Determinants of Repeated Induced Abortion among Women of Reproductive Age Seeking Post-Abortion Care in Addis Ababa, Ethiopia, ۲۰۲۲: Unmatched Case Control Study

Background & aim: Repeated induced abortion (RIA) poses a significant risk to women's reproductive and mental health. Despite the high incidence of RIA in Ethiopia, there is limited analytical evidence, particularly using case-control designs, to identify its specific determinants among women seeking post-abortion care. This study aimed to investigate the determinants of RIA among women of reproductive age in public and private hospitals in Addis Ababa, Ethiopia, in ۲۰۲۲.Methods: A hospital-based unmatched case-control study was conducted from June ۱ to July ۷, ۲۰۲۲. The sample included ۳۳۶ women (۱۱۲ cases:  ≥ ۱ previous induced abortion; ۲۲۴ controls: first-time induced abortion). Data were collected via interviews using semi-structured questionnaires. Logistic regression was used to identify factors, with statistical significance set at p < ۰.۰۵ (۹۵% Confidence Interval, CI).Results: The response rate was ۱۰۰%. The strongest determinants of RIA were: alcohol consumption (AOR=۲۰.۸; ۹۵% CI ۹.۰, ۴۸.۱), not using contraceptives after previous abortion (AOR=۷.۸; ۹۵% CI ۳.۰, ۲۰.۴), no education (AOR=۷.۹۷; ۹۵% CI ۲.۲, ۲۹.۵), sexual gender-based violence (AOR=۷.۱۵; ۹۵% CI ۳.۱, ۱۶.۳), elementary school education (AOR=۳.۴; ۹۵% CI ۱.۲, ۱۰.۱), and having multiple sexual partners (AOR=۳.۰۱; ۹۵% CI ۱.۴, ۶.۴). Abortion due to rape (AOR=۶.۴) and unplanned sex (AOR=۳.۱) were also significant factors.Conclusion: RIA in Addis Ababa is strongly associated with behavioral (alcohol consumption, multiple partners), social, and structural (low education, contraceptive non-use) factors. Interventions should integrate reproductive health services with targeted counseling for alcohol use, sexual gender-based violence screening, and enhanced, mandatory post-abortion contraceptive counseling, particularly for low-literacy women.

کلیدواژه ها:

Repeated Induced Abortion Post-abortion Care ، Contraceptive use ، Alcohol Consumption ، Gender-Based Violence