Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.