Improving the quality of sexual and reproductive health and rights (SRHR) through pre-service training, research, and evidence-based clinical care delivery in Sub-Saharan Africa

Abstract
Background: The right of every woman to receive protection against unwanted pregnancies and unsafe abortions is a non-alienable universal human right. Although several global commitments have been made to uphold these rights, such as the Sustainable Development Goals (SDGs) and Global Strategy for Women’s, Children’s and Adolescents’ Health, high global numbers of unwanted pregnancies, unsafe abortions, and associated complications reveal significant gaps in access to effective contraception and safe abortion care. This study explores the determinants influencing unsafe abortion care-seeking among Cameroonian women, with particular emphasis on restrictive legal frameworks and unmet contraceptive needs. We conducted a qualitative study to understand the multifaceted determinants influencing unsafe abortion practices among Cameroonian women, including their reproductive needs, the impact of legal and socio-cultural factors, and their contraceptive needs.
Methods: Data were collected via semi-structured interviews/questionnaires with sixty women treated for post-abortion complications across six referral centers in Cameroon’s northern and southern regions, which represented rural, semi-urban, and urban settings. The interviews/surveys were conducted after the study participants were managed for abortion-related complications and were stable and willing to communicate. We sought their authorization to invite or call them 1 week and 3 months after discharge for a follow interview.
Results: After concluding initial interviews of participants in five out of six of our study sites, thematic analysis was used to categorize common themes in the data. Three main themes emerged: 1- unsafe abortion was sought due to social constraints including self-shame and perceived societal negative views, fear of partner (husband or partner), 2- majority participants were unaware of contraceptive services available either cost-free or relatively inexpensive, 3-most participants were not aware of Cameroonian abortion laws.
Conclusions: These insights have implications for policy, practice, and future interventions, emphasizing the importance of continually educating women using various platforms abortions legislature and contraceptive access in their various communities.