What is the relationship between contraceptive services and knowledge of abortion availability and legality? Evidence from a national sample of women and facilities in Ethiopia

Author:

Zimmerman Linnea A1ORCID,Karp Celia1,Kassa Munir2,Lulu Birikty3,Yihdego Mahari4,Anjur-Dietrich Selena1,Seme Assefa5,Shiferaw Solomon5,Ahmed Saifuddin1

Affiliation:

1. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , 615 N Wolfe Street, Baltimore, MD 21205, USA

2. Federal Ministry of Health , Ethiopia

3. Maternal, Child and Nutrition Directorate, Federal Ministry of Health , Ethiopia

4. Ethiopian Public Health Association , Ethiopia

5. School of Public Health, Addis Ababa University , Ethiopia

Abstract

Abstract In Ethiopia, abortions are legal for minors and for rape, incest, foetal impairment or maternal disability. Knowledge of abortion legality and availability is low, and little effort has been made to disseminate this information for fear of invoking anti-abortion sentiment; instead, systems rely on health providers as information gatekeepers. This study explores how exposure to and interaction with family planning service delivery environment, specifically (1) availability of contraceptive and facility-based abortion services within 5 km of one’s residence and (2) contact with a health provider in the past 12 months, relate to women’s knowledge of the legality of accessing abortion services and of where to access facility-based abortion services. We used data from a nationally representative sample of 8719 women in Ethiopia and a linked health facility survey of 799 health facilities. Our outcome of interest was a categorical variable indicating if a woman had (1) knowledge of at least one legal ground for abortion, (2) knowledge of where to access abortion services, (3) knowledge of both or (4) knowledge of neither. We conducted multilevel, multinomial logistic regressions, stratified by residence. Approximately 60% of women had no knowledge of either a legal ground for abortion or a place to access services. Women who visited a health provider or who were visited by a health worker in the past 12 months were significantly more likely to know about abortion legality and availability. There were no differences based on whether women lived within 5 km of a facility that offered contraception and abortion services. We find that health workers are likely valuable sources of information; however, progress to disseminate information may be slowed if it relies on uptake of services and limited outreach. Efforts to train providers on legality and availability are critical, as is additional research on knowledge dissemination pathways.

Funder

Bill and Melinda Gates Foundation

Publisher

Oxford University Press (OUP)

Subject

Health Policy

Reference61 articles.

1. Prevalence and determinants of post—abortion family planning utilization in a tertiary hospital of northwest Ethiopia: a cross sectional study;Abate;Contraception and Reproductive Medicine,2020

2. Determinants of induced abortion among women received maternal health care services in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case–control study;Abebe;BMC Women’s Health,2022

3. Performance Monitoring for Action Ethiopia (PMA-ET) 2019 Cross-sectional Service Delivery Point Survey, PMA2019/ET-2019-CS-SQ;Addis Ababa University School of Public Health and the Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health,2019

4. Performance Monitoring for Action Ethiopia (PMA-ET) 2019 Cross-sectional Household and Female Survey (Version 1);Addis Ababa University School of Public Health, The Bill & Melinda Gates Institute for Population and Reproductive Health at The Johns Hopkins Bloomberg School of Public Health,2020

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3