Carmen Fusco

Research and Promotion of Women’s Health and Rights Association, Brazil

Title: Social determinants of health – from concept to practice in the outcomes of unintended pregnancies which result in induced abortion


Carmen L. B. Fusco is President of “Research and Promotion of Women’s Health and Rights Association” Brazil. He has a doctoral degree in Collective Health. Main research areas are Social Determinants of Health, Sexual and Reproductive Health, SDT’s, HIV, Unsafe Abortion, Women’s Health, and Women’s Rights.


The present research is a continuation of another one previously developed about unsafe abortion (UA), associated socio-demographic characteristics (SDC) and morbidity, and goes further in its analysis of the social determinants of health (SDH) that influence this occurrence, generating inequities in health

This study compared data of three groups of 51 women (total of 153) submitted to induced abortion (IA), as per situation and site of the procedure: one with “unsafe abortion” (Slum), one with “legal and safe” IA (Public hospital) and a third group with “illegal and safe” IA (Private clinics with appropriate standard of care). Univariate and multinomial logistic regression analyses were performed for the three categories with Private as reference. In the final model (MMLR) , the variables that proved to have a statistically significant association with IA (CI=95%; p<0,05) were:  income, level of schooling , ethnicity/color and place of birth  for Slum and, for the Hospital location, the variable ethnicity lost significance.  Morbidity, resulting from the outcome, showed a highly significant discrepancy between the first sample (Slum), with 94.12% of women who reported post-abortion complications, and the other two samples (Hospital and Private) in which no case of complication was identified or reported.

 A critical analysis was also made on the influence of the SDH implied in abortion in all samples, and on the degree of inequity generated in each one (intra-group) and among them. We aimed to better understand SDH concepts in practice. Proposals of action/intervention related to the “entry points” and findings were also suggested.