埃塞俄比亚堕胎合法性知识及基于医疗机构的堕胎服务可及性方面的地区和居住差异。

Regional and residential disparities in knowledge of abortion legality and availability of facility-based abortion services in Ethiopia.

作者信息

Sheehy Grace, Dozier Jessica L, Mickler Alexandria K, Yihdego Mahari, Karp Celia, Zimmerman Linnea

机构信息

Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA.

出版信息

Contraception. 2021 Jun 7. doi: 10.1016/j.contraception.2021.05.019.

DOI:10.1016/j.contraception.2021.05.019

PMID:34111422

Abstract

OBJECTIVES

To generate regional, residential, and nationally representative estimates of knowledge of abortion legality and availability among women of reproductive age in Ethiopia, and examine how knowledge varies across regions and by urban/rural residence.

STUDY DESIGN

Our study draws on data from a nationally representative, cross-sectional survey implemented in 2019 in each of Ethiopia's regional and administrative states, yielding a sample of 8,837 women aged 15-49. We compare weighted estimates and regional distributions of three outcomes: 1) general awareness and 2) correct knowledge of the abortion law, and 3) knowledge of facility-based abortion service availability.

RESULTS

Significant regional and urban/rural disparities in knowledge of abortion legality and availability exist. Nationally, 27% of women are aware of the abortion law and just 5% of women have comprehensive knowledge of the law, while 30% know where to access facility-based abortion services. Regionally, estimates range significantly, from 2% in Somali to 45% in Addis Ababa for general awareness of the law, 0% in Afar to 27% in Harare for comprehensive knowledge of the law, and 8% in Afar to 57% in Tigray for knowledge of abortion availability. Knowledge of all measures is higher in urban than in rural areas.

CONCLUSIONS

Regional disparities in abortion knowledge may contribute to geographic inequities in access to and use of safe abortion care. Efforts to expand knowledge of abortion legality and availability are needed and should be tailored to regional contexts.

IMPLICATIONS

Knowledge of abortion legality and availability is imperative to protecting and expanding access to safe abortion care, especially in contexts like Ethiopia where abortion is available for multiple indications. Efforts to improve knowledge of abortion legality and availability are needed, and should be locally tailored to address regional inequities.

摘要

目的

生成埃塞俄比亚育龄妇女中关于堕胎合法性及可获得性的地区、居住地和全国代表性估计，并研究知识在不同地区以及城市/农村居住地之间如何变化。

研究设计

我们的研究利用了2019年在埃塞俄比亚每个地区和行政区实施的具有全国代表性的横断面调查数据，样本为8837名15 - 49岁的女性。我们比较了三个结果的加权估计和地区分布：1）一般认知，2）对堕胎法的正确认知，以及3）基于医疗机构的堕胎服务可获得性的认知。

结果

在堕胎合法性及可获得性的认知方面存在显著的地区和城乡差异。在全国范围内，27%的女性知晓堕胎法，仅有5%的女性对该法律有全面了解，而30%的女性知道在哪里可以获得基于医疗机构的堕胎服务。在地区层面，估计值差异显著，法律的一般认知从索马里州的2%到亚的斯亚贝巴的45%，法律的全面认知从阿法尔州的0%到哈拉雷的27%，堕胎可获得性的认知从阿法尔州的8%到提格雷州的57%。所有指标的认知在城市地区都高于农村地区。