Multilevel analysis of factors associated with pregnancy termination in Ethiopia

Yemane, Getahun Dejene; Korsa, Birhanu Bedada; Jemal, Sebwedin Surur

doi:10.1016/j.amsu.2022.104120

Cited by 3 publications

(6 citation statements)

References 34 publications

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“…The current study complements the growing evidence that women who knew about modern contraceptive methods were three times more likely to terminate a pregnancy compared to their counterparts. This association corroborated recent findings in Ethiopia [10] and Nepal [67], where women with excellent contraceptive and abortion knowledge were likely to terminate a pregnancy than those with poor contraceptive knowledge. Similarly, this study found a significant association between individual decision-making regarding contraceptive use and pregnancy termination.…”

Section: Discussionsupporting

confidence: 90%

“…The overall prevalence of pregnancy termination was 5.3%, with higher proportions reported from PNG's Highlands region (45.2%). The prevalence of pregnancy termination was relatively lower than that of studies from East Africa (7.8%) [39], including Ethiopia (8.5%) [10],…”

Section: Discussioncontrasting

confidence: 59%

“…The association between place of residence and pregnancy termination has received much consideration in numerous studies, demonstrating that women residing in urban areas are significantly more likely to terminate a pregnancy [10,14,37]. Compared to rural women in this study, those in urban areas were about six times more likely to terminate a pregnancy.…”

Section: Discussionmentioning

confidence: 59%

“…Likewise, about 4.7-13.2% of all global maternal deaths each year are attributed to unsafe abortion [4,9]. Disability and deaths associated with unsafe pregnancy termination persist as a public health burden, particularly in settings where health disparities are evident, and/or abortion laws are restrictive [8,10,11]. Similarly, in countries where patriarchal societies, cultural norms, religious beliefs, and economic factors influence women's decisions, pregnancy termination is never easy [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…Despite the high risk of disability and death, the choice to undergo a pregnancy termination is personal and may be affected by several circumstance-specific considerations and healthcare services. For instance, evidence from population-based surveys in LMICs revealed that demographic (e.g., age, marital status, parity, education), socioeconomic (e.g., employment), health risk behaviors (e.g., substance abuse, sexual activities), and sociocultural (e.g., gender norms, belief systems) factors are associated with pregnancy termination [10,14,25]. Previous experience with pregnancy termination, access to reproductive health services, and attitudes towards this practice have also been well documented [13,25].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of pregnancy termination and associated factors among married women in Papua New Guinea: a nationally representative cross-sectional survey

Maviso,

Aines,

Potjepat

et al. 2024

Preprint

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BackgroundPregnancy termination or induced abortion is not decriminalized, and access to safe abortion services is largely unavailable in Papua New Guinea (PNG). However, the practice is common throughout the country. This study aimed to estimate the prevalence and determine factors associated with pregnancy termination among married women aged 15–49 in PNG.MethodsSecondary data from the 2016–2018 PNG Demographic and Health Survey (PNGDHS) was used. A total weighted samples of 6,288 married women were included. Complex Sample Analysis method was used to account for the cluster design and sample weight of the study. Chi-square tests and multivariable logistic regression were used to assess factors associated with pregnancy termination. Adjusted odds ratios (aORs) with 95% Confidence Intervals (CIs) were reported.ResultsThe prevalence of pregnancy termination was 5.3%. Nearly half (45.2%) of all pregnancy terminations occurred in the Highlands region. Women aged 35–44 years (aOR = 8.54; 95% CI: 1.61–45.26), not working (aOR = 6.17; 95% CI: 2.26–16.85), owned a mobile phone (aOR = 3.77; 95% CI: 1.60–8.84), and lived in urban areas (aOR = 5.66; 95% CI: 1.91–16.81) were more likely to terminate a pregnancy. Women who experienced intimate partner violence (IPV) were 2.27 times (aOR = 2.27; 95% CI: 1.17–4.41) more likely to terminate a pregnancy compared to those who did not experience IPV. Women with unplanned pregnancies were 6.23 times (aOR = 6.23; 95% CI: 2.61–14.87) more likely to terminate a pregnancy. Women who knew about modern contraceptive methods and made independent decisions for contraceptive use were 3.38 and 2.54 times (aOR = 3.38; 95% CI: 1.39–8.18 and aOR = 2.54; 95% CI: 1.18–5.45, respectively) more likely to terminate a pregnancy.ConclusionThe findings highlight the role of sociodemographic and maternal factors in pregnancy termination among married women in PNG. Maternal age, occupation, mobile phone ownership, place of residence, IPV, unplanned pregnancy, knowledge of modern contraceptive methods, and decision-maker for contraceptive use were significantly associated with pregnancy termination. Efforts aimed at reducing unplanned pregnancies and terminations should focus on improving easy access to contraceptives and comprehensive sexual and reproductive health education for married couples. Post-abortion care should also be integrated into the country’s legal framework and added as an important component of existing sexual and reproductive health services.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of pregnancy termination and associated factors among married women in Papua New Guinea: a nationally representative cross-sectional survey

Maviso,

Aines,

Potjepat

et al. 2024

Preprint

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Trends, spatiotemporal variation and decomposition analysis of pregnancy termination among women of reproductive age in Ethiopia: Evidence from the Ethiopian demographic and health survey, from 2000 to 2016

Tebeje,

Seifu,

Seboka

et al. 2024

Heliyon

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Explainable artificial intelligence models for predicting pregnancy termination among reproductive-aged women in six east African countries: machine learning approach

Setegn,

Dejene

2024

BMC Pregnancy Childbirth

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Pregnancy termination remains a complex and sensitive issue with approximately 45% of abortions worldwide being unsafe, and 97% of abortions occurring in developing countries. Unsafe pregnancy terminations have implications for women’s reproductive health. This research aims to compare black box models in their prediction of pregnancy termination among reproductive-aged women and identify factors associated with pregnancy termination using explainable artificial intelligence (XAI) methods. We used comprehensive secondary data on reproductive-aged women’s demographic and socioeconomic data from the Demographic Health Survey (DHS) from six countries in East Africa in the analysis. This study implemented five black box ML models, Bagging classifier, Random Forest, Extreme Gradient Boosting (XGB) Classifier, CatBoost Classifier, and Extra Trees Classifier on a dataset with 338,904 instances and 18 features. Additionally, SHAP, Eli5, and LIME XAI techniques were used to determine features associated with pregnancy termination and Statistical analysis were employed to understand the distribution of pregnancy termination. The results demonstrated that machine learning algorithms were able to predict pregnancy termination on DHS data with an overall accuracy ranging from 79.4 to 85.6%. The ML classifier random forest achieved the highest result, with an accuracy of 85.6%. Based on the results of the XAI tool, the most contributing factors for pregnancy termination are wealth index, current working experience, and source of drinking water, sex of household, education level, and marital status. The outcomes of this study using random forest is expected to significantly contribute to the field of reproductive healthcare in East Africa and can assist healthcare providers in identifying individuals’ countries at greater risk of pregnancy termination, allowing for targeted interventions and support.

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Multilevel analysis of factors associated with pregnancy termination in Ethiopia

Cited by 3 publications

References 34 publications

Prevalence of pregnancy termination and associated factors among married women in Papua New Guinea: a nationally representative cross-sectional survey

Prevalence of pregnancy termination and associated factors among married women in Papua New Guinea: a nationally representative cross-sectional survey

Trends, spatiotemporal variation and decomposition analysis of pregnancy termination among women of reproductive age in Ethiopia: Evidence from the Ethiopian demographic and health survey, from 2000 to 2016

Explainable artificial intelligence models for predicting pregnancy termination among reproductive-aged women in six east African countries: machine learning approach

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