The effects of a community-based intervention on women’s knowledge and attitudes about safe abortion in intervention and comparison towns in Oromia, Ethiopia

Wado, Yohannes Dibaba; Dijkerman, Sally; Fetters, Tamara; Wondimu, Dereje; Desta, Demeke

doi:10.1080/03630242.2017.1377799

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…An example of an intervention at the community level aimed at improving the knowledge and attitudes that women had about safe abortion in Oromia, Ethiopia [ 22 ]. Education on reproductive health and rights was provided within the community setting, building on already ongoing interventions in the community and involving health staff as well as providers in community mobilisation efforts.…”

Section: Resultsmentioning

confidence: 99%

A strategic analysis of health behaviour change initiatives in Africa

Mogo¹,

Shanawaz

Ademola-Popoola

et al. 2023

Global Health Action

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Background Changed health behaviours can contribute significantly to improved health. Consequently, significant investments have been channelled towards health behaviour change initiatives in Africa. Health behaviour change initiatives that address social, economic and environmental levers for behaviour change can create more sustained impact. Objectives Through a scoping study of the literature, we explored the literature on behaviour change initiatives in Africa, to assess their typologies. We explored whether the availability of initiatives reflected country demographic characteristics, namely life expectancy, gross domestic product (GDP), and population sizes. Finally, we assessed topical themes of interventions relative to frequent causes of mortality. Methods We used the Behaviour Change Wheel intervention categories to categorise each paper into a typology of initiatives. Using Pearson’s correlation coefficient, we explored whether there was a correlation between the number of initiatives implemented in a country in the specified period, and socio-demographic indicators, namely, GDP per capita, total GDP, population size, and life expectancy. Results Almost 64% of African countries were represented in the identified initiatives. One in five initiatives was implemented in South Africa, while there was a dearth of literature from Central Africa and western parts of North Africa. There was a positive correlation between the number of initiatives and GDP per capita. Most initiatives focused on addressing sexually transmitted infections and were short-term trials and/or pilots. Most initiatives were downstream focused e.g. with education and training components, while upstream intervention types such as the use of incentives were under-explored. Conclusion We call for more emphasis on initiatives that address contextual facilitators and barriers, integrate considerations for sustainable development, and consider intra-regional deprivation.

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Section: Resultsmentioning

confidence: 99%

A strategic analysis of health behaviour change initiatives in Africa

Mogo¹,

Shanawaz

Ademola-Popoola

et al. 2023

Global Health Action

View full text Add to dashboard Cite

show abstract

“…Participants’ reliance on word-of-mouth recommendations presents a possible intervention point for increasing access to services and mitigating abortion-related fears. Programs that train community volunteers to disseminate information about sexual and reproductive healthcare, including abortion, have effectively increased knowledge of safe abortion options elsewhere [ 40 ] and may be a powerful way to mobilize community-based networks in Nigeria. There is also growing evidence that digital media campaigns can be an effective platform for SRH promotion, particularly for young people [ 41 ], and may provide another avenue for disseminating abortion-related information and connecting people with safe abortion providers.…”

Section: Discussionmentioning

confidence: 99%

“I just have to hope that this abortion should go well”: Perceptions, fears, and experiences of abortion clients in Nigeria

et al. 2022

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This qualitative study aimed to examine how abortion clients in Nigeria perceive abortion and explore the role their beliefs and fears play in their care-seeking experiences and interactions with providers. Abortion is severely legally restricted in Nigeria but remains common. We conducted in-depth interviews with 25 people who obtained abortion services through three distinct models of care. We coded interview transcripts and conducted thematic analysis. Clients perceived negative attitudes toward abortion in their communities, though clients’ own beliefs were more nuanced. Clients recounted a range of fears, and nearly all mentioned worrying that they might die as a result of their abortion. Despite their concerns, clients relied on social networks and word-of-mouth recommendations to identify providers they perceived as trustworthy and safe. Kind and non-judgmental treatment, clear instructions, open communication, and reassurance of privacy and confidentiality by providers alleviated client fears and helped clients feel supported throughout their abortion process. Within restrictive contexts, the mobilization of information networks, provision of high-quality care through innovative models, and personalization of care to individual needs can assuage fears and contribute to reducing stigma and increasing access to safe abortion services.

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Community-based intervention improves abortion knowledge and reduces abortion stigma among women in Oromia, Ethiopia: a quasi-experimental mixed methods evaluation

Chekol¹,

Dijkerman²,

Muluye³

et al. 2022

BMC Women's Health

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Background Since liberalization of the Ethiopian abortion law, there have been significant improvements in the availability and utilization of facility-based abortion services in the country. However, nearly half of abortions still take place outside of health facilities, where the quality of procedures remains unknown. Abortion stigma is one reason that unsafe abortion persists. This study aims to evaluate the effect of community interventions conducted from 2016 to 2019 on the level and manifestation of abortion stigma and knowledge in a community in Oromia region, Ethiopia. Methods The study is a quasi-experimental mixed methods evaluation including intervention and comparison communities. Two cross-sectional structured household surveys with independent samples, participatory evaluation wheels, and participatory impact diagrams were conducted with women of reproductive age (15–49) living in the communities. The baseline was conducted in 2016 and the endline in 2019. Difference-in-differences analysis was used to estimate the effect of the intervention on abortion knowledge and Stigmatizing Attitudes, Beliefs, and Actions Scale (SABAS) scores in the intervention community. Results One thousand five hundred fifty-five women participated in the household survey and 28 women participated in participatory evaluation meetings. Over one-third (37%) of women surveyed in the intervention community were exposed to the intervention activities. Knowledge of one or more indications of legal abortion increased from 21 to 85% in the intervention community, compared to an increase from 30 to 57% in the comparison. Mean SABAS scores decreased by 9.3 points in the intervention community and increased by 5.3 points in the comparison community. Differences-in-differences models indicate that exposure to the intervention resulted in decreased stigma scores (coefficient = − 9.33, p < 0.001) and increased knowledge (coefficient = 0.26, p < 0.001). Conclusions This is one of the first studies to measure changes in community-level abortion stigma and knowledge over time in Ethiopia using a mixed method, quasi-experimental design. The results indicate that the community-based intervention improved abortion knowledge and reduced abortion stigma.

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The effects of a community-based intervention on women’s knowledge and attitudes about safe abortion in intervention and comparison towns in Oromia, Ethiopia

Cited by 5 publications

References 17 publications

A strategic analysis of health behaviour change initiatives in Africa

A strategic analysis of health behaviour change initiatives in Africa

“I just have to hope that this abortion should go well”: Perceptions, fears, and experiences of abortion clients in Nigeria

Community-based intervention improves abortion knowledge and reduces abortion stigma among women in Oromia, Ethiopia: a quasi-experimental mixed methods evaluation

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