The World Health Organization outlines the basics of social determinants of health in the article, “Social Determinants of Heath: The Solid Facts”. Amidst the article, social support is regarded as an important factor in one’s overall well-being. “Belonging to a social network of communication and mutual obligation makes people feel cared for, loved, esteemed and valued. This has a powerful protective effect on health. Supportive relationships may also encourage healthier behaviour patterns,” (WHO, 2003). The Office of Disease Prevention and Health Promotion also outlines six major broad categories of the social determinants of health; healthcare, economic stability, food, community and social context, education and neighborhood and physical environment. And in the article, “The Social Determinants of Health: It’s Time to Consider the Causes of the Causes”, Braveman and Gottlieb write this, “The consistency and reproducibility of strong associations between social (including socioeconomic) factors and a multitude of health outcomes in diverse settings and populations have been well documented, and the biological plausibility of the influence of social factors on health has been established,” (2014).
Given this information, community and social context has to be the most pertinent one when analyzing the unsafe abortion issue in Ghana. This category can include things like civic participation, discrimination, incarceration, or social cohesion (Office of Disease Prevention and Health Promotion). As outlined in my Activity Post for week 4, there were many factors described that contribute to women choosing to undergo unsafe abortions. Research conducted by BMC Women’s Health found seven major factors that contributed to this phenomenon; lack of knowledge of services, socio-economic conditions, abortion perceived as taboo, stigma of unplanned pregnancy, a desire to bare children only after marriage, avoiding parental disappointment, and desire to pursue education (Atakro et al., 2019). Of these seven factors, a majority of them seem to be related to a social and cultural context.
Beginning with abortion being perceived as taboo within Ghanaian culture, we can begin to understand why social context heavily influences the alarming rate of unsafe abortions. Because Ghanaians are mainly of Christian and Muslim faith, many people deem abortion as an act against God. Therefore, women who decided to have an abortion, usually choose to have unsafe ones because they are conducted in a more secret or discrete manner. So even though abortions are legal in Ghana, under certain conditions, having one in a hospital, where it’s more public, is not ideal. Additionally, there is a stigma attached to a woman with an unplanned pregnancy. “Many people in the Ashanti region expected women to get engaged and properly married before getting pregnant. Women who became pregnant outside wedlock avoided embarrassment by aborting their babies through unsafe means,” (Atakro et al., 2019). Finally, parental disapproval also urges women to pursue unsafe abortions. The reason for this could be explained as such, “They would want to maintain existing cordial relationships between them and their parents/guardians as many of them were still living under the care of their parents or guardians,” (Atakro et al., 2019).
References
Atakro, C. A., Addo, S. B., Aboagye, J. S., Menlah, A., Garti, I., Amoa-Gyarteng, K. G., . . . Boni, G. S. (2019). Contributing factors to unsafe abortion practices among women of reproductive age at selected district hospitals in the Ashanti region of Ghana. BMC Womens Health, 19(1).
Braveman, P., & Gottlieb, L. (2014). The Social Determinants of Health: Its Time to Consider the Causes of the Causes. Public Health Reports, 129(2), 19-31.
Office of Disease Prevention and Health Promotion. (n.d.). Social Determinants of Health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Wilkinson, R. G., & Marmot, M. (2003). Social determinants of health: The solid facts. Copenhagen: World health organization, Regional Office for Europe.