KNOWLEDGE REGARDIG LEGALIZATION OF ABORTION

AMONG REPRODUCTIVE AGE GROUP WOMEN IN

DHANGADHI, KAILALI

By

Sunita Chaudhary

T.U. REG. NO.

5-2-940-63-2017

Research Proposal submitted in Partial Fulfillment of the

Requirements

Of Bachelor in Nursing programme from

JF Institute of Health Science, Hattiban, Lalitpur

Affiliated to Tribhuwan University,

Institute of Medicine

2020
 TABLE OF CONTENTS
CONTENTS PAGE NO
TITLE PAGE i
TABLE OF CONTENTS ii-iii
LIST OF TABLE OF FIGURES iv

CHAPTER I ; INTRODUCTION
1.1 Background of the study 1-2
1.2 Need of the study
1.3 objectives of the study
1.4 significant of the study
1.5 Variables of the study
1.6 Conceptual framework
1.7 Research question
1.8 Operational Definiation

CHAPTER II; LITERATURE REVIEW

2.1 Introduction
2.2 Review of the literature
2.3 Summary of the Reviewed literature

CHAPTER III; METHODOLOGY

3.1 Research design
3.2 Research setting and study population
3.3 Sampling Technique and Sampling size
3.4 Research Instrumentation
3.5 Data collection procedure
3.6 Data Analysis procedure

ESTIMATED BUDGET
REFERENCES
APPENDICES
Appendix A ; Work plan
Appendix B ;I nformed Consent Form
Appendix C ; Instrumentation

List of Figure
Conceptual Framework for Knowledge towards Abortion
among reproductive age women
 CHAPTER I
INTRODUCTION

1.1 Background of the study

Worldwide 25million unsafe abortion (45% of all abortion occur every year between 2010 and
2014 according to new study by WHO and the Guttmacher Institute published today in the Lancet .
The majority of unsafe abortion or 97% occurred in developing countries in Africa, Asia and
Latent America. Appromately of all abortion from 2010 to 2014 were conducted safely ,Almost
one third 31 % of abortion were “less safe “ meaning they were performed by a trained provider
using an unsafe or out dated method such as “ shaep curttage “ or by an untrained albeit using
a safe method like misoprostol , a drug that can be used for many medicine purpose , including
to induce an abortion. About 14% were “ least safe “ abortion meaning they were either
performed by a untrained person using dangerous method , such as introducing of foreign objects
and use of herbal concoctions. Death from complication of unsafe abortion were high in regions
where most abortion happened.(According to WHO)

The incidence of abortion Globally , the annual number of abortion increased by 5.7 million
between 1990 and 1994 and 2010 – 2014 , from 50.2 million to 55.9 million . 28% in developing
regions from ( from 38.4 million to 49.3 million ) Global rate fell significantly between 1990
-1994 and 20101 – 2014, the drop was relatively small in absolute term ( from 40 to 35 abortion
per 1,000 women, however , a large and statistically significant decline in the rate did occur in

developing regions. Regionally the highest estimated abortion rate in Latent America and the
Caribbean (44 abortion per 10000 women , and the lowest rate in North America and Oceania (17
and 19 per 1,000 , respectively .). The rate in Africa and Asia are very close to the world average
( 34 and 36 per 1,000). At the sub regional level , rates are fairly homogenous with in Africa and
Asia , however , they vary widely within Latent America and the Caribbean( from 33 per 1,000
in centeral America to 59 per 1,000 in the Cairbben ). And with in Europ( from 16per 1,000 in
western Europ to per 1,000 in Eastern Europe.( Singh .S, Remez. L, Sedgh. G, Kwok.L, Onda.T
2017)

Worldwide , some 5million women are hospitalized each year for treatement of abortion –
related complications such as hemorrhage and sepsis , and abortion related deaths leave
220,000 children motherless . The main cause of death from unsafe abortion are hemorrhage ,
infection , sepsis , genital trauma , and necrotic bowel . Data on nonfatial longterm complication
are poor , but those document include wound healing, infertility , consequences of internal
organ njury( Urinary and stool incontinence from vesicovagnal or rectrovaginal fistula and
bowel resection other measurable consequences of unsafe abortion include loss of productivity
and psychological damage.(Lisa.B.H, MD,MA, NawalM.Nour,MD, MPH 2009)

The survey conducted by The Greens and conducted online by a commercial market research
agency using plane based sampling on Knowledge on current abortion law view on abortion in
New south wales in 2018 among1051 men and women shows that three quartile of respondents
( 76%) were unaware about abortion remains criminal offences under New south wales
legalization.(Alexandra et….. al 2019)

A cross sectional study conducted among 1484 women of reproductive age on women knowledge
and attitudes surrounding abortion in Zambia in 2016 shows that 16% women of reproductive
age correctly identified the ground for which abortion is legal . Only 40% women of reproductive
age knew that abortion was legally permitted in extreme situation where the pregnancy threatens the
life of mothers. Attitude remains conservative. women with correct knowledge in abortion law in
Zambia tended to have more liberal attitudes towards abortion and access to safe abortion
service .( Jenny, et……al2016)

A cross sectional study conducted among 442 women on knowledge regarding abortion in Eastern
Africa, Ethiopia in 2010 shows that 48.21% has knowledge about abortion legalization in Ethiopia.
But more than half that is 51.79% has no knowledge about legalization abortion. This shows that
there is a gap to aware the mother about legalization of abortion. It indicate health education should
be given on reproductive health to the society. (Shimelsh ,et…… al 2013)

A cross section study conducted on Knowledge and attitude towards safe abortion among 246
female students of Kerbriayah Town of Somali Region, Ethiopia in 2017 shows that 48% had
moderate knowledge and 60% had moderate attitude towards abortion.( Gargi. D 2017)

A descriptive cross sectional study on knowledge regarding abortion in Indonesia in 2019 shows
that 49.1% has moderate knowledge regarding abortion (Eak et….al 2019)

A community based cross sectional study conducted among 422 women of reproductive age on
knowledge towards abortion in Yirga cheffe town Southern national , nationalities and people
region in2010 shows that 48.21 % has knowledge about abortion legalization in Ethiopia. But more
than half that is 51.79% has no knowledge about the legalization of abortion. This shows that there
is a gap to aware the mothers about legalization of abortion (Shimelash et…. al 2013)
A survey conducted on factor associated with unsafe abortion practice in Nepal in 2011to 2016
shows that ot of 911 women who used abortion services during 2011 to 2016 , slightly over 505
were living in rural area . Overall, 50% of the women and 72% of their husbands had secondary
and higher level of education having access were almost equally distributed .out of 25,536
women surveyed during the period 2011 to 2016, 911 women used abortion services and of
these abortion services, 23% were unsafe abortion. The estimated as 95% per 1000 women aged 15-
49, whereas the rate of unsafe abortion was sevent 95% per 1000 women aged 15-49 years. The
sub- stantial proportion of unsafe abortion were conducted in mountain region 39% and among
those with the disadvantage ethnic background( Dalit and Madheshi and Muslim). Similarly , a
higher proportion women found to undertake safe abortion practice if they or their husband
reported no education 36% , If they could not read or write , belonging were found to the
households of lower wealth index, or were involved in agriculture occupation. If women had
lower knowledge of legal conditions and safe abortion places 62% if they had no exposure to mass
media, then a higher proportion of women used unsafe abortion services. If women delay or space
childbirth or did not want birth, then a higher proportion of women were found to use unsafe
services.( Khatro.RB, Poudel.S and Ghimire.P.R 2019)
A cross section study based on structured interviews that took place at palpa community Hospital
in rural Nepal on Knowledge and attitude on Abortion in 201 5. The study had a quantitative
approach and collected data were only used for statical analyses. 118 patients and 7 medical
students were included. Only 10% knew that abortion was legal until 12 weeks of pregnancy
regardless the reason. A significant difference in knowledge was mostly seen between medical
students and the other study participants. The attitudes differed significantly depending on the
reasons for abortion, and become more positive with increasing knowledge.(Lovisa .H 2015) .

A cross sectional study conducted among 105 participants on knowledge regarding legalization of
abortion with reproductive age group of Anantalingeshwor Muncipality, Bhaktapur in 2018
shows that more than 56.2% participants perceives towards meaning of legal abortion as the
abortion under law. Among total participants 69.5% have no knowledge regarding practice of
abortion in relatives whereas 30.5% were known about the abortion done by their relatives .
(Belbas. M, Neupane.J 2018)
1.2 Need for the Study

Worldwide 25million unsafe abortion (45% of all abortion occur every year between 2012014. The
majority of unsafe abortion or 97% occurred in developing countries in Africa, Asia and Latent
America. Around 7milion women are admitted in hospital every year in developing countries, as a
result of unsafe abortion. The annual cost of treating major complication from abortion is estimated
at US$553 million. Mortality from unsafe abortion disproportionally affect women in Africa. While
the continent accounts for 29% of all unsafe abortion, it seems 62% of unsafe abortion related
deaths (According to WHO 2020).

A cross section study conducted on 483 under graduated female students on knowledge on safe
abortion among female students in Debre Markos university , Amhara Region state , North west
Ethiopia in 2016 shows that 41.2% were knowledgeable about liberalized safe abortion and 58.8
% were moderate knowledge. A (Biru,et….al 2019)

A cross sectional study conducted on Knowledge on legalization of abortion and experience of

abortion among female youth of Nepal in 2016 shows that only two fifth ( 41% ) female youth
was aware of abortion legalization in the country . 595 were unaware about abortion. Knowledge
on at least one condition of abortion law is even lower (21%). Less than two percentage (1.5%
female youth reported that they ever had an abortion. (Adhakari.R 2016)

A cross sectional study conducted on Prevalence and factor associate with abortion in Nepal in
2018 shows that according to the wealth index quintiles , the highest prevalence of abortion was
reported among the richest women (27.0%) and lowest among the poorest women (13%). He five
year prevalence of unsafe abortion was 16% out of total abortion. Unsafe abortion was higher
20.0% in the younger age women(15-24 years).Likewise, the prevalence of unsafe abortion was
higher among the women of Muslim and other religion 19.0% and those who were in the poorest
wealth quintiles33.0% . (Yougi, KC and Neupane 2018)

A cross-sectional survey was carried out to assess the knowledge and practice of abortion among
women of reproductive age in Nepal. A semi-structured questionnaire was administered to 181
women during their visit to a Marie Stops Center in. The overall knowledge level of abortion among
respondents was low to moderate. Respondents’ knowledge of legal abortion in Nepal was
associated with their and their husband’s educational attainment, and their family income. About
half (44.7%) had a history of abortion primarily due to unwanted pregnancies. Sexual reproductive
health interventions are needed at community level in order to equip women of reproductive age
group with comprehensive knowledge and skills to reduce the likelihood of unsafe abortion. There
is a need for more studies on abortion in Nepal.( Khanal .P, Sanjel .K ,Chalise .H 2014)
 A cross section descriptive study conducted on knowledge , attitude on abortion among
reproductive age in Maniple Teaching Hospital Pokhara ,Nepal in 2019 shows that total sample
were 100 and sampling technique was purposive . The data was analyzed using Excel 2007,
SPSS for windows version 16.o. Majority (83%) of having average knowledge regarding
abortion, and remaining 4% were having poor knowledge . It was also found that majority d (10%)
of women had poor attitude. There were significant association between knowledge and the level of
education.(Adhkari, et……al 2019)

Above study shows that knowledge of Reproductive age women on Abortion is inadequate. Unsafe
abortion occur most commonly in developing countries in Africa, Asia and Latent America.
Mortality from unsafe abortion disproportionally affect women in Africa, and rural area of Nepal.
Hence, awareness regarding abortion is essential to reduce national burden of abortion. Adequate
knowledge is required for reproductive women they are more prone to practice unsafe behavior. So
this type of study is necessary to aware reproductive age women about abortion to prevent unsafe
abortion.

1.3 Objectives of the study

General

To find the knowledge among reproductive age women.

Specific objectives

To assess the level of knowledge regarding abortion.

To measure the association of knowledge with selected socio- demographic variable.

1.4 Significance of the Study

This study finding provides factual information about knowledge regarding abortion among
reproductive age women of Dhangadhi , Kailali.

This study will provide baseline data for further study in same field.

1.5 Study Variables

Dependent Variables

Knowledge regarding abortion among community people.

Independent Variables

Demographic

 Age
 Gender
 Ethnicity
 Marital status
 Educational status

 Source of information
 Internet
 Journals
 Television
 1.6 Conceptual Framework

Sources of information
Demographic Data
 Internet
 Age Knowledge  Journal
 Gender regarding  Telivision
 Ethnicity abortion
 Education
 Marital status

Fig 1: Conceptual framework showing variables associate with knowledge on Abortion

among community people.

Conceptual framework is the network of interrelation concepts that provides a structure

for organization and describing a phenomena . In this framework, the researcher aimed to
show the relationship between dependent and independent variables. The age religion,
ethnicity, family income, family history. With medical background and source of
information are independent variables and knowledge regarding Abortion is dependent
variables.
1.7 Research Question
What is the level of knowledge regarding abortion among community peopl

1.8 Operational Definition

Knowledge; It refers to the information regarding abortion .which is acquired through

experience or education by perceiving and learning among reproductive age women? It can
be measured through semi structured questionnaire

Abortion; The termination of the pregnancy before foetus become viable. It usually between

20 to 27 weeks of gestation. In Nepal it has been agreed from 22 weeks.

Community people refers; people who are living in specific area over a period of time.

1.9 Delimitation of the study

 The study will be conducted only for academic purpose.

 The duration of data collection will be limited to 2 weeks only.
 CHAPTER II
LITERATURE REVIEW
2.1 Introduction
This chapter presents a review of literature that has been done and published in journals ,
reports, articles , and overviews from online or offline search . It is the key step in the research
process. The review of literature was done through an extensive exhaustive and systematic
examination of publications relevant to the research study.

Review of literature are carried out both on electronic ( Google, Google scholar, pub med,) and
non-electronic ( books , journal, articles, and reports) document’s and will be continue
throughout my study

period . The purpose is to learn more about the study problem. Write a proposal and develop
instrument as well as application of methodology.

2.2 Review of literature

A cross section study conducted on 483 under graduated female students on knowledge on safe
abortion among female students in Debre Markos university , Amhara Region state , North west
Ethiopia in 2016 shows that 41.2% were knowledgeable about liberalized safe abortion and 58.8
% were moderate knowledge. (Biru et….al 2019)

A cross sectional study conducted among 348 female on Assessment of knowledge , Attitude ,
and practice of reproductive age group towards abortion care at Dere Markos Referral Hospital ,
Debre Markos Ethiopia in 2015 shows that23% have no knowledge from those who knew about
legal abortion service 30% were from friends 28 % from TV , 13% from school 2.08% from
magazine and Newspaper (2.604) were from radio(Addis et…..al 2015).

A cross sectional study conducted among 222 GPs who were associated with the university of
Limerick Graduate Entry Medical school (GEMS) and GP training program on Knowledge
attitude towards abortion following it’s legalization in Irish 2018 shows that 82.7% had no
training in this area with only 4% indicating that they had sufficient training . Nearly 93.7%
were willing to share abortion information with patients. Just under half respondents 48.0% would
willing to provide pills , with(37%) unwilling to do so only 41.7% respondents believed that
provision of abortion service should be the part of general practice with 30.9% saying that it
should not .
 As to whether doctors should be entitle to a conscientious objection but should also be
obliged to refer the patient , 72.4% respondents agreed . Over two –third of respondents 70.1%
felt that necessary patient support services are not currently available.(Raymond et………..al
2019)

A descriptive cross sectional study carried out in two of the nine public secondary school were
Girls senior secondary school and Herbert Macaulay Giel’s senior high school both in Min land
LAG of Lagos state in Southwestern Nigeria the number of students were 450 and 300
respectively and 250 to 160 respectively only 38.8% of the respondents knew that any
pregnancy can be aborted irrespective of the gestational age score of least 50%e.The attitude of
the respondents which support abortion were generally poor 6.8% of the respondents had
overall attitude . The most common source of information about abortion was friend 52.4%
followed by mass media 18.4% family 11.2% other sources 8.7% the Church shows the nine
public secondary school in Min land LAG 3% .(Abdul et…..al 2020.

A descriptive cross sectional study conducted among 1575 in four state universities in western
province namely of Colombo , University of Sri Lanka in 2018 shows that 30% had satisfactory
knowledge and in majority 16.3% had poor knowledge . 55% female had more good knowledge
than male 51%. Also those who studied in bio science stream 70.2% and had their secondary
education mixed schools 54.4% had good knowledge than other categories. Knowledge on safe
abortion was scarce among undergraduates in sir Lanka. One study found that around 96%
participants were not aware of adverse outcomes of abortion among Sir Lanka women seeking
termination of pregnancy Though 915 of them thought that induced abortion was immoral ,
94% did not know that it was an unlawful act. According to another study among adolescents in
Sir Lanka, knowledge on risk involved abortion was less than 45%. We found that 63.5% of under
graduated knew that abortion is not legally allowed in Sir Lanka except to prevent death of
mothers . One Sir Lanka study reported that only 34% of resident in the district of Colombo had
known induce abortion was legal in Sir Lanka under similar circumstances . Another Sir Lanka
study reported that 94% of women seeking termination of pregnancy did not know that it was an
illegal act. One study reported that 40% of women of reproductive age in Zambia knew that
abortion was permitted in the extreme situation where pregnancy threatens the life of the
mothers.(Upuli .P and Chrishantha .A 2018)

A descriptive cross sectional study conducted on knowledge , attitude , behavior about abortion
among women of Peunayong , Banda Aceh , Indonesia in 2017 on knowledge , attitude , behavior
were assessed using questionnaire . The result were analyzed using statical program. The total
subject recruited in this study were 55 subjects. 50.9% of subjects has good knowledge and
49.1% the subjects had moderate knowledge 52.7 5 had moderate attitude and 36.4% of subjects
had good attitude 54.5 % of subjects had a good behavior regarding abortion.( Eak et… al2019)
A survey conducted on inequalities of the safe abortion in Nigeria in 2019 among 11 106 women of
reproductive age completed the female survey. The 10 671 respondents who answered the question
on number of close female confidantes reported 0.8 confidantes on average and provided
demographic and abortion experience details for their 5883 closest confidantes. Respondents were
on average 29.1 years old, most had attended at least some secondary school (46.9%) and the
majority were currently married or cohabiting (63.7%). Respondents primarily identified as
Christian (not including Catholic) (44.0%) or Muslim (39.2%), and Igbo (22.5%) or Hausa (21.0%)
ethnicity. Many respondents were nulliparous (35.1%), yet nearly one in five had five or more
children (18.1%). Unadjusted confidante data indicate they were similar in age (average 28.4), but
slightly more educated; 26.3% had her education compared with 20.3% of respondents.
Additionally, respondents in rural areas were more likely to report a confidante. After adjusting
confidante data to account for respondents who did not report a confidante and applying the post--
stratification weights, the distribution of confidante characteristics were no longer statistically
significantly different from that of the respondents. Women aged 15–19 were the most likely to
have had the most unsafe abortions (87.8% and 84.7%), as were women who had never attended
school (79.1% and 86.4%). Respondents residing in rural areas were significantly more likely to
have had the most unsafe likely-abortions (70.8%). By state, respondents from Anambra, Kaduna,
Nasarawa and Taraba had the highest levels of the most unsafe likely-abortions. Based on
respondent data, the poorest women (81.0%) were the most likely to have experienced the most
unsafe likely-abortions. Results from a multivariable logistic regression indicated that age was
independently associated with likely-abortion safety among respondents. (Suzanne, et…..al 2019)
A cross sectional study conducted on opinion and knowledge regarding abortion of
undergraduate Nursing students in Brazil in 2019 shows that 46 undergraduate nursing students
participated in this study. The data data were collected through the application of an electronic
questionnaires sent by email individually to the students. Descriptive responses were verified. As
pointed out by the students, there would be a weakness in academic training regarding the
abortion. Nursing students were asked if they had knowledge about the Gestational Interruption
Program, or Legal Abortion Program, and it was verified that 59.1% of these students had no
knowledge about the service, and 40.9 knew it partially. When they were asked whether the
university’s current academic curriculum would cover technical, ethical and legal content on
abortion, 90.9% of the students indicated that it cannot be discussed broadly all matters related to
the subject of abortion.
(Alessandra, et…al 2019)
A cross section study conducted on knowledge and attitude regarding abortion in Zambia in 2016
among 227 Health care provider shows that only 71% care provider and 79% of abortion experts
were aware that abortion is allowed in case of physical risk to the women’s health . There were
lower level of knowledge about incest as a criterion for abortion, with only 46% of provider and
67% of experts knowing this is legal criteria. And the legal criteria for which there was a lowest
level of awareness was if the fetus would be handicapped have a fetal anomaly. only 47% of
provider and 71% of experts were aware of this legal condition .Almost the experts , 19% and
14% incorrectly believed that abortion is legally allowed if the girls is under age 16 and she is
mentally incapable , respectively . In sum , 25% of provider and 47% of experts knew all four
reasons, 22% and 30% knew three reasons , 33% and 15% knew two reason , 18% and 6% knew
of reason and 3% in both groups did not know any reason.(Mugove, et….al 2019)
A cross section study conducted on knowledge of safe abortion among female students in Debre
Markos University, Northwest Ethiopia in 2016 among 483 undergraduate students simple random
sample were used to collect data. Data was entered in Epi Info version 7 and analyzed by SPSS
version 20. Odd ratio with 95% confidence interval was used to identify associated factors and
multivariable logistic regression to adjust the effects of possible confounders. 41.2% were
knowledgeable about liberalized safe abortion and 58.8%were not knowledgeable. (Biru.et….al
2016).
A survey conducted on factor associated with unsafe abortion practice in Nepal in 2011to 2016
shows that ot of 911 women who used abortion services during 2011 to 2016 , slightly over 505
were living in rural area . Overall, 50% of the women and 72% of their husbands had secondary
and higher level of education having access were almost equally distributed .out of 25,536
women surveyed during the period 2011 to 2016, 911 women used abortion services and of
these abortion services, 23% were unsafe abortion. The estimated as 95% per 1000 women aged 15-
49, whereas the rate of unsafe abortion was sevent 95% per 1000 women aged 15-49 years. The
sub- stantial proportion of unsafe abortion were conducted in mountain region 39% and among
those with the disadvantage ethnic background( Dalit and Madheshi and Muslim). Similarly , a
higher proportion women found to undertake safe abortion practice if they or their husband
reported no education 36% , If they could not read or write , belonging were found to the
households of lower wealth index, or were involved in agriculture occupation. If women had
lower knowledge of legal conditions and safe abortion places 62% if they had no exposure to mass
media, then a higher proportion of women used unsafe abortion services. If women delay or space
childbirth or did not want birth, then a higher proportion of women were found to use unsafe
services.( Khatro.RB, Poudel.S and Ghimire.P.R 2019)

A descriptive-cross-sectional study conducted among the interns of the College of Medical

Sciences Gandaki Medical College pokhara, Nepal. On Attitude and perception among medical
interns towards abortion in 2016. The questionnaire was distributed to all the current interns of the
College of Medical Sciences on the month of August 2016 which was the study duration. Consent
was taken from the individual participants before distributing the questionnaire. Among the total
of 109 interns working in the hospital at the study time, 96 responded. The responses were entered
in Microsoft Excel 2010 and further analyzed by SPSS version 18.0. (70.8%) told that it was good
and (27.1%) graded themselves as having just fair knowledge in the field. Twenty four (25.0%)
responded that they had clinical practice in abortion care services during their course of study.
The findings of self-assessed educational program characteristics is presented When the query
about the inclusion of the topic of reproductive health in their course of study (67.7%) responded
that it was adequately covered and (32.3%) opined that the topic was somewhat covered. Only
two of the respondents self-assessed that their theoretical knowledge of sexual and reproductive
health was very good (Pardhan.M and subedi .N 2016)
A cross section study based on structured interviews that took place at palpa community Hospital
in rural Nepal on Knowledge and attitude on Abortion in 201 5. The study had a quantitative
approach and collected data were only used for statical analyses. 118 patients and 7 medical
students were included. Only 10% knew that abortion was legal until 12 weeks of pregnancy
regardless the reason. A significant difference in knowledge was mostly seen between medical
students and the other study participants. The attitudes differed significantly depending on the
reasons for abortion, and become more positive with increasing knowledge.(Lovisa .H 2015) .

A cross-sectional descriptive research design conducted knowledge and attitude of abortion among
under graduate students of Gandaki Medical College pokhara, Nepal in 2017. Proportionate
stratified sampling technique and simple random sampling technique was used to select the
subjects. Total 90 students were chosen as a sample and structured self-administered questionnaire
was used to collect data. The mean age of the respondents were (64.40%) of the respondents were
females; majority (84.40%) of the respondents were of upper caste group. Most (94.4%) of the
respondents had adequate knowledge on legalization of abortion and majority (94.30%) of the
respondents had positive attitude towards legalization of abortion. The study shows that the most
knowledgeable area was on concept of abortion (88.55%) and the least knowledgeable (58.00%)
area was on method of abortion. Factors like age, gender, residence and educational faculty were
not found to be associated with knowledge on legalization of abortion The mean age of the
respondents was 19.82. Most 58 (64.40%) of the respondents were females; majority 76 (84.40%)
of the respondents were of upper caste group. Most 85 (94.4%) of the respondents had adequate
knowledge on legalization of abortion and majority 83 (94.30%) of the respondents had positive
attitude towards legalization of abortion. The study shows that the most knowledgeable area was on
concept of abortion (88.55%) and the least knowledgeable (58.00%) area was on method of
abortion. Factors like age, gender, residence and educational faculty were not found to be associated
with knowledge on legalization of abortion. 62.2%) respondents had knowledge about abortion.
Ninety (100%) answered the correct meaning of safe abortion, (94.4%) mentioned the correct
definition of illegal abortion. Majority (98.9%) of them had idea about the correct term for
spontaneous abortion. Majority.( Ojha .s and silwal .M 2017)

. A cross sectional study conducted among 105 participants on knowledge regarding legalization
of abortion with reproductive age group of Anantalingeshwor Muncipality, Bhaktapur in 2018
shows that more than 56.2% participants perceives towards meaning of legal abortion as the
abortion under law. Among total participants 69.5% have no knowledge regarding practice of
abortion in relatives whereas 30.5% were known about the abortion done by their relatives .
(Belbas. M, Neupane.J 2018)
2.3 Summary of the literature Review
This chapter deals with the review of research which includes the fact and information about
the research conducted previously . Many books , journal, articles and internet search about
knowledge regarding abortion in reproductive age were consulted for the literature review .
Overall reviewed literature concluded that there is inadequate knowledge among reproductive
age women regarding abortion in rural area of Nepal and in regional European countries .
 CHAPTER III

METHODOLOGY

The chapter will present a description of the methodology and different steps which are
undertaken for collecting and organizing data for research . It will include Research design ,
setting of the study , population , sampling and sampling technique , inclusion criteria
instrumentation, content validity and reliability procedure for data collection plan data analysis
and ethical consideration.

3.1 Research Design

The descriptive cross sectional study design will be used to identify the knowledge regarding
abortion among reproductive age women.

3.2 Research setting and population

3.2.1 Research setting / Area

The study will be conducted in Dhangadhi sub metropolitan ward no 3.

3.2.2 Research population

The population for this study will be 3512 According to census data of 2011 .among then target
population (15-49 yrs) women.
3.3 Sampling technique and sampling size

3.3.1 Sample size

The sample is calculated by using solvin’s formula n=N/1+Ne^2

Where,

N= Total population

N= Sample size

Error =0.5%

Given ,

Reproducatative age population of Nepal=7117526

Total female population=13645463

Now by using formula,

Reproducatative age popn/ Total female popn=100%

0.25* 100%

52%

Now,

%*6745=N

52/100*6754=N

0.52*6754=N

3512=N

Again,

N=3512

n= ?

e= 0.05%
By using Formula,

n=N/1+Ne^2

n=3512 1+3512*(0.05)^2

n=3512/1+ 3512*0.0025 =3512/1+8.7

n=3512/9.7

n=3512/10 round off

n=351

3.3.2 Sampling technique

Non probability, purposive sampling technique will be used as sampling procedure. The total
sample size will 351 for the study.

3.3 Inclusion criteria

People who are willing to participate in the study.

Age group above 15 to 49 years women.

3.4 Resesrch Instrumentation

A self -developed semi Structure questionnaire will be prepared on the basis of research objectives
after consultation with research advisor and subject experts. The questionnaire will consist of two
parts.

Part I; Socio Demographic data of respondents

It will consist self -developed structured questionnaire which includes items for demographic
characteristics.

Part II; Knowledge about abortion

It will consist self- developed questionnaire related to knowledge regarding abortion

3.4.1 Validity and reliability

The instrument content validity will be maintained by developing the instrument by intensive
literature review based on the objective of the study based on previously established
instrument and by the Nepali language teacher and expertise and then back translate English
with the help of the expert.

Reliability of instrument will be maintain pre testing questionnaire in 10% of the total sample
size in an sankhamul , Kathmandu. Where I will be residing.

3.5 Data collection procedure

At first Administrative Approval letter will be obtained from Janamaitri Foundation Institute of
Health Science.

The study will be conducted only after getting written permission from ethical board of
Nepal Health Research Council ( NHRC) as well as approval from research committee of JFIHS.

Formal written permission will be taken from sub metropolitan chairperson by submitting the
official letter from Janamitri Foundation Institute of Health Science and submitted to respective
municipality.

The data will be collected by using self -developed and self-administered questionnaire after
taking informed consent from each participant briefing about risk – benefit ratio , right to refuse
and withdraw , right to information and privacy . Respondent’s anonymity and confidentiality
will be maintained by using code number in questionnaire instead of name of the respondents.
3.6 Plan for Data collection

 After collecting data, data will be checked, rechecked for accuracy and completeness and
consistency by researcher on the day of data collection.
 The collected data will be compiled , entered , classified , coded manually by
researcher , then data will be entered in Excel and Exported in to SPSS version 20 for
future analysis.
 Data will be analyzed according objectives and appropriate statistic will be used.
 Data will be descriptive statics be analyzed by using that is percentage , frequency,
mean and inferential statics be analyzed by using to determine interrelationship among
the variables.

ESTIMATED BUDGET PLAN

The budget allocated for different items are as follows;

SN ACTIVITIES TOTAL AMOUNT(NRS

1 Stationary 2000 /-
2 Proposal Writing 500 /-
- Printing
3 Transportation 4000 /-
4 Statistician 1500 /-
5 Printing & Binding 3000 /-
- Report
-Questionnaire Photocopy
6 For Ethical consideration in NHRC 1000 /-
7 Miscellaneous 2000 /-
Total 14000 /-
 REFRENCES

Lisa B.Haddad, MD,MA ,Nawal M.Nour,MD,MPH2009 Unsafe abortion Unnecessary Maternal

Moterlity. Women Health and Development World 2(2).1222-12

Addis S , Mesfin W .K, Yonas Y , Habtamu A, Getenet D , Fitwi Tinsae(2015) Assessment of

knowledge

attititude and practice women of reproductive age group towards abortion care at

Debra Markos Referal Hospital, Debre Markos Ethiopia. . 2015, 3(5)); 618-624

Science

Journal of Public Health.

http;//www. Science publishing group com/j/sjps)

Khanal P,Senjel K, Chalise H.N (2014) Knowledge and practice regarding abortion among women

of

Nepal. Asia –Pacific E- Journal of Health Social Science 3 number 1 revised ISSN 2244-

0204

https // sites Google com/site/asia pacifice journal/ June 2014 volume 3, Number 1

revised

ISSN 2244-0240

Adhakari R (2016 knowledge on Legalization abortion among female youth in Nepal; A cross

sectional study . Adhakari Reproductive Health 13; 48

 DIO 10 1186/s 12978-016-0166-4

Yogi A, K.C P and Neupane S (2018) Prevalance and factor associated with abortion and unsafe

abortion in Nepal; a national wide cross sectional study. BMC Pregnancy and child

birth (

2018) 18:376

https//doi org / 10 1186 /s 12884 -018-2011-y

Assifa A.R ,Sullivan E.A, Kang M, Dawson A.J Adolescent abortion in 11 high income countries

including Australia: towards the establishment of minimum data set. Australian and New

Zealand Journal of Public Health 2019 43( 6)

Raymond O.C, MB, FRCG, MICGP,MSC, Jane O, Doherty, BA, ,Michael O.M, MIAHIP,Dip P,

Eimear S, BA, Knowledge and attitudes of Iris GPs towards abortion following its

legalization : a cross sectional study , BJPG 2019 DIO: 10.3399/bjgopen10x101669.

Belbase M and Neupane J Knowledge regarding legalization of abortion among women with

reproductive age group of Anantalingeshwor Municipality, Bhaktapur ,EG Gynecology

7.11(2018:413-420.

Kullberg G, and Pokerel Y.R Abortion –Knowledge and attitudes in Amp Papal, Nepal Lovisa

Hornell 2015, mesfin W.K,Yonas Y, Habtamu Institute of medicine Gothenburg, Sweden.

Ojha S and Silwal M Knowledge and attitude on legalization of Abortion among

undergraduate students . 2017 GMC-N 10(2)

Addis A, A, Getenet D, Fitwin T Assessment of knowledge, Attitude and practice women of

reproductive age group towards abortion care at Debreb Markos Referral Hospital ,

Debre Markos ,Ethiopia , Science Journal of Public Health 2015;3(5):618-624.

Cresswell J.A, Schroeder R, Dennis M ,Owolabi O,Vwaika B,Musheke M,CampbellaO , Filippi

V , Women knowledge and attitudes surrounding abortion in Zumbia :A cross sectional

survey across three provinces , BMJ 2016;6e010076, DIO:10:1136/bmjopen-2015-010076.

Abdul-Hakeem O. Abiola, Oluwabunmi A. Oke, Mobolanle R. Balogun, Foluke A. Olatona,

Maymunah A.

Adegbesan-Omilabu, Knowledge ,attitude and practice of abortion among female students of

two public senior secondary school in Logos Mainland Local Government Area ,

Lagos state, 2016 Journal of Clinical Science 13(2). http://www.jcs journal march 7 2020

IP:103.1028.37.

Perera Uand Abeysena C Knowledge and attitude on safe abortion among undergraduates of state

Universities in Western Provenance, Sirlanka, Journal of Community physicians of Sirlanka

2018 24(2).

Gunardi E.R, Rahaman E.A, Affandi B, Ikhsan M, Knowledge , Attitude and Behavior about

Abortion among Adult Women At Peunayong District , Banda Axeh, Indonesia, Journal of

Pharmaceutical and Clinical Research. (2019) 12(7).

Anotyeye P and Mayhew S.H Globalization and Transition in Abortion care in Ghana, BMC Health

Service Research (2019) 19:185. http // doi org/10:1186/s 1213-019-4010-8

Oyeniran A.A, Bello F.A, Oluborode B, Awowole I, Lota\o O.M, Irinyenikan T.A , Fabamwo

A.O, Oluborode B, Ganatra B, Guest .P Fawole B, Narrative of women presenting with

abortion complication in Southwestern Nigeria: A qualitative study , PLOS ONE 2019, https//

doi org / 10.1371 journal Pone 0217616.

Fontenele AL, Ferreira G.I Neves M.GC, GUIHEM D.B, opinion and Knowledge of

Undergraduates Nursing students on Abortion foreseen in Law : Descriptive study, Cienc

cuid saude (2019)n18(1) e4512 DIO: 10.4025.

Madziyire M.G, Moore A, Riley T, Sully E, Chipato T, Knowledge and attitudes towards abortion

from health care providers and abortion experterts in Zimbabwe: A cross sectional study,

The pain Africa Journal (2019) 34:94 dio: 11604/pamj.2019. 34.94.18107.

 WORK PLAN 

ACTIVITIES                     DURATION IN WEEKS

1st  2nd  3rd  4th  5th  6th  7th  8th 
Title Presentation

Literature Review

Proposal writing/ presentation

Data collection

Data analysis/ report writing

Report presentation/ submission ccc

 APPENDIX I

INFORMED CONCENT FORM FOR RESPONDENTS

JF INSTITUTE OF HEALTH SCIENCE / LACHS

AFFILIATED TO TU/ IOM

HATTIBAN, LALITPUR

Research Title; Knowledge regarding Abortion among reproductive age women in selected
community people

Namaste, I am Sunita Chaudhary BNS 3rd year student of JF Institute of Health Science / LACHS.
This study is being conducted for the partial fulfillment of the course of the objectives of BNS 3rd
year. The purpose of the study is to assess the knowledge regarding abortion among reproductive
women. Dhangadhi, Kailali. You can choose whether to be part of this study or not.

If you volunteer to be in this study. You may with fraw at any time without consequences of any
kind. You may also refuse to answer any question that you are reluctant to answer.

You need not provide your name and information provided by you will remain confidential. The
information provided by you will be coded as 1, 2, 3 ….. When the result of research will be
published. no information will be included that will reveal your identity if you agree to
participate in this study please answer the questionnaire.

Hoping for positive response.

Thank You

Consent Form

I am willing participating in the study and I have ben explained fully about the details . its
purpose and its possible implication in future . I have had opportunity to ask questions about
it and any question that I asked have been answered to my satisfaction . I hereby give consent
voluntarily to participate as participant for the above mentioned study knowing that all the
information provided by me will be treated with confidentiality by the investigator.

………………………………………………

Signature of the participant

 APPENDIX C

JF INSTITUTE OF HEALTH SCIENCE / LACHS

AFFILIATED TO TU/ IOM

HATTIBAN, LALITPUE

QUESTIONNAIRE

Topic; Knowledge regarding abortion among reproductive women of selected community.

Objective; To identify the level of knowledge regarding abortion among reproductive women.

Direction ; The questionnaire listed below is prepared absolutely for the purpose of
preparing research paper of Bachelor of Nursing Science of JF Institute of Health Science .
privacy , anonymity and confidentiality will be maintained by not disclosing the name of the
participants . You are kindly requested to provide response for them structured questionnaire
will be administered for this purpose . It will take 15- 20 minute to fill the form.

The questionnaire consists of two parts;

Part I ; Social – demographic information.

Part II; Questions related to knowledge regarding abortion.

Code No; Date of data collection;

A) SOCIO- DEMOGREPHIC CHARACTERISTICS
Instruction; Please tick the ( ) for the correct answer in the bracket given below

A) SOCIO- DEMOGREPHIC CHARACTERISTICS

Instruction; Please tick the ( ) for the correct answer in the bracket given below.

Question

1. Age completed year) …………………. Years

2. Ethnicity

a) Brahmin/ Chhetri

b) Madhesi

c) Janajati

d) Newar

e) Dalit

f) Others …………………………………( Specify)

3. Religion

a) Hindu

b) Muslim

c) Buddhist

d) Christian

e) Kirat

f) Other ………………………………………..( Specify)

 4. Marital status

a) Married

b) Unmarried

c) Divorce

d) Widows

e) Others …………………………………………….( Specify)

5.Education

a) SEE passed

b) Intermediated

c) Bachelor

d) Masters

e) Others ……………………………………………..( specify)

6. Family Income (per month); ………………………………….

7. Have you ever done abortion?

a) Yes
Part II ; The knowledge regarding abortion among reproductive women.

• Instruction Please tick ( ) for the correct answer in the bracket given below.

1. What is abortion?

a) To terminate pregnancy

b) To terminate unwanted pregnancy

c) To terminate pregnancy unwanted pregnancy through medicine

d) To terminate unwanted pregnancy through surgical procedure

2. What are the legal ground for abortion? (multiple choice question)

a) On request

b) socio- economic reasons

c) Health of women (with specific condition

d) Rape

e) Mental health with specific condition

3 what are the etiology of abortion?

a) Ovular or fetal

b) Maternal

c) Paternal

d) unknown

e) All of the above

4. what are the clinical features of abortion ?

a) Bleeding

b) Lower abdominal cramps

c) Partial expulsion of conception which resembles grapes

d) All of the above

5. At what gestation week abortion is safe?

a) Up to 9 weeks ( )

b) Up to 21 weeks ( )

c) Up to 22 weeks (

d) > 22 weeks ( )

6. What pain management is actually provided?

a) General anesthesia ( )

b) Analgesic ( )

c) Local anesthesia ( )

d) Sedation ( )
7. Is counselling routinely offered your client? ( multiple choice)

a) For the procedure ( )

b) For follow up ( )

c) For contraception ( )

d) For other needs (

8. What are the complication of abortion? (multiple choice question)

a) Hemorrhage

( )

b) High grade fever

( )

c) Incomplete abortion

( )

d) Shock

( )

e) Infection

( )
9. What area the contraindication of abortion? (multiple choice question)

a) Surgery of uterus and cervix

( )

b) Hypersensitivity Reaction

( )

c) Advance pregnancy

( )

d) Genital Infection

10. From What source did you know about abortion ?( Multiple choice question )

a) Textbook

( )

b) Internet

( )

c) Health personnel

( )

d) Family members and Friends

( )

e) TV/ Magazine/ Newspaper

f) Others ……………………………( specify)

THANKS YOU FOR YOUR CO- OPERATION

 ANSWER KEY OF KNOWLEDGE QUESTIONNIARE;

Q. NO CORRECT ANSWER

1 B

3 E

4 D

5 A

6 B