Social Network-Based Methods for Measuring Abortion Incidence in Ethiopia and Uganda

Elizabeth A. Sully, Guttmacher Institute
Solomon Shiferaw, Addis Ababa University
Assefa Seme, Addis Ababa University
Frederick Makumbi, Makerere University
Simon P. S. Kibira, Makerere University
Lauren Firestein, Guttmacher Institute
Selena Anjur-Dietrich, Guttmacher Institute
Doris Chiu, Guttmacher Institute
Suzanne Bell, Johns Hopkins Bloomberg School of Public Health
Margaret Giorgio, Guttmacher Institute

The current reliance on self-reported and health systems data to measure abortion incidence is complicated by both abortion stigma and the growing prevalence of out-of-facility abortions. Social network-based methods may overcome these challenges. This paper assesses two nationally representative social-network based methods to estimate abortion incidence among women in Ethiopia and Uganda: the Network Scale-Up Method (NSUM) and the Confidante Method. This paper compares abortion rates calculated using these two methods and evaluates these findings in light of the assumptions, advantages and limitations of each approach. The confidante method produced higher abortion estimates than the NSUM in Uganda and Ethiopia. Both methods were limited in their ability to account for the visibility of abortion in social networks. Social network-based methods show promise in producing improved abortion incidence estimates. More research is needed to address the limitations of both approaches and to better estimate the visibility of abortion among social connections.