A substantial proportion (35%) of adolescent pregnancies in sub-Saharan Africa are unintended; 10-19 year olds account for 25% of all abortions in Africa, higher than in any other world region. Unsafe abortion is a major public health problem, not only in countries where access to safe abortion services is highly restricted legally. Even where it is available legally, access, provision and knowledge of services can be inadequate. Adolescents are more likely to have an unsafe abortion and to experience complications (including death) of unsafe abortion compared to older women, even in settings where safe abortion is available. This research aims to establish how the implementation of contraception and abortion services for adolescents in sub-Saharan Africa can be improved. It will do this by comparing services in three countries: Ethiopia, Malawi and Zambia. These three countries represent a range of abortion legal frameworks, from least restrictive (Ethiopia) to most restrictive (Malawi). The research will generate new evidence by collecting data from two groups: adolescents seeking either safe abortion or post abortion care at facilities; and, key informants involved in the implementation of contraception and abortion services for adolescents.
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