Despite restrictive abortion law in Nigeria, women still seek abortion
services. Restrictive policies on abortion make it difficult for safe and legal
abortion to be obtained. Hence, abortion is provided on clandestine basis in
some private health facilities, and where the cost of such service is
prohibitory, women resort to unsafe methods, including visiting quacks and self
medication, resulting in severe complications including death. In Nigeria, little
is known about the personal and professional attitudes of individuals who are
currently providing abortion services. Exploring the factors which determine
health care providers’ involvement in or disengagement from abortion services
may facilitate improvement in the planning and provision of future services.
Methods: Data were collected using qualitative research methods. Thirty-six
in-depth interviews and one focus group discussion were conducted between
January 2010 and July 2010 with health care providers who were involved in a
range of abortion services provision in theWestern
Nigeria. Data were analysed using a thematic analysis approach.
Results: Complex patterns of service delivery were prevalent throughout many
of the health care facilities. Fragmented levels of service provision operated
in order to accommodate health care providers’ willingness to be involved in
different aspects of abortion provision. Closely linked with this was the
urgent need expressed by many providers for liberalization of abortion laws inNigeriain
order to create a supportive environment for both clients and providers. Almost
all providers were concerned about the
numerous difficulties women faced in seeking an abortion and their
general quality of care. An overriding concern was poor pre and
post abortion counselling including contraceptive counselling and provision. Conclusion:
This is the first known qualitative study undertaken in Nigeria exploring
providers’ attitudes towards abortion and it adds to the body of information addressing
the barriers to safe abortion services. In order to provide an enabling
environment and sustain a pool of abortion service providers, a drastic change
in Nigerian abortion laws is mandatory, after which policies that both
attract prospective abortion service providers and retain existing ones can
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