What is the best way to improve women’s knowledge and usage of safe abortion services?

Findings of a study conducted by Ipas Development Foundation (IDF), comparing the effectiveness of two behavior change communication interventions in Bihar and Jharkhand, have now been published in BMJ Open. The study was designed to improve women’s knowledge and usage of safe abortion services, as well as the dose-effect of the intervention exposure
The first intervention, a high-intensity model (HIM), consisted of communication activities including interpersonal communication through group meetings and interactive games, wall signs, street dramas, and distribution of low-literacy reference materials. Unlike the HIM intervention, the BCC strategy used in the second intervention, a low-intensity model (LIM), was focused on increasing access to safe abortion services in 949 villages through community intermediaries and wall signs.
We conducted two cross-sectional household surveys among married women aged 15–49 years in intervention and comparison districts. Difference-in-difference models were used to assess the efficacy of the intervention, adjusting for sociodemographic characteristics. Although both intervention types improved abortion knowledge, the HIM intervention was more effective in improving comprehensive knowledge about abortion. There were improvements in knowledge on the legality of abortion.
A higher level of exposure to abortion-related messages was related to more accurate knowledge about abortion within both intervention groups. Evidence was mixed on changes in abortion care-seeking behavior. More work is needed to ensure that women seek safe abortion services in lieu of informal services that may be more likely to lead to postabortion complications.