{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:31:30Z","timestamp":1740184290260,"version":"3.37.3"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["IVN009639"],"award-info":[{"award-number":["IVN009639"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004439","name":"William and Flora Hewlett Foundation","doi-asserted-by":"publisher","award":["2020-2085"],"award-info":[{"award-number":["2020-2085"]}],"id":[{"id":"10.13039\/100004439","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Niger is a country in which legal restrictions and a dearth of research has long limited our understanding of the extent and safety of induced abortion. The current study is the first national study of induced abortion in Niger. It uses direct (self-report) and indirect (best friend method) to provide nationally representative estimates of induced abortion incidence and safety and evaluates the performance of the indirect measurement approach. We used cross-sectional, representative survey data on women aged 15\u201349 in Niger collected between January and May 2022; final sample included 3,696 women. The survey included questions on respondents\u2019 and their closest female friends\u2019 experience with abortion, including methods and sources used. We calculated one-year abortion incidence and the proportion of abortions involving non-recommended methods and\/or sources to determine safety separately for respondents and friends, overall and by background characteristics. The fully adjusted one-year friend abortion rate was 6.7 abortions per 1,000 women in 2021, which was substantially higher than the corresponding respondent rate of 0.4 per 1,000 women. Confidence intervals were wide, but friend estimates suggest higher abortion rates among women in their 20s, those with secondary or higher education, and those with no children. Nearly all abortions were unsafe (97% respondents, 100% friends), involving non-recommended methods and\/or sources. While abortion numbers were small, unsafe abortion appeared more common among older women, married women, those with children, and those residing in rural areas. Our findings indicate that, despite legal restrictions, some women undergo abortions in Niger at great risk to their physical safety. Ensuring adequate access to quality voluntary family planning services to prevent unintended pregnancy and postabortion care to treat complications is essential to reducing the risk of unsafe abortion in the country.<\/jats:p>","DOI":"10.1371\/journal.pgph.0002353","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T17:21:17Z","timestamp":1697217677000},"page":"e0002353","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Abortion incidence and safety in Niger in 2021: Findings from a nationally representative cross-sectional survey of reproductive-aged women using direct and indirect measurement approaches"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7650-5940","authenticated-orcid":true,"given":"Suzanne O.","family":"Bell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sani","family":"Oumarou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5859-3115","authenticated-orcid":true,"given":"Elizabeth A.","family":"Larson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Souleymane","family":"Alzouma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Moreau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"pgph.0002353.ref001","volume-title":"Management of Unintended and Abnormal Pregnancy","author":"C Joffe","year":"2009","edition":"1"},{"issue":"9","key":"pgph.0002353.ref002","doi-asserted-by":"crossref","first-page":"e1152","DOI":"10.1016\/S2214-109X(20)30315-6","article-title":"Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990\u20132019","volume":"8","author":"J Bearak","year":"2020","journal-title":"Lancet Glob Health"},{"issue":"9550","key":"pgph.0002353.ref003","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1016\/S0140-6736(06)69481-6","article-title":"Unsafe abortion: the preventable pandemic","volume":"368","author":"DA Grimes","year":"2006","journal-title":"Lancet"},{"issue":"9947","key":"pgph.0002353.ref004","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/S0140-6736(14)60696-6","article-title":"Global, regional, and national levels and causes of maternal mortality during 1990\u20132013: a systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"NJ Kassebaum","year":"2014","journal-title":"Lancet"},{"issue":"6","key":"pgph.0002353.ref005","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: a WHO systematic analysis","volume":"2","author":"L Say","year":"2014","journal-title":"The Lancet Global health"},{"issue":"10041","key":"pgph.0002353.ref006","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/S0140-6736(16)30380-4","article-title":"Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends","volume":"388","author":"G Sedgh","year":"2016","journal-title":"Lancet"},{"key":"pgph.0002353.ref007","unstructured":"Institut National de la Statistique\u2014INS\/Niger and ICF International. 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