The rural-urban divide in the determinants of pregnancy termination among married women: Insights from less developed countries

Bwalya Bwalya, Mulungushi University
Vesper H Chisumpa, University of Zambia, Department of Demography, Population Sciences, Monitoring and Evaluation
Clifford Obby Odimegwu, University of the Witwatersrand, Johannesburg

Introduction: Despite progress in maternal healthcare in developing nations, significant disparities persist in access to sexual and reproductive health (SRH) services between urban and rural communities. This study sought to identify the factors influencing pregnancy termination decisions among married women residing in both settings. Methodology: Weighted DHS data from 61 countries was used to analyse the determinants of pregnancy termination among 259,013 and 456,269 married women aged 15 – 49 in urban and rural areas. Descriptive statistics, chi-square test and multilevel mixed-effects modelling were employed to examine individual, household and community level factors. Results: Urban married women had higher pregnancy termination prevalence (20.5%) than rural women (17.3%). Individual-level factors were similar across regions, but household and community predictors varied. Partners education, household size, and wealth index influenced pregnancy termination in both regions at household level, with addition effects of community media and family planning exposure (aORs = 1.07; 95% CI: 1.04 – 1.10; and aORs = 1.05; 95% CI: 1.01 – 1.08) in rural areas. Conclusion: The study highlights the varying factors influencing pregnancy termination decisions in urban and rural areas of developing countries. It emphasizes the need for geographically specific policies and programs to address this significant SRH issue.

Keywords: Sexual and Reproductive Health and Rights, Multi-level modeling

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