Evidence map›Paper›PMID 40474997›Full record

ArticleEClinicalMedicine2025

Incidence and safety of abortion in two humanitarian settings in Uganda and Kenya: a respondent-driven sampling study.

Ruvani Jayaweera, Lilian Odhoch, Juliet Nabunje, Clement Oduor, Carmela Zuniga, Bill Powell, Wyclife Barasa, Flavia Aber, Beatrice Nyalwal, Yohannes Dibaba Wado and 3 more

Abstract read
In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ruvani JayaweeraIbis Reproductive Health, Oakland, CA, USA.
Lilian OdhochResilience Action International, Kakuma Refugee Camp, Kenya.
Juliet NabunjeInternational Rescue Committee, Yumbe, Uganda.
Clement OduorAfrican Population and Health Research Center, Nairobi, Kenya.
Carmela ZunigaIbis Reproductive Health, Oakland, CA, USA.
Bill PowellIpas, Chapel Hill, NC, USA.
Wyclife BarasaResilience Action International, Kakuma Refugee Camp, Kenya.
Flavia AberInternational Rescue Committee, Yumbe, Uganda.
Beatrice NyalwalInternational Rescue Committee, Yumbe, Uganda.
Yohannes Dibaba WadoAfrican Population and Health Research Center, Nairobi, Kenya.
Ramatou OuedraogoAfrican Population and Health Research Center, Nairobi, Kenya.
Jessica KakesaInternational Rescue Committee, Yumbe, Uganda.
Tamara FettersIpas, Chapel Hill, NC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Access to abortion is a fundamental human right. The need for abortion services is amplified in complex humanitarian emergencies. However, most humanitarian agencies do not provide abortion services. There is a lack of data on the direct experiences of abortion of those living in displacement. This study aimed to describe abortion practices, safety, and incidence in two refugee settings. Methods: Between March and October 2022, we surveyed 1201 women and girls with recent abortion experiences (past 5 years) from Bidibidi Refugee Settlement, Uganda, and Kakuma Refugee Camp, Kenya, using respondent-driven sampling (RDS). Participants completed an interviewer-administered survey. Population-based estimates of abortion experiences were weighted using the RDS-II estimator to account for the sampling design. We used the sequential sampling population size estimation method to estimate annual abortion incidence. We also conducted a health facility assessment of 27 facilities (16 in Bidibidi, 11 in Kakuma) to describe the availability of facility-based abortion services in these communities. Findings: Among those with an abortion in the past 5 years, the most common methods of abortion were traditional herbs (81% in Bidibidi, 45% in Kakuma) and non-medication abortion pharmaceuticals such as painkillers and antimalarials. Few participants reported using WHO-recommended methods of abortion (mifepristone in combination with misoprostol, misoprostol alone, or manual vacuum aspiration). Self-reported morbidity was high. Nearly a quarter reported avoiding seeking post-abortion care. The estimated annual abortion rate was 52 per 1000 in Bidibidi (95% simulation interval 20-106) and 55 per 1000 in Kakuma (95% simulation interval 19-119). Only 5 of 27 health facilities (1 of 16 in Bidibidi, 4 of 11 in Kakuma) reported providing safe abortion services. 15 of 16 in Bidibidi and 9 of 11 in Kakuma reported providing post-abortion care. Interpretation: Refugees in these two contexts have little access to WHO-recommended methods of abortion, and the need for safe abortion services is high. Funding: This study was funded by Elrha's Research for Health in Humanitarian Crises (R2HC) Programme. Elrha aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by the Foreign, Commonwealth & Development Office of the United Kingdom, Wellcome Trust, and the UK National Institute for Health Research.

Indexed as

AbortionAbortion incidenceHumanitarian settingsRefugeeRespondent-driven sampling

Identifiers

PMID40474997
PMCPMC12138476

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.