the need for increase public education on contraceptive use and the adverse effects of abortion through the use of modern media can go a long way to reduce the incidence of induced abortion in Ghana.
Running title: Induced abortion in Ghana
Globally, each year 22 million women are involved in unsafe abortion. Most (98.0%) of unsafe abortions happen in developing nations [1]. In 2008, the global rate for unsafe abortion stood at 14 per 1000 women for the age group of 15–44, whereas the rate for Sub- Saharan Africa stood as high as 31 per 1000 women within their reproductive age group of 15–44 [1]. Basinga et al., a study that was carried out in Sub- Saharan Africa, did reveal that the majority of induced abortions in the region are largely unsafe as the bulk of them are illegal [2]. In states that are engulfed with poor access to safe abortion services and legal abortions, most women with unplanned pregnancies are alternative to the practice of unsafe abortions [3].
The dangers associated with unsafe abortion range from severe morbidities such as serious bleeding, sepsis, and organ failure to no complications [4-6]. Whereas abortions are becoming less problematic worldwide, this is not the same for Africa as evidence points to a rather high rate of hospitalization resulting from complicated abortion due to unsafe practices from the Eastern and sub-Saharan Africa regions. Globally, Africa has high rates of gynecological hospitalization from unsafe abortion-related complications [7].
The adverse effects of induced abortions are not deterrent factors enough as several studies have shown a substantial percentage of women secure more than one abortion during their reproductive lifetime [8-11]. In Sudan, for example, a study in five hospitals showed that over 40 % of women pursuing medical care for problems of unsafe abortion had a history of at least one earlier unsafe abortion [10]. Also, research in Ethiopia revealed that among women looking for abortion-related services, the incidence of history abortion was 30 % [11].
Induced abortion is a common practice for women worldwide; nevertheless, the practice of unsafe abortion rates in Ghana is in height and is a constant issue of public health concern. Abortion increases maternal mortality in Ghana by 15-30% [12]. The law regarding criminal abortion in Ghana was modified in 1985 making induced abortion legal concerning some situations [13]. However, in Ghana to admittance to harmless abortion practice is hindered by restricted access to legal abortion services, finance, sociocultural barriers, and social stigma [14].
Ghana has endeavored to tackle the problem of unplanned pregnancies leading to unsafe abortions by encouraging the utilization of modern contraceptives, reproductive health strategic plans, and capacity building of trainee midwives in health training institutions to complete abortion care [12,15]. Regardless, contraception acceptance remains poor at 25%, and 31% of pregnancies are unplanned, the incidence of induced abortion has risen to 7% in 2017 from 5% in 2007, and illegal abortion is a key issue in maternal morbidity and mortality [12,16,17].
An earlier study by Boah et al. attempted to identify predictors of unsafe abortion in Ghana [18], but their study is different from this current study which attempted to identify predictive factors associated with inducing abortion in Ghana, which involved both safe and unsafe abortion. The findings of this study will be of policy relevance to the Ghanaian Ministry of Health and other foreign experts in the field of female, sexual, and reproductive health.
The study design for this study was an analytic cross-sectional survey using data from the 2017 Ghana Maternal Health Survey (GMHS). The Ghana Statistical Service (GSS) conducted the 2017 GMHS with technical assistance from ICF's Demographic and Health Survey (DHS) program. Ghana's 2010 Population and Housing Census provided the sampling frame (PHC). Eligible participants were women aged 15 to 49 years who were permanent residents of selected households or guests who stayed in selected households the night before the survey. The study's areas and households were selected using a multistage stratified cluster sampling technique. The details of the survey procedures and the questionnaires used can be found in the final report [16].
The study included all the survey participants (25062) and the main dependent variable of the study was the history of ever abortion among the study participants. The independent variables included demographic characteristics, mass media exposure, history of first sexual intercourse, and family planning practice.
Statistical analysis was done using SPSS Statistics for Windows, Version 20.0 (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp). Categorical variables results were presented using frequencies and percentages using tables and figures. Continuous variables were results were represented using mean and standard deviation. The association between dependent and independent variables was done using chi-square. Factors with a significant association at the bivariate level were further modeled using a binary logistics regression model to identify predictor variables of induced abortion. Statistical significance was set at a p-value of < 0>
The ICF Institutional Review Board (IRB) approved the protocol for the 2017 GMHS. Meanwhile, ethical approval was not necessary for this study because it involved a secondary analysis of a dataset without exposure to the identity of the respondents and their households. Nonetheless, permission was obtained from ICF through the DHS program for the use of the datasets in this study and the terms of data use were observed.
Demographic characteristics of the respondents’
There were 25062 respondents (women aged from 15 to 49 years) in this survey, the average age of the women was 29.5 ±9.8, with a modal age of 15. The majority (74.0%) of the respondents were educated with at least primary level education. In terms of ethnicity, the majority (35.3%) were Akans, and then 30.5% for Mole-Dagbani. At the time of the survey, the majority of the respondents were married (43.4%). The religion that dominated the respondents was Christianity (70.8%) than Islam (24.3%) and residency was almost the same for Urban and Rural, 50.1%, and 49.9% respectively. The study was across the than ten regions of Ghana, 31.7% for coastal belt (Western (9.3%), Central (6.4%), Greater (10.1%) and Volta (5.8%)), 30.4% for the forest belt (Eastern (8.7%), Ashanti (12.5%) and Brong-Ahafo (9.2%)) and 38.0% for the savanna belt (Northern (16.8%), Upper West (10.8%) and Upper East (10.4%)) (Table 1).
| Frequency (n = 25062) | Percentage | |
Age group | 15-19 | 4888 | 19.5% |
20-24 | 4259 | 17.0% | |
25-29 | 4179 | 16.7% | |
≥ 30 | 11736 | 46.8% | |
Marital status | Married | 10869 | 43.4% |
Living with a man | 4183 | 16.7% | |
Not in union | 10010 | 39.9% | |
Ever attended school | Yes | 18554 | 74.0% |
No | 6508 | 26.0% | |
Ethnicity | Akan | 8837 | 35.3% |
Ga/Dangme | 1279 | 5.1% | |
Ewe | 2474 | 9.9% | |
Guan | 905 | 3.6% | |
Mole-dagbani | 7651 | 30.5% | |
Grusi | 1284 | 5.1% | |
Gurma | 1799 | 7.2% | |
Mande | 293 | 1.2% | |
Other | 540 | 2.2% | |
Religion | Christianity | 17751 | 70.8% |
Islam | 6080 | 24.3% | |
Traditional | 617 | 2.5% | |
Other religion | 3 | 0.0% | |
No religion | 611 | 2.4% | |
Type of place of residence | Urban | 12544 | 50.1% |
Rural | 12518 | 49.9% | |
Regional belt | Coastal belt | 7938 | 31.7% |
Forest belt | 7610 | 30.4% | |
Savanna belt | 9514 | 38.0% | |
Table 1: Demographic characteristics of the respondents’
Other independent variables
For those who responded to these questions majority (69.2%) of the respondents were not into reading newspapers. Meanwhile, the majority of them listen to the radio and watch television at least once a week (46.0% and 52.1% respectively). With ownership mobile, the majority (64.3%) were having a mobile phone and about 62.7% of the respondents were having used the internet almost every day. Moreover, 81.6% of them knew their fertile period and about 76.3% of them had their first sex at 15 -19 years (Table 2).
| Frequency | Percentage | |
Reads new paper | Yes | 3805 | 30.8% |
No | 8534 | 69.2% | |
Listens to radio | Yes | 17830 | 71.1% |
No | 7232 | 28.9% | |
watches TV | Yes | 17783 | 71.0% |
No | 7279 | 29.0% | |
Own a mobile phone | Yes | 16117 | 64.3% |
No | 8945 | 35.7% | |
Ever used internet | Yes | 5215 | 20.8% |
No | 19847 | 79.2% | |
Age of first sex | 7-14 | 0 | 0.0% |
15-19 | 14281 | 76.3% | |
20-24 | 3897 | 20.8% | |
25-29 | 481 | 2.6% | |
≥ 30 years | 63 | 0.3% | |
Knowledge of fertility period | Yes | 20450 | 81.6% |
No | 4612 | 18.4% | |
Table 2: Other independent variables
Induced abortion in Ghana
The prevalence of induced abortion among the respondents was 14.8%. According to the respondents,’ the major reasons for abortion included: lack of readiness to be a mother (13.9%), lack of money to care for the baby (13.3%), to be able to continue schooling (11.7%), of space childbirth (11.1%) and partner denial of pregnancy (9.0%).
Regional proportions of induced abortion
Proportionally, the region with the highest number of respondents with abortion history was Greater Accra Region (25.5%), followed by Ashanti Region (23.8%), then Western Region (20.7%), and Brong Ahafo Region (20.4%). And the region with lowest proportion of abortion history was Northern Region (3.2%), X2 (9, 25062) = 1530.280, P ≤ 0.001 (Figure 1).
Factors associated with induces abortion in Ghana
With chi-square analysis, all demographic characteristics of the respondents’ indicated a significant relation with respondents’ history of abortion. Age group X2(6, 25062) = 853.48, P ≤ 0.001, marital status X2(2, 25062) = 571.465, P ≤ 0.001, ever attended school X2(1, 25062) = 415.993, P ≤ 0.001, religion X2(3, 25062) =661.257, P ≤ 0.001, ethnicity X2(8, 25062) = 1583.835, P ≤ 0.001 and type of place of residence X2(1, 25062) =453.478 , P ≤ 0.001 (Table 3).
| Ever had abortion |
X2 |
df |
P-value | ||
Yes | No | |||||
Age group | 15-19 | 129 | 4759 | 850.863 | 3 | .000 |
20-24 | 514 | 3745 |
|
|
| |
25-29 | 762 | 3417 |
|
|
| |
≥ 30 | 2297 | 9439 |
|
|
| |
Marital status | Married | 1420 | 9449 | 571.465 | 2 | .000 |
Co-habitation | 1115 | 3068 |
|
|
| |
Single | 1167 | 8843 |
|
|
| |
Ever attended school | Yes | 3243 | 15311 | 415.993 | 1 | .000 |
No | 459 | 6049 |
|
|
| |
Religion | Christianity | 3271 | 14480 | 661.257 | 3 | .000 |
Islam | 342 | 5738 |
|
|
| |
Traditional | 22 | 595 |
|
|
| |
No religion | 67 | 547 |
|
|
| |
Ethnicity | Akan | 2150 | 6687 | 1583.835 | 8 | .000 |
Ga/Dangme | 294 | 985 |
|
|
| |
Ewe | 499 | 1975 |
|
|
| |
Guan | 135 | 770 |
|
|
| |
Mole-Dagbani | 384 | 7267 |
|
|
| |
Grusi | 76 | 1208 |
|
|
| |
Gurma | 91 | 1708 |
|
|
| |
Mande | 27 | 266 |
|
|
| |
Other | 46 | 494 |
|
|
| |
Type of place of residence | Urban | 2451 | 10093 | 453.478 | 1 | .000 |
Rural | 1251 | 11267 |
|
|
| |
Chi-square analysis revealed a significant relationship between the other independent variables and induced abortion. Reads newspaper X2(1, 25062) = 3.979, P ≤ 0.046, listen to radio X2(1, 25062) = 287.137, P ≤ 0.001, watches TV X2(1, 25062) =435.607, P ≤ 0.001, own mobile phone X2(1, 25062) =785.655, P ≤ 0.001, ever used internet X2(1, 25062) =71.401, P ≤ 0.001, age at first sex X2(3, 25062) =128.974, P ≤ 0.001, knowledge of fertile period X2(1, 25062) =221.923, P ≤ 0.001 (Table 4).
| Ever had abortion |
X2 |
df |
p-value | |||
Yes | No | ||||||
Reads new paper | Yes | 564 | 3241 | 3.979 | 1 | .046 | |
No | 1386 | 7148 |
|
|
| ||
Listens to radio | Yes | 3065 | 14765 | 287.137 | 1 | .000 | |
No | 637 | 6595 |
|
|
| ||
watches TV | Yes | 3159 | 14624 | 435.607 | 1 | .000 | |
No | 543 | 6736 |
|
|
| ||
Own a mobile phone | Yes | 3135 | 12982 | 785.655 | 1 | .000 | |
No | 567 | 8378 |
|
|
| ||
Ever used internet | Yes | 963 | 4252 | 71.401 | 1 | .000 | |
No | 2739 | 17108 |
|
|
| ||
Age at first sex | 7-14 | 0 | 0 | 128.974 | 3 | .000 | |
15-19 | 2593 | 11688 |
|
|
| ||
20-24 | 465 | 3432 |
|
|
| ||
25-29 | 31 | 450 |
|
|
| ||
≥ 30 | 3 | 60 |
|
|
| ||
Knowledge of fertile period | Yes | 3345 | 17105 | 221.923 | 1 | .000 | |
No | 357 | 4255 |
|
|
| ||
Table 4: Chi-square analysis of respondents’ other independent variables and their history of induce abortion
Predictors of induced abortion
In this current study woman practice of induced abortion was more likely as her age advanced, 20 -24 years (AOR = 3.27, 95%, C.I. = 2.37 – 4.52), 25 – 29 years (AOR = 6.23, 95%, C.I. = 4.50 -8.63) and ≥ 30 (AOR = 9.74, 95%, C.I. = 7.06 – 13.43). Women in marriage were more protected from induced abortion, co-habitation (AOR =1.73, 95%, C.I. = 1.47 – 2.03), and single (AOR = 1.19, 95%, C.I. = 1.03 – 1.38). Women apart from being Christians were protected from induced abortion, Islam (AOR = 0.71, 95%, C.I. = 0.55 – 0.92), traditional (AOR = 0.11, 95%, C.I. = 0.02 – 0.86) and no religion (AOR = 0.45, 95%, C.I. = 0.22 – 0.95). In terms of regional prediction, two regions when compared to Western region predicted induce abortion, Ashanti (AOR = 1.29, 95%, C.I. = 1.04 -1.59) and Brong-Ahafo (AOR = 1.39, C.I. = 1.09 – 1.77). Meanwhile, women from the three northern regions were less likely to practice induced abortion as compare to those from Western region, Northern (AOR = 0.41, 95%, C.I. = 0.28 – 0.59), Upper East (AOR = 0.42, 95%, C.I. = 0.27 – 0.64) and Upper west (AOR = 0.64, 95%, C.I. = 0.43 – 0.95). And with ethnicity, women of Mole-Dagbani tribe were less likely 0.6 times to practice induced abortion when compared to those from Akan tribe. With the use of modern media, those without exposure to mobile phone use were less likely to practice induce abortion (AOR = 0.79, 95%, C.I. = 0.64 – 0.98). However, induced abortion was more likely among those without exposure to newspaper (AOR = 1.15, 95%, C.I. = 1.01 – 1.31). Finally, woman age of first sex was associated with induced abortion, women with first sex after 19 years were protected from induced abortion, 20 -24 years (AOR = 0.37, 95%, C.I. = 0.32 – 0.43), 25 -29 years (AOR = 0.11, 95%, C.I. = 0.07 – 0.17) and ≥ 30 years (AOR = 0.04, 95%, C.I. = 0.01 – 0.27) (Table 5).
Variables in the equation |
B |
Wald |
P-value |
AOR | 95% C.I. for AOR | ||
Lower | Upper | ||||||
15-19 |
| Reference | .000 | 1 |
|
| |
20-24 | 1.186 | 51.910 | .000 | 3.274 | 2.371 | 4.521 | |
25-29 | 1.830 | 121.514 | .000 | 6.232 | 4.502 | 8.629 | |
| ≥ 30 | 2.276 | 191.936 | .000 | 9.736 | 7.056 | 13.434 |
| Married |
| Reference | .000 | 1 |
|
|
| Co-habitation | .548 | 45.193 | .000 | 1.729 | 1.474 | 2.028 |
| Single | .173 | 5.332 | .021 | 1.189 | 1.027 | 1.378 |
Ever attended (Yes) |
| Reference |
|
|
|
| |
| Ever attended (No) | -.175 | .168 | .682 | .839 | .363 | 1.940 |
Christianity |
| Reference | .002 | 1 |
|
| |
| Islam | -.341 | 6.908 | .009 | .711 | .552 | .917 |
| Traditional | -2.169 | 4.431 | .035 | .114 | .015 | .861 |
| No religion | -.794 | 4.384 | .036 | .452 | .215 | .950 |
| Akan |
| Reference | .005 | 1 |
|
|
| Ga/Dangme | -.090 | .603 | .438 | .914 | .727 | 1.148 |
| Ewe | -.126 | 1.382 | .240 | .882 | .715 | 1.088 |
| Guan | -.212 | 1.607 | .205 | .809 | .583 | 1.123 |
| Mole-Dagbani | -.587 | 16.209 | .000 | .556 | .418 | .740 |
| Grusi | -.270 | 1.502 | .220 | .763 | .495 | 1.176 |
| Gurma | -.027 | .017 | .897 | .973 | .644 | 1.471 |
| Mande | .312 | .517 | .472 | 1.366 | .584 | 3.196 |
| Other | -.526 | 3.537 | .060 | .591 | .341 | 1.022 |
Residence (Urban) |
| Reference |
|
|
|
| |
| Residence (Rural) | -.074 | 1.068 | .301 | .929 | .807 | 1.068 |
| Western |
| Reference | .000 | 1 |
|
|
| Central | -.254 | 3.694 | .055 | .776 | .599 | 1.005 |
| Greater Accra | .207 | 3.377 | .066 | 1.230 | .986 | 1.535 |
| Volta | -.111 | .485 | .486 | .895 | .654 | 1.224 |
| Eastern | -.167 | 2.071 | .150 | .846 | .674 | 1.062 |
| Ashanti | .253 | 5.416 | .020 | 1.287 | 1.041 | 1.593 |
| Brong-Ahafo | .328 | 6.939 | .008 | 1.388 | 1.088 | 1.772 |
| Northern | -.905 | 22.279 | .000 | .405 | .278 | .589 |
| Upper East | -.875 | 16.291 | .000 | .417 | .272 | .637 |
| Upper west | -.453 | 4.934 | .026 | .636 | .426 | .948 |
| Newspaper use (Yes) |
| Reference |
|
|
|
|
| Newspaper use (No) | .137 | 4.149 | .042 | 1.147 | 1.005 | 1.308 |
Radio use (Yes) |
| Reference |
|
|
|
| |
| Radio use (No) | -.052 | .351 | .554 | .949 | .798 | 1.128 |
| TV use (Yes) |
| Reference |
|
|
|
|
| TV use (No) | -.199 | 3.497 | .061 | .820 | .666 | 1.010 |
| Mobile Phone (Yes) |
| Reference |
|
|
|
|
| Mobile Phone (No) | -.231 | 4.574 | .032 | .794 | .642 | .981 |
| Internet use (Yes) |
| Reference |
|
|
|
|
| Internet use (No) | -.127 | 3.536 | .060 | .881 | .772 | 1.005 |
First sex (15 -19) |
| Reference | .000 | 1 |
|
| |
First sex (20-24) | -.984 | 176.059 | .000 | .374 | .323 | .432 | |
First sex (25-29) | -2.247 | 90.221 | .000 | .106 | .067 | .168 | |
First sex (≥ 30) | -3.313 | 10.663 | .001 | .036 | .005 | .266 | |
Know of the fertile period (Yes) |
| Reference |
|
|
|
| |
Know of the fertile period (No) | -.179 | 2.319 | .128 | .836 | .664 | 1.053 | |
Dependent variable (ever had abortion) dummy code as 0 = No and 1 = Yes. H-L GOF test X2 (8) = 4.428, P = .817
Table 5: Binary logistics regression for predictors of induced abortion in Ghana
The logistic regression model appropriately explained the outcome variable (induced abortion) since the Hosmer-Lemeshow goodness-of-fit test p - value was more than 0.05 (X2 (8) = 4.428, P = .817).
The main purpose of this study was to find factors associated with induced abortion in Ghana among women. According to the Guttmacher Institute, 23% of all pregnancies in Ghana for the year 2017 ended in abortion [19]. In this study, the prevalence of induced abortion history (ever had an abortion) among the respondents was 14.8%. This study finding is a little higher than a similar study, which reported cases of induced abortions to be 13.6% in rural Ghana [20]. However, this was lower than another national prevalence (21.1%) in Nepal [21]. And the major reasons for induced abortion among others were, lack of readiness to be a mother, and lack of money to care for the baby. This is in line with earlier studies which also reported that in most nations, the most commonly named reasons for induced abortion were socioeconomic difficulties and unplanned pregnancies [22, 23].
In a study by Guttmacher Institute, more than half (53%) of all pregnancies in Ghana were unintentional, stretching from 23% in the Northern zone to 51% in the Coastal zone and 66% in the Middle Zone and this resulted in abortions from 24 for the Northern zone to 51 to the Middle Zone and 45 for the Coastal zone per 1000 women [19]. In this present study, proportionally the region with the highest number of respondents with induced abortion history was in the coastal zone and the lowest in the northern zone. This confirms the regional prediction, two regions when compared to the Western region predicted induced abortion. Women from the Ashanti and Brong-Ahafo regions were more likely to practice induced abortion in Ghana. Meanwhile, women from the three northern regions were less likely to practice induced abortion as compared to those from the Western region. This further confirms why women of the Mole-Dagbani tribe were less likely 0.6 times to practice induced abortion when compared to those from the Akan tribe. Similar to a national study ethnicity and region of the women predicted abortion [21].
In this current study, a woman's practice of induced abortion was more likely as her age advance. This study result is the same when compared to an earlier study in Nepal [21]. However, this is not familiar to earlier studies in Africa, which all reported higher age was a protective factor against abortion induction [20,23]. The explanation is that younger women are more predisposed to sexual coercion and rape which can lead to unintended pregnancies and a good number of induced abortions are consequences due to unintended pregnancies [23-25].
Also, married women were less likely to practice induce abortion as compared to single women and women in the co-habitation union. This study finding is similar to studies in Ghana, which reported that unmarried women were more likely to induce abortion as compared to married women [20,26]. However, a similar study in Ethiopia reported no significant association between induced abortion and marital status [23].
Moreover, exposure to modern mass media such as newspapers was a protective factor against inducing abortion in Ghana, but those exposed to a mobile phone were more likely to practice induce abortion in Ghana. This finding supports the conclusion that exposure to the media may be enough to change one’s sexual and reproductive behavior if the contents of the particular media source do positively address sexual and reproductive health issues [27].
Finally, a woman's age of first sex was associated with induced abortion; women with first sex after 19 years were less likely to practice induce abortion. According to Magnusson et al., age at first intercourse is connected with inconsistent or nonuse of contraceptives in later life [28].
This study is not without limitations, the study did not explore all factors known to be associated with induced abortion. Furthermore, the data used for this study was a cross-sectional study that has to do with the recall of information from the past, and recall bias was more likely, especially with regards to questions on abortion.
The main purpose of the study was to identify factors associated with abortion in Ghana. The following factors were identified to be a predictor of induced abortion in Ghana: age of the woman, marital status, media exposure, age at first sex, ethnicity, and region of the woman. It is recommended that increase public education on contraceptive use and the adverse effects of abortion through the use of modern media can go a long way to reduce the incidence of induced abortion in Ghana.
All dataset related to the findings of this study is available online at www.dhsprogram.com
There is no conflict of interest with this submission.
Funding for this study was completed by authors without any external funding.
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This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
