Gender and Educational Disparities in Abortion Knowledge, Attitudes, and Legal Awareness in Ghana: Implications for Public Health Education and Policy

Unsafe abortion remains a major public health concern in Ghana and continues to contribute substantially to maternal morbidity and mortality. Although abortion is legally permitted under specific conditions, access to safe services is often constrained by stigma, misinformation, and limited awareness of the law. This study examined gendered and socio-educational disparities in abortion-related knowledge, attitudes, and legal awareness among residents of Fiapre, a peri-urban community in the Sunyani West Municipality. A cross-sectional survey was conducted among 240 residents recruited through convenience sampling at a local health facility. Data were collected using a structured, pretested questionnaire and analyzed using descriptive statistics, chi-square tests, and binary logistic regression. Awareness of safe abortion practices was generally high, with a greater proportion of women than men identifying health facilities as appropriate settings for safe abortion. Recognition of unsafe methods, including self-induced abortion, was also high across genders. Marked differences emerged by occupation, as nearly all formally employed respondents identified hospitals as the correct setting for abortion care, compared with fewer informally employed participants. Educational attainment was the strongest predictor of legal awareness, with individuals without formal education being significantly less likely to know that abortion is legal under certain conditions in Ghana. These findings highlight the importance of targeted, community-based reproductive health and legal education interventions, particularly for populations with lower educational attainment, to promote informed decision-making and reduce reliance on unsafe abortion practices.