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. 2025 Jun 5;25(1):2108.
doi: 10.1186/s12889-025-23334-7.

Prevalence and determinants of abortion among married women of reproductive age in rural and urban areas of the Southeastern Zone of Tigray, Ethiopia, 2024 a postwar study

Abrehaley Teklemariam Gebremariam  1 , Girmatsion Fisseha Abreha  2 , Kinfe Abraha Gebre-Egziabher  3 , Awtachew Berhe Weldu  2
Affiliations

Prevalence and determinants of abortion among married women of reproductive age in rural and urban areas of the Southeastern Zone of Tigray, Ethiopia, 2024 a postwar study

Abrehaley Teklemariam Gebremariam et al. BMC Public Health. .

Abstract

Abortion is the termination of a pregnancy, with safe abortions adhering to World Health Organization standards. Comprehensive abortion care (CAC) includes safe services and post-abortion care, including modern techniques, medications, contraceptive counseling, emotional support, and community connections. Globally, 257 million women lack access to safe contraception, and nearly a quarter face barriers to refusing sex. Systemic pressures on women and girls to become mothers highlight their autonomy and undervaluation. This study aims to evaluate abortion prevalence and factors among married women in rural and urban Tigray, Ethiopia, in 2024. It aims to fill existing gaps and inform policy decisions, particularly in the war-affected region.

Methods: A community based cross-sectional study was conducted in the South Eastern Zone of Tigray, Northern Ethiopia, targeting married reproductive-age women (15-49 years). A multistage sampling technique was used to select 910 participants from 80 tabiyas across the zone. Data were collected through structured questionnaires. Quantitative data were analyzed using STATA version 17, employing descriptive statistics and logistic regression to identify factors associated with abortion. Ethical approval was obtained from Mekelle University IRB, and verbal informed consent was secured from all participants.

Result: The overall prevalence of abortion among the study participants was 7.2%. The majority of participants were aged 30-39 years (41.2%), and over half resided in rural areas (57.5%). Most respondents identified as Orthodox Christians (98.8%). Joint decision-making is predominant in family planning, child number, techniques, service accessibility, birth timing, and location, with only 1.8% to 2% of decisions made by the husband. Women aged 20-29 are 4.8 times more likely to have an abortion compared to those aged 15-19, 5.2 times more likely to have an abortion if they experienced an unwanted pregnancy, and 60% less likely to have an abortion using modern family planning methods.

Conclusion: The study found a high prevalence of abortion among married women of reproductive age in postwar South Eastern Tigray. Abortion was more likely among women aged 20-29 and those with unwanted pregnancies, while modern contraceptive use was linked to a lower risk of abortion.

Recommendation: Improving access to modern contraception, family planning education, and reproductive health services is vital, requiring coordinated efforts from government, NGOs, and healthcare providers to ensure sustainable and equitable care.

Keywords: Abortion; Determinants; Married women; Postwar Ethiopia; Reproductive age; Southeastern Tigray.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical clearance was obtained from the Institutional Review Board (IRB) Committee of the College of Health Sciences at Mekelle University with a notification of protocol approval number MU_IRB 2173/2024. Permission to collect data from the South Eastern Zone of Tigray was granted by the Tigray Regional Health Bureau (TRHB). Verbal informed consent was obtained from all participants and, for those under the age of 16, from their parents or legal guardians. The study adhered to the ethical principles of the Declaration of Helsinki and the national research ethics guidelines of Ethiopia. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Map showing the study area of the Southeastern Zone of Tigray, Ethiopia 2024
Fig. 2
Fig. 2
Schematic presentation of the sampling procedure used to select married women of reproductive age in rural and urban areas of the Southeastern Zone of Tigray, Ethiopia, 2024
Fig. 3
Fig. 3
Distribution of abortion prevalence among married women of reproductive age by urban and rural 227 residence in the Southeastern Zone of Tigray, Ethiopia, 2024
See this image and copyright information in PMC

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