Journal of Reproductive Health, Gender, and HIV in Africa | 10 November 2002
Replication Study: Analysing Barriers to Safe Abortion Access Among University Students in Maseru Following Legislative Reform
P, u, l, e, n, g, M, o, k, h, e, t, h, i, ,, T, e, b, o, h, o, M, p, h, u, t, h, i, n, g, ,, M, s, R, a, c, h, a, e, l, T, h, o, m, a, s
Abstract
Legislative reform in Lesotho aimed to liberalise access to safe abortion services. An original study in Maseru identified key barriers among university students. This replication study tests the transferability of those findings in the contrasting socio-legal context of Lagos, Nigeria, where abortion law remains highly restrictive. The purpose was to replicate a prior Maseru study by analysing barriers to safe abortion access among university students in Lagos. The objective was to determine if similar barriers persist in a restrictive legal environment and to identify any context-specific challenges. A cross-sectional mixed-methods design replicated the original study’s approach. Data were collected via anonymous self-administered questionnaires and semi-structured interviews with a purposive sample of female undergraduate students at a major university in Lagos. Quantitative data were analysed descriptively; qualitative data underwent thematic analysis. Despite differing legal contexts, several barriers from Maseru were confirmed in Lagos, notably high perceived stigma and cost. Fear of social judgement was a predominant theme, reported by 78% of survey respondents. In the restrictive setting, a significant additional barrier was profound fear of legal repercussions and provider refusal, which intensified secrecy and delayed care-seeking. This replication confirms that legislative change alone is insufficient to guarantee access, as significant socio-cultural barriers persist across contexts. In highly restrictive legal environments like Lagos, these barriers are compounded by fears of criminalisation, indicating law reform is a necessary but not sole component of improving access. Interventions must address deep-rooted stigma through campus-based education and peer support programmes. In restrictive settings, harm-reduction strategies, including providing accurate information on post-abortion care and supporting confidential referral pathways, are urgently needed. Advocacy for legal reform must be coupled with these parallel measures. abortion access, replication study, university students, legal barriers, stigma, Nigeria, Lesotho This study provides comparative evidence on how legal context shapes barriers to safe abortion, highlighting the critical role of stigma and fear of criminalisation even after legislative reform. It underscores the need for multifaceted interventions beyond law change.