Billah Md Arif, Koly Kamrun Nahar, Begum Farzana, Naima Shakera, Sultana Quazi Suraiya, Sarker Tithi Rani, Mustary Elvina, Haque Md Mahbubul, Reidpath Daniel, Hanifi Syed Manzoor Ahmed
Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, 1212, Bangladesh.
United States Agency for International Development (USAID), Dhaka, Bangladesh.
Reprod Health. 2025 May 10;22(1):68. doi: 10.1186/s12978-025-01950-1.
Women in urban slums are particularly susceptible due to a lack of knowledge about sexual and reproductive health (SRH), and abortion is frequently performed. Our study investigates the level and predictors of SRH knowledge among the reproductive-aged women who have had abortions and lived in urban slums in Dhaka, Bangladesh.
We adopted a cross-sectional survey among the reproductive-aged women who experienced any kind of abortion from July 2020 to January 2022 living in the UHDSS sites, applying a predefined interviewer-assisted survey questionnaire. Data were analyzed using descriptive statistics (i.e., mean, standard error, and 95% confidence interval (CI)) for continuous and percentage distribution for categorical variables. Bi-variate analysis was used to examine for associations. After checking the assumptions, multinomial regression analysis was used to confirm the determinants with 95% CIs.
A total of 338 women participated (221 spontaneous abortions and 117 induced abortions) with an average age of 26.59 ± 0.355, age at first marriage of 16.69 ± 0.173, and marital length of 9.45 ± 0.386. Except for the use of emergency contraceptives (32%), many women correctly identified condom effectiveness for preventing pregnancy (89%), STDs and HIV/AIDS prevention (79-80%), and abortion (98%). About 34 to 64% of them experienced stigmas attached to sexually explicit items. Few of them knew about abortion complications (9 to 57%), with the exception of bleeding associated with abortion (91.7%). Overall, 3 out of 4 women lacked sufficient SRH knowledge, with a mean score of 58.28 (95% CI: 56.70, 59.87), which was slightly higher for women who had spontaneous abortions 58.90 (95% CI: 57.02, 60.78) and lower for women who had induced abortions 57.69 (95% CI: 54.94, 60.45). Women aged 20-29 and 30 + years had high level of SRH knowledge than those of under 20 years. Women with higher education, longer marriages, and who availed post abortion care had high level of SRH knowledge than respective counterparts. However, employed slum women other than garment workers had lower levels of SRH knowledge than housewives.
Our findings can be used in the abortion policies and strategies for vulnerable women and we recommend an intervention to increase awareness and knowledge on SRH, which is essential for those women to achieve the maternal reproductive health parameters.
城市贫民窟的女性由于缺乏性与生殖健康（SRH）知识而特别容易受到影响，堕胎现象经常发生。我们的研究调查了在孟加拉国达卡城市贫民窟生活且有过堕胎经历的育龄妇女的SRH知识水平及其预测因素。
我们于2020年7月至2022年1月期间，在超高清监测系统（UHDSS）站点对有过任何堕胎经历的育龄妇女进行了横断面调查，采用预先定义的访谈员辅助调查问卷。数据采用描述性统计分析（即连续变量的均值、标准误差和95%置信区间（CI））以及分类变量的百分比分布进行分析。采用双变量分析来检验关联性。在检查假设条件后，使用多项回归分析来确定具有95%CI的决定因素。
共有338名妇女参与（221例自然流产和117例人工流产），平均年龄为26.59±0.355岁，初婚年龄为16.69±0.173岁，婚姻时长为9.45±0.386年。除了使用紧急避孕药的比例为32%外，许多妇女正确认识到避孕套在预防怀孕方面的有效性（89%）、预防性传播疾病和艾滋病毒/艾滋病方面的有效性（79 - 80%）以及堕胎方面的有效性（98%）。其中约34%至64%的人经历过与性相关内容的污名化。她们中很少有人了解堕胎并发症（9%至57%），但与堕胎相关的出血情况除外（91.7%）。总体而言，四分之三的妇女缺乏足够的SRH知识，平均得分为58.28（95%CI：56.70，59.87），自然流产妇女的得分略高，为58.90（95%CI：57.02，60.78），人工流产妇女的得分较低，为57.69（95%CI：54.94，60.45）。20 - 29岁和30岁及以上的妇女比20岁以下的妇女具有更高水平的SRH知识。受过高等教育、婚姻时间较长且接受过堕胎后护理的妇女比相应的对照组具有更高水平的SRH知识。然而，除服装工人外的就业贫民窟妇女的SRH知识水平低于家庭主妇。
我们的研究结果可用于针对弱势妇女的堕胎政策和策略，并且我们建议进行干预以提高对SRH的认识和知识，这对于这些妇女实现孕产妇生殖健康参数至关重要。
