Sexual and reproductive health literacy, misoprostol knowledge and use of medication abortion in Lagos State, Nigeria: a mixed methods study

Little is known about the link between health literacy and women’s ability to safely and successfully use misoprostol to self-induce an abortion. While abortion is only allowed to save a woman’s life in Nigeria, misoprostol is widely available from drug sellers. We interviewed 394 women in 2018 in Lagos State, Nigeria, who induced an abortion using misoprostol obtained from a drug seller to determine their sexual and reproductive health literacy (SRHL) and misoprostol knowledge levels; and how these were associated with ending the pregnancy successfully or seeking care for (perceived) complications. Our results show that women’s misoprostol knowledge (measured both quantitatively and qualitatively) was low, but that almost all women were nevertheless able to use the drug effectively and safely. Higher SRHL was associated with being more likely to end the pregnancy successfully and also seeking post-abortion healthcare. Our study is the first to examine this association and adds to the scarce literature examining the relationship between health literacy and self-use of misoprostol to induce abortions in restrictive settings.

10.1111/sifp.12156

0039-3665

217-237

Vaisanen, Heini

ee5b9497-7825-4fd8-8b7e-3d5d2b164766

Moore, Ann M.

60ae6073-f289-4453-a79e-4f1019b9367c

Owolabi, Onikepe

ac945e29-142d-44c9-8984-7f347cd24076

Stillman, Melissa

4476a8ec-d496-4aae-8ed2-0a75f818edeb

Fatusi, Adesegun O.

4d73250d-f972-4383-90fe-3c0245af99ee

Akinyemi, Akanni

99b6089a-d258-4cad-9580-22132d4589ce

June 2021

Vaisanen, Heini

ee5b9497-7825-4fd8-8b7e-3d5d2b164766

Moore, Ann M.

60ae6073-f289-4453-a79e-4f1019b9367c

Owolabi, Onikepe

ac945e29-142d-44c9-8984-7f347cd24076

Stillman, Melissa

4476a8ec-d496-4aae-8ed2-0a75f818edeb

Fatusi, Adesegun O.

4d73250d-f972-4383-90fe-3c0245af99ee

Akinyemi, Akanni

99b6089a-d258-4cad-9580-22132d4589ce

Vaisanen, Heini, Moore, Ann M., Owolabi, Onikepe, Stillman, Melissa, Fatusi, Adesegun O. and Akinyemi, Akanni (2021) Sexual and reproductive health literacy, misoprostol knowledge and use of medication abortion in Lagos State, Nigeria: a mixed methods study. Studies in Family Planning, 52 (2), 217-237. (doi:10.1111/sifp.12156).

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Accepted/In Press date: 20 January 2021

e-pub ahead of print date: 27 May 2021

Published date: June 2021

Additional Information: Funding Information: The authors thank the members of the Technical Advisory Committee for their guidance throughout the duration of the study: Professor Babalola Adeyemi (Obafemi Awolowo University), Dr. Kayode Afolabi (Federal Ministry of Health, Nigeria), Dr. Olanike Adedeji, and Professor Olumuyiwa Odusanya (Lagos State University, College of Medicine). The authors also acknowledge Susheela Singh and Amanda Berry of the Guttmacher Institute for their contributions to the study design. This study benefited from input from a larger three‐country study team, including staff from Guttmacher Institute, Academy for Health Development (AHEAD, Nigeria), Centre for Research, Evaluation Resources and Development (CRERD, Nigeria), Oriéntame (Colombia), and Reconstra (Indonesia). Finally, the authors express their appreciation to all study participants. The three‐country study on which this article is based was supported by UK Aid from the UK Government under Project number 203177‐101; the Dutch Ministry of Foreign Affairs under Activity number 4000000282; and an anonymous foundation. The health literacy and misoprostol knowledge modules were supported by the University of Southampton's Strategic Interdisciplinary Research Development Fund; and the ESRC Centre for Population Change (CPC). Funding Information: The authors thank the members of the Technical Advisory Committee for their guidance throughout the duration of the study: Professor Babalola Adeyemi (Obafemi Awolowo University), Dr. Kayode Afolabi (Federal Ministry of Health, Nigeria), Dr. Olanike Adedeji, and Professor Olumuyiwa Odusanya (Lagos State University, College of Medicine). The authors also acknowledge Susheela Singh and Amanda Berry of the Guttmacher Institute for their contributions to the study design. This study benefited from input from a larger three-country study team, including staff from Guttmacher Institute, Academy for Health Development (AHEAD, Nigeria), Centre for Research, Evaluation Resources and Development (CRERD, Nigeria), Ori?ntame (Colombia), and Reconstra (Indonesia). Finally, the authors express their appreciation to all study participants. The three-country study on which this article is based was supported by UK Aid from the UK Government under Project number 203177-101; the Dutch Ministry of Foreign Affairs under Activity number 4000000282; and an anonymous foundation. The health literacy and misoprostol knowledge modules were supported by the University of Southampton's Strategic Interdisciplinary Research Development Fund; and the ESRC Centre for Population Change (CPC). Publisher Copyright: © 2021 The Authors. Studies in Family Planning published by Wiley Periodicals LLC on behalf of Population Council

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