Abortion care in Ethiopia: Challenges and Opportunities

Abstract

Introduction Every year, approximately 210 million women globally experience pregnancy, with roughly one-third of these pregnancies resulting in miscarriage, stillbirth, or induced abortions. The presence of restrictive abortion laws not only hinders women from accessing abortion care but also creates hurdles for healthcare providers in delivering this service within legally authorized health facilities Objective: To identify the challenges and opportunities experienced in receiving and providing abortion care in the public health facilities of Ethiopia. Methods: A facility-based cross-sectional study was carried out in SNNPR, Ethiopia, where data was collected from abortion care users through face-to-face questionnaires administered by trained midwives. Healthcare providers also completed a self-administered questionnaire. The data collected underwent thorough checking, cleaning, and entry into EpiData version 3.1 software. Subsequently, the data was exported to IBM Statistical Package for Social Sciences software (SPSS) version 25 for analysis. Data collection and analysis were from 2020 to 2021. Results: Women who attended abortion care at public health centers and public hospitals enrolled in the study. In addition to abortion care, 162 (39.2%) women had the opportunity to received HIV/AIDS services, 139 (33.7%) received family planning services and 8 (1.9%) had received both HIV and FP services. These abortion care users identified several challenges, including increased waiting time, concerns about confidentiality, fear of stigma and discrimination, healthcare providers may be overwhelmed and decreased service quality. Healthcare providers also mentioned challenges such as a lack of trained staff, socio-cultural issues in the community, insufficient medical supplies, and inadequate equipment for providing abortion services. On the other hand, opportunities for improving abortion care were identified as enhanced teamwork, increased access to other health services, reduced stigma and discrimination, more efficient use of staff time, and fewer visits required for healthcare services. Conclusion: Increasing the number of and access to integrated services, adequate equipment and medication, as well as ensuring that healthcare providers are trained to be competent to offer an integrated service, would enhance the utilization of abortion care and enable the provision of comprehensive services.