Utilizing a Mathematical Model to Estimate Abortion Decline Scenario

TL;DR

This paper uses a mathematical model based on Bongaarts' determinants to estimate how changes in contraceptive use and reproductive behaviors could significantly reduce abortion rates in Indonesia, aiding policy planning.

Contribution

It demonstrates the application of a Bongaarts-based mathematical model to project abortion decline scenarios using Indonesian demographic data.

Findings

Estimated current abortion rate is 1.9-2.2 per woman.

Increasing contraceptive prevalence to 69% could reduce abortions by one per woman.

Delaying marriage and increasing birth intervals can drastically lower abortion rates.

Abstract

Abortion is one of the biggest causes of maternal deaths, accounting for 15% of maternal deaths in Southeast Asia. The increase in and effectiveness of using contraception are still considered to be the effective method to reduce abortion rate. Data pertaining to abortion incidence and effective efforts to reduce abortion rate in Indonesia is limited and difficult to access. Meanwhile such supporting information is necessary to enable the planning and evaluation of abortion control programs. This paper exemplifies the use of a mathematical model to explain an abortion decline scenario. The model employs determinants proposed by Bongaarts, which include average reproductive period, contraceptive prevalence and effectiveness, total fertility rate (TFR), and intended total fertility rate (ITFR), as well as birth and abortion intervals. The data used is from the 1991-2007 Indonesian Demography and Health Survey (Survei Demografi dan Kesehatan Indonesia/SDKI), and the unit of analysis is women who had been married and aged 15-49 years old. Based on the current contraceptive prevalence level in Indonesia at 59-61%, the estimated total abortion rate is 1.9-2.2. Based on the plot of this total abortion rate, an abortion decline scenario can be estimated. At the current TFR level of 2.6, the required contraceptive prevalence is 69% (9% increase) for a decrease of one abortion case per woman. With a delay of one year in the age of the first marriage and a birth interval of three years, it is estimated that the abortion rate will decline from 3.05 to 0.69 case per woman throughout her reproductive period. Based on the assumption of contraceptive prevalence growth at 1-1.4%, it can be estimated that abortion rate will reach nearly 0 between 2018 and 2022.