Pregnancy termination and determinant factors among women of reproductive age in Kenya, evidence from Kenyan Demographic and Health Survey 2022: Multilevel analysis

Abstract

Background: Pregnancy termination is one of the common causes of maternal mortality, particularly in developing countries, and remains a global public health concern despite the efforts made to enhance maternal healthcare services. Maternal mortality is still the highest in sub-Saharan Africa, including Kenya, due to pregnancy termination. Objectives: This study aimed to investigate the current burden of pregnancy termination and its determinants among reproductive-age women in Kenya. Design: A cross-sectional study design with multilevel analysis. Methods: The total weighted samples of 19,530 women of reproductive age were included in this study. The data were taken from the Kenyan Demographic and Health Survey 2022. A multilevel multivariable logistic regression model was used to identify the determinant factors of pregnancy termination. In the multivariable multilevel analysis, the adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare significant determinants of pregnancy termination among women of reproductive age. Results: The overall prevalence of pregnancy termination among women of reproductive age in Kenya was 14.19%. The determinant factors associated with pregnancy termination were the age of the women; as age increased, the risk of pregnancy termination increased, 25–29 years (AOR = 2.23; 95 CI (1.08–4.60)), 30–34 years (AOR = 2.98; 95% CI (1.43–6.18)), 35–39 years (AOR = 3.24; 95% CI (1.55–6.76)), 40–44 years (AOR = 4.57; 95% CI (2.16–9.68)), 45– 49 years (AOR = 5.16; 95% CI (2.33–9.98)); marital status: married (AOR = 5.63; 95% CI (3.08–10.29)), ever married (AOR = 5.05; 95% CI (2.74–9.33)); wealth index: richest (AOR = 1.32; 95% CI (1.05–1.63)); employment status: employed (AOR = 1.23; 95% CI (1.09–1.38)); preceding birth interval: greater than 24 months (AOR = 1.21; 95% CI (1.06–1.38)); urban residence (AOR = 1.25; 95% CI (1.06–1.46)); and Islamic followers (AOR = 1.64; 95% CI (1.31–2.06)). Conclusion: Pregnancy termination among women of reproductive age in Kenya has become an important public health concern. Policymakers and other stakeholders should focus on maternal healthcare service programs to prevent the termination of pregnancy. The determinant factors are an important input to developing strategies to improve the accessibility of maternal healthcare services in the country.