Health care providers attitude towards safe abortion care and its associated factors in Northwest, Ethiopia, 2021: a health facility-based cross-sectional study

Abstract

Background: A negative attitude towards abortion among health care providers providing abortion services could be an obstacle even under a law, which permits abortion on request. Healthcare providers are expected to perform and be change agents of abortion services. However, little information is known about the attitude toward safe abortion among healthcare providers in Ethiopia.

Objective: This study aimed to assess health care provider's attitudes towards safe abortion care and its associated factors at the public health facilities of Bahir Dar City, Northwest Ethiopia.

Methods: A health facility-based cross-sectional study was employed from March 1 to 30/2021 among 416 health-care providers. The data were collected by computer-based generated simple random sampling technique, entered, coded, and cleaned using Epi data version 4.2 and analyzed using Statistical Package of Social Sciences version 25.0. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant.

Results: The response rate of the study was 99.3%, and 70.2% [95% CI: 65.6-74.6] of health-care providers had a favorable attitude towards safe abortion care. Multivariable analysis indicated that health care providers who are found in the age group of 25-29, 30-34, and ≥ 35 years [AOR = 3.34, 95% CI = 1.03-10.85], [AOR = 4.58, 95% CI = 1.33- 15.83] and [AOR = 5.30, 95% CI = 1.43-19.66] respectively, male health care providers [AOR = 3.20, 95% CI = 1.55-6.60], midwives [AOR = 6.50, 95% CI = 2.40-17.44], working at hospital [AOR = 4.77, 95% CI = 1.53-14.91], ever trained on safe abortion [AOR = 5.09, 95% CI = 2.29-11.32], practicing of an abortion procedure [AOR = 2.52, 95%, CI = 1.13-5.60], knowledge of abortion [AOR = 7.35, 95% CI = 3.23-16.71], awareness on revised abortion law [AOR = 6.44, 95% CI = 3.15-13.17] and need further legalization of abortion law [AOR = 11.78, 95% CI = 5.52-24.26] were associated with a favorable attitude towards safe abortion care.

Conclusions: Healthcare providers who had a favorable attitude toward safe abortion care were relatively high compared to the previous studies. Age, sex, profession, workplace, training, knowledge, and practice-related factors were associated with a favorable attitude toward safe abortion. This study indicated that, a need for intervention to help improve the attitude of healthcare providers toward safe abortion care, especially for those working in the maternity care units.

Keywords: Abortion; Attitude; Favorable; Health care provider; Knowledge; Safe abortion.

Fig. 1

Awareness of the revised abortion law of the country among health care providers in the public health facilities of Bahir Dar city, North-west, Ethiopia, 2021, (n = 413)

Fig. 2

Reason for not practicing/performing abortion procedures among health care providers in the public health facilities of Bahir Dar city, North-west, Ethiopia, 2021, (n = 268)

Fig. 3

Reason for the need for further legalization of the country abortion law among health care providers in the public health facilities of Bahir Dar city, North-west, Ethiopia, 2021, (n = 230)

Fig. 4

Reason for no need for further legalization of the country abortion law among health care providers in the public health facilities of Bahir Dar city, North-west, Ethiopia, 2021, (n = 147)