Population Dynamics and Reproductive Health Unit, African Population and Health Research Centre , Nairobi, Kenya.
Monitoring, and Evaluation Advisor, Ipas , Chapel Hill, NC, USA.
Women Health. 2021 Feb;61(2):133-147. doi: 10.1080/03630242.2020.1844358. Epub 2020 Nov 16.
This national study examined the socio-demographic, health facility, and provider characteristics associated with the use of postabortion contraception in Ethiopia in 2014. We used data from a Prospective Morbidity Survey (PMS) conducted in Ethiopia in 2014 to measure abortion incidence and morbidity nationally. Data were collected on the presentation, care and treatment of 5,604 women who sought abortion services in 365 health facilities over 30 days. Descriptive and multivariate logistic regression analysis were used to examine postabortion contraceptive uptake. Nearly 75% of abortion clients received postabortion contraception. The majority received short-acting methods, around one-third chose a long-acting or permanent method. Most women sought abortion services at public health centers (61.8%) and were cared for by midlevel providers (82.5%). Multivariate regression results showed that women who sought services during the first trimester (odds ratio/OR = 1.44; 95% confidence interval/CI 1.06, 1.95), for induced abortions (OR = 3.55; 95% CI 2.52, 4.99), from public sector facilities, and those served by midlevel providers, had greater odds of receiving postabortion contraception. We conclude that providing strong contraceptive services postabortion in government facilities, including long-acting methods in the method mix, and providing this care by midlevel providers could further reduce unmet need for contraception and repeat abortions.
这项全国性研究调查了 2014 年与埃塞俄比亚人工流产后使用避孕措施相关的社会人口学、卫生机构和提供者特征。我们使用了 2014 年在埃塞俄比亚进行的前瞻性发病率调查(PMS)的数据来衡量全国范围内的流产发生率和发病率。在 30 天内,在 365 个卫生机构中对 5604 名寻求堕胎服务的妇女的就诊、护理和治疗情况进行了数据收集。采用描述性和多变量逻辑回归分析来检查人工流产后采用避孕措施的情况。近 75%的人工流产患者接受了人工流产后避孕措施。大多数人使用了短效方法,约三分之一的人选择了长效或永久性方法。大多数妇女在公立卫生中心(61.8%)寻求堕胎服务,并由中级提供者(82.5%)照顾。多变量回归结果表明,在孕早期(优势比/OR=1.44;95%置信区间/CI 1.06,1.95)、因人工流产(OR=3.55;95%CI 2.52,4.99)而寻求服务、来自公共部门设施、并由中级提供者提供服务的妇女,更有可能接受人工流产后避孕措施。我们的结论是,在政府设施中提供强有力的流产后避孕服务,包括在方法组合中提供长效方法,并由中级提供者提供这种护理,可以进一步减少避孕需求未得到满足和重复堕胎的情况。