More women access public health facilities for safe abortion in Assam

A majority of women seeking safe abortion services in Assam turn to public health facilities instead of their private counterparts, a recent study has said. The study on Unintended Pregnancy, Abortion and Postabortion Care in Assam, was conducted jointly by Indian Institute for Population Sciences, Mumbai, Population Council, New Delhi and New York-based Guttmacher Institute.
The study was done in Bihar, Uttar Pradesh, Madhya Pradesh, Tamil Nadu, Gujarat and Assam. Assam registered 15 per cent of all the induced abortions in public facilities while Bihar, Gujarat and Uttar Pradesh lagged behind at two per cent, three per cent and four per cent respectively, according to the study. The estimated 5,80,100 abortions done in Assam every year, include those carried out in health facilities and other settings.
Seventy-three per cent of abortions done in health care units are performed in public facilities, according to the study. The abortion rate in the state was found to be 66 terminations per 1,000 women in the reproductive age group, the study pointed out. An estimated 90 per cent of the abortions occurring in health facilities in the state are surgical, while about 10 per cent are done using Medical Methods of Abortion (MMA).
The study was conducted in Bihar, Uttar Pradesh, Madhya Pradesh, Tamil Nadu, Gujarat and Assam and among the six states, Assam was the only state to have demonstrated better access to safe abortion services in public facilities. The northeastern state registered 15 per cent of all induced abortions in public facilities while Bihar, Gujarat and Uttar Pradesh lagged behind at two per cent, three percent and four per cent respectively, according to the study.
Some of the barriers in accessing facility-based abortions were lack of trained staff, paucity of equipment and supplies, social or religious concerns and lack of registration to provide abortion, the study said. Nearly 94 per cent of the facility-based induced abortions in Assam are performed in the first trimester and only six per cent of abortions provided in facilities occurred beyond 12 weeks, the study said. According to the study, 55 per cent of pregnancies in Assam were unintended out of which 41 per cent resulted in abortion.
As per recommendations put forward by the report, there is an impending need to improve access to facility-based abortion services, especially in underserved rural areas of Assam, by ensuring that all public facilities are adequately stocked with equipment and supplies. There is also a need to streamline the process of registering private clinics to enable them to offer safe and timely abortion services.
In addition, efforts need to be streamlined towards improving the quality and availability of voluntary contraceptive services for all women, through increased investments in maternal health, and education, delaying their age at marriage and enhancing sexual and reproductive health rights.