Status of safe abortion service utilization and levels ofsatisfactioninselectedpublic health facilities of SNNPR, Ethiopia, 2008/09

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Addis Ababa University


Background: Each year more than 500,000 women, 99% of them in developing countries, diefrom pregnancy and childbirth-related complications. Complications due to unsafe abortionprocedures account for an estimated 68,000 (13 %) of maternal deaths worldwide per year. Indeveloped regions, nearly all abortions (92%) are safe, whereas in developing countries, morethan half (55%) are unsafe.Ethiopia has one of the highest maternal mortality ratios in the world,with maternal mortality ratio of 673 deaths per 100,000 live births.Several studies in Ethiopiaindicate that unsafe abortion may account for up to 25-35% of the maternal deaths in Ethiopia.Objective:The objective of this study was to assess status of safe abortion service utilizationand levels of satisfaction in public health facilities of SNNPR.Method:A descriptive, cross-sectional, facility based study was conducted among safe abortionservice users from March, 2008–May, 2009 using both a structured interviewer administeredquestionnaire and semi-structured in-depth interview. The Region and respective zones wereselected purposively and simple random sampling was used to select health facilities in thezones. A total of 208 safe abortion service users(192 women with the quantitative and 16 women with qualitative method) were participated inthe study. Epi-info version 8.4 and SPSS version 13 were used for data entry, cleaning andanalysis. The results were interpreted by employing frequency table, percentage, means, Oddsratio and 95% confidencelimit. Result: From the total 192 service users 34.9% of them currently married, 72(37.5%) of theservice users were high school students, 27.1% were housewives and 17.7% of service userswere illiterate. Seventy five (39.1%) of safe abortion service users used one of the familyplanning methods previously. To have an abortion service 40% of women travelled more than10Km and the time taken to reach health facilities was 1hr and above for 25% of the serviceusers. Forty six percent of service users use on foot transport system and only 32.8% serviceusers were easily access to transportation. More than 49% of women waited one hour and aboveto get the service. About twenty five percent of women paid more than 100birr and according to22.9% of women respondents the service payment was coasty. Out of all safe abortion serviceusers 44.3% of women have knowledge on current abortion law. Only 62% of women took anyof the contraceptive methods after safe abortion. Place of residence was significantly associatedwith knowledge on abortion law. Conclusion and Recommendation:High school students, married women as well as age groupof 15-24 years women constitute the major portion of service users. Most of the women neveruse any of the family planning methods previously. Most of safe abortion service users didn’thave knowledge on current abortion law. Residence was a predictor of knowledge on currentabortion law. There was transport inaccessibility, longer waiting time and costy service paymentby the service users. Most of the women didn’t take any of the contraceptive methods afterabortion service. A relatively low decision power of women to seek safe abortion service wasnoted in this study.The role of health extension workers as the source of information for the women on theavailability of safe abortion service at the health facilities was low compared to the other sources.Expansion of family planning services including emergency contraception, increasing awarenessand knowledge of health workers, healthextension workers and community on abortion law aswell as expansion of safe abortion service at all health facilities with acceptable waiting time andaffordable cost should be considered.