Estimating Incidence of Induced Abortion and Unintended Pregnancy Among Women in Refugee Settlements in Uganda

Estimates of the incidence of induced abortion and unintended pregnancies in refugee settings are lacking, limiting efforts to improve sexual and reproductive health services. We adapted the abortion incidence complications method to estimate the incidence of induced abortion and unintended pregnancy among women aged 15-49 years in refugee settlements in Uganda. We draw data from a survey of 102 health facilities providing postabortion care (PAC) services to women and girls across 13 refugee settlements in Uganda and a knowledgeable informant survey of 59 individuals familiar with induced abortion among the refugee population in Uganda. An estimated 4131 PAC cases were due to induced abortion among women in refugee settings. The overall induced abortion incidence rate among women living in refugee settlements in Uganda was 37.3 per 1000 women aged 15-49. Of the 31,189 live births, 25,023 pregnancies were unintended, translating to an unintended pregnancy rate of 73.7 per 1000 women of reproductive age. Of all pregnancies to women living in refugee settlements, 25 percent were estimated at end in induced abortion, 24 percent in unplanned birth, 37 percent in planned birth, and 15 percent in miscarriage. The findings suggest a need to improve access to contraceptives, safe abortion, and PAC services in refugee settlements in Uganda.