Interpersonal Communication and Health Message Exposure in Decision Making on Abortion among Women Aged 18-49 Years in Nakuru County, Kenya

Abstract

Elimination of maternal death and complications due to abortion remains a global concern. Whereas policy and guidelines on the same are in place, studies to guide evidence-based programming in health communication strategies and programs in reproductive health are inadequate. This study sought to examine how interpersonal communication and health message exposure influenced decision making on abortion among women aged between18 to 49 years in Nakuru County. The specific objectives of the study were: to determine the influence of interpersonal communication on decision making on abortion among women aged 18 to 49 years in Nakuru County; to examine influence of health message exposure on decision making on abortion among women of aged 18 to 49 years in Nakuru County; to determine the moderating effects of demographic characteristics between interpersonal communication and decision making on abortion among women of aged 18 to 49 years in Nakuru County, and finally to determine the moderating effects of demographic characteristics between health message exposure and decision making on abortion among women of aged 18 to 49 years in this study site. The study adopted a mixed method research approach, specifically using the convergent parallel designs. The target population of the study was women who had experienced an induced abortion in the age bracket of 18-45 years in Nakuru County. A sample size of 340 women was purposively selected from patients seeking services at four health facilities in Nakuru. Primary data was utilized in this study. Quantitative data was collected using a semi structured questionnaire comprising both closed and open-ended questions. This sample was randomly selected on real time basis from clients seeking Post Abortion Care (PAC) services. Qualitative data was collected using key informant interview guides from 28 health providers who were purposively sampled to include only those providing PAC services at both public hospitals in the county. Ten In-depth interviews were carried out on PAC clients. STATA Version 15 was used to analyse quantitative data while qualitative data was analysed based on thematic areas. The data was later merged and interpreted identifying areas of similarities and convergence as well as contradictions. The study found that interpersonal communication and health message exposure are significant in decision making on abortion in women of reproductive age in Nakuru County. The study concluded that fear of social sanctions like rejection and isolation by the family and social groups was the major cause of termination of pregnancy even among women who had prior health message exposure on abortion and other reproductive health information.The study recommends the need to design anti-abortion community communication campaigns that target families and community groups with the aim of reducing stigma towards women with unplanned pregnancies. The study also recommends empowerment programs for young women to increase their self-efficacy in decision making on matters of reproductive health.