ArticlePLOS global public health2025
Adolescent abortion care trajectories and safety in Ethiopia, Malawi, and Zambia: A comparative mixed methods study.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Experiences and self-reported outcomes of abortion care in Sub-Saharan countries: a mixed methods systematic review.Journal of health, population, and nutrition · 2026Pooled it
- Addressing abortion through individual and community-level determinants: Evidence from Southern Ethiopia.PloS one · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Lack of access to safe abortions continues to be a major sexual and reproductive health concern. Adolescents can face barriers to safe abortions due to the unique implications of their age. Understanding adolescent abortion experiences and care trajectories is critical. Qualitative and quantitative evidence is analysed from interviews with 313 adolescents aged 10-19 years who sought abortion-related care in public health facilities in Addis Ababa (Ethiopia), Lilongwe (Malawi), and Lusaka (Zambia) between April 2018 and September 2019. The trajectories framework is used to understand how adolescent abortion-related care-seeking differs across a range of socio-legal national contexts. A comparative study design incorporates varying levels of restriction on access to abortion: Ethiopia (legal on broad social or economic grounds, services implemented); Zambia (legal on broad social or economic grounds, complex services with barriers to implementation and information provision); and Malawi (legally highly restricted). Most adolescents (n = 97, 98%) in Ethiopia obtained a medically safe abortion, and most adolescents (n = 70, 64%) in Zambia and almost all adolescents (n = 94, 94%) in Malawi obtained a less medically safe abortion. There is a significant association between country and whether an adolescent tried to end a pregnancy before coming to the facility, X²(2, N = 313) = 135.93, p < 0.001. In Malawi 97% (n = 101) of adolescents had sought to end the pregnancy before coming to the facility, compared to 18% (n = 18) in Ethiopia. Cross-country variations in the relative safety of the abortion and type of care sought by adolescents reflect national laws, policies and service availability. The most facility-based abortions were recorded where care is most accessible (Ethiopia), and most non-facility-based and least safe abortions were recorded where care is the most restricted (Malawi). Across all countries, adolescents experienced delays to their care-seeking; 39% (n = 39), 71% (n = 74), and 66% (n = 73) in Ethiopia, Malawi, and Zambia respectively. Adolescents reported high levels of respectful treatment across countries, with a minority reporting negative experiences. A minority of adolescents in each country reported that unofficial money was paid to facility staff. There were different experiences of post-abortion contraception in the three countries, including an absence of choice. Adolescents' trajectories - particularly those involving multiple attempts and barriers to achieving abortion care - require tenacity and determination. Our analyses show that less restrictive abortion policies and accessible abortion services improve adolescent chances to access abortion care.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.