Estimating the Incidence of Induced Abortion in Java, Indonesia, 2018

Area of Science:

• Reproductive Health
• Public Health
• Demography

Background:

• High maternal mortality in Indonesia necessitates reliable data on induced abortion.
• Legal restrictions and stigma surrounding abortion in Indonesia complicate incidence measurement.
• Innovative approaches are crucial for accurately assessing abortion rates in restricted settings.

Purpose of the Study:

• To compare the standard Abortion Incidence Complications Method (AICM) with a modified AICM for estimating induced abortion incidence in Java.
• To determine the most effective method for measuring abortion rates in a legally restricted and stigmatized environment.
• To provide reliable data on abortion incidence to inform public health interventions.

Main Methods:

• Conducted three surveys in Java (April 2018-January 2019) involving health facilities, knowledgeable informants, and women aged 15-49.
• Applied both the standard AICM and a modified AICM to estimate the one-year induced abortion incidence rate.
• Evaluated each method based on data quality and alignment with known sexual and reproductive health indicators.

Main Results:

• The modified AICM estimated 42.5 abortions per 1,000 women (aged 15-49), significantly higher than the standard AICM's estimate of 25.8 per 1,000.
• Discrepancies in reported abortion safety between informants and women suggest the standard AICM underestimates incidence.
• The modified AICM demonstrated superior performance in capturing a more accurate picture of abortion incidence.

Conclusions:

• The modified AICM is a more effective tool for measuring abortion incidence in Java.
• Abortion is more common than previously estimated, underscoring the need for improved access to contraceptives.
• High-quality postabortion care is essential, and further research into abortion safety, particularly self-managed abortion, is recommended.