Safe Abortion Care, Utilization of Post Abortion Contraception and associated Factors, Jimma Ethiopia

Abstract

Background: Each year, throughout the world, approximately 210 million women became pregnant and around one in 10 pregnancies end in an unsafe abortion. The interventions to prevent unsafe abortion and its complications include providing safe abortion service, treatment of abortion complications and access to modern contraceptive services. In Ethiopia and the study area in particular, availability of safe abortion care (SAC) and utilization of post abortion family planning is not well documented. Objective: To assess the availability of safe abortion care utilization of post abortion contraception and associated factors in Jimma town, south west Ethiopia. Methods and Materials: A facility based cross sectional study design was implemented from December 2015 to January 2016 in public, NGO and private health facilities of Jimma town. Women seeking abortion care services were interviewed using structured questionnaire and purposefully selected key informants including facility heads service providers and MCH head from the town health office were also interviewed using interview guides. Checklist assisted service observation and health facility audit was conducted. Epi Data version 3.1 is used for data entry and SPSS version 20.0 for analysis. Results: From 184 post abortion clients, 98(53.3%) were between 18-24 years of age, for 109(59.2%) education level is high school and above, 75(40.8%) and 23(30.7%) had history of previous pregnancy and abortion respectively. In this study, safe abortion care is found available in 6 health facilities 2 hospitals, 1 health center, 2 NGO, and 1 private clinic. Two of the health facilities were categorized as comprehensive and four others as basic safe abortion centers. The other two were categorized as non basic SAC facilities. Post abortion family planning utilization is 70.1%. From a total of 385 abortion related services during the three month from November 2015 to January 2016, 43(11.2%) were directed to treatment of abortion related complications. Severe abortion complications accounts 6(1.5%) of these complications and 1(0.2%) was reported to be resulted from unsafely terminated pregnancy. Age 18-24 years (AOR 95% CI: 9.308(2.817, 30.754)), married (AOR 95% CI: 6.711(1.099, 40.963)), having good awareness about the SAC services (AOR 95% CI: 4.594(1.185, 17.818)) were associated with PAFP utilization. Conclusion and Recommendation: In this study, more than quarter of the clients left the health facilities without post abortion family planning (PAFP). This is calling for action to scale up the counselling services, avail full options of contraception and raise awareness of the community on prevention and consequences of unwanted pregnancy and resulting abortion related complications.