Mass media exposure and self-efficacy in abortion decision-making among adolescent girls and young women in Ghana: Analysis of the 2017 Maternal Health Survey.

introductionWorldwide, 25 million unsafe abortions (45% of all abortions) occurred every year between 2010 and 2014 and 97%, occurred in low-and-middle income countries. Abortion among adolescent girls and young women (15-24 years) is a major public health issue, especially in low-and middle-income countries, including Ghana. Using data from the 2017 Maternal Health Survey, we sought to examine the association between mass media exposure and adolescent girls and young women's self-efficacy in abortion decision making. MATERIALS AND

methodsA sample of 5,664 adolescent girls and young women in Ghana was considered in this study. Both descriptive and inferential analytical approaches were employed to analyse the data. The descriptive analytical approach involved the use of proportions to illustrate the proportion of adolescent girls and young women who had self-efficacy in abortion decision-making. Self-efficacy in abortion decision-making was derived from the question 'Could you decide on your own to get an abortion?' Respondents who answered "Yes" to this question were considered as having self-efficacy in abortion decision making. At the inferential level, a chi-square test and bivariate and multivariable logistic regression models were employed with statistical significance pegged at p-value <0.05. The results of the bivariate and multivariable logistic regression analyses were presented using crude and adjusted odds ratios respectively.

resultsLess than a quarter of adolescent girls and young women (24%) in Ghana had self-efficacy in abortion decision-making. We further found that adolescent girls and young women who were exposed to mass media had higher odds in self-efficacy in abortion decision-making compared to those who were not exposed to the mass media [AOR = 1.55, CI = 1.14-2.11]. It was also found that adolescent girls and young women aged 20-24 [AOR = 1.45, CI = 1.25-1.68], those who were cohabiting [AOR = 1.40, CI = 1.02-1.93], and those from the Ashanti region [AOR = 2.39, CI = 1.85-3.07] had higher odds on self-efficacy in abortion decision-making. On the other hand, adolescent girls and young women from the Eastern Region [AOR = 0.52, CI = 0.36-0.73] and those belonging to the Ga-Adangbe ethnic group [AOR = 0.70, CI = 0.50-0.99] had lower odds in self-efficacy in abortion decision-making.

conclusionLess than a quarter of adolescent girls and young women in Ghana have self-efficacy in abortion decision-making which can affect adolescent girls and young women's future abortion seeking behaviours. Exposure to mass media was strongly associated with self-efficacy in abortion decision making. We recommend that policy makers should promote mass media campaigns scheduled on regular intervals in order to inform the target audience about safe abortions in Ghana. This could go a long way to ensure that cases of unsafe abortions are reduced to the starkest minimum.