Generating National Unsafe Abortion Estimates: Challenges and Choices

Guttmacher Institute/IUSSP The primary objective of this chapter is to encourage and facilitate researchers in finding ways to make and publish national-level estimates of unsafe abortion where such estimates are currently unavailable. Knowing the magnitude of unsafe abortion in a given country facilitates an informed discussion on the abortion issue and on improving women’s reproductive health there. The countrylevel incidence of unsafe abortion can be employed for local advocacy and interventions, and would better establish the scope of the problem at regional and global levels. We support such endeavors by drawing attention to underused data and relevant research to approximate national estimates of unsafe abortion. Currently, there are fewer than 20 published country-level estimates; however, data of acceptable quality exist that can be evaluated and analyzed to produce more appraisals of individual countries. A well thought-out, critical assessment of the magnitude of unsafe abortion at the country level is more useful than mere recognition of the problem. This chapter builds on WHO methodology and experience in making regional and global estimates over the last 15 years. It also reflects an extensive review of the literature and approaches used to collect and present information on the incidence of unsafe abortion. We first briefly explain WHO’s experience in the estimation of unsafe abortion. Then we outline how country-level assessments of unsafe abortion can be developed by drawing on existing methodologies, so researchers can make use of work that has already been done. Finally, we suggest that appropriate population data accompany all estimates of unsafe abortion incidence to allow calculations of rates or ratios, so estimates are strictly comparable. We also identify regions with little usable data or where data are outdated. This chapter thus covers ways of facilitating and improving the national measurement of the incidence of unsafe abortion and of narrowing existing information gaps.