EC Gynaecology

Background: Globally, about 80 million pregnancies end in stillbirth or induced abortion each year. Due to high unmet need for family planning and its subsequent effects, many women in Ethiopia are experiencing the challenges of abortion and unwanted child birth. As a result, the Federal Ministry of Health of Ethiopia has designed the distribution of contraceptives in all health facilities including drug stores and the provision of safe abortion services in medical setup for those who demand the service based on the legal background of the country. However, despite these provisions, the problem of unintended pregnancy and abortion remained unsolved.

Objective: To identify barriers to modern contraceptive use among women seeking abortion services in Addis Ababa.

Method: A hospital based case control study was conducted in Addis Ababa at four selected hospitals. The case group (190 women) consisted of patients who came for seeking abortion service and the control group (380 women) who are contraceptive clients at the same hospital. A pre-tested, semi-structured questionnaire was administered to each individual to collect information on identification data, socio-demographic profile, and different barriers to contraceptive use. Odds ratio and their 95% confidence intervals were estimated using binary logistic regression, with contraceptive use as an outcome in the multivariate regression analysis. In addition in depth interviews were conducted with the service provider using in depth interview guide.

Results: A total of 570 women were interviewed. Among the socio demographic variables, contraceptive nonuse was higher among illiterate and those with primary education level. After adjustment for potential confounders, being married (AOR = 3.35; 95% CI: 1.18, 6.74), hearing about side effect from other rather than experiencing or seeing it (AOR = 2.75; 95% CI: 1.56, 4.92) knowing contraceptives can be utilized from health centers (AOR = 1.65; 95% CI: 1.24, 3.15; P, 0.02) increase use of contraceptive method. In contrary switching contraceptive methods before will reduce use contraceptive methods (AOR = 0.61; 95% CI: 0.45, 0.89; P, 0.001).

Keywords: Contraceptive Use; Abortion Care Service; Public Hospitals; Addis Ababa; Family Planning

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