Department of Midwifery, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
Front Public Health. 2022 May 20;10:883710. doi: 10.3389/fpubh.2022.883710. eCollection 2022.
Post-abortion contraceptive utilization is the initiation and use of family planning methods at the time of management of abortion or before fertility returns. A significant discrepancy was reported regarding the prevalence and its associated factors of post-abortion contraceptive utilization in Ethiopia. So, this systematic review and meta-analysis aimed to estimate the pooled prevalence of post-abortion contraceptive utilization and its associated factors in Ethiopia.
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used. The databases such as PubMed, Google Scholar, Science Direct, Cochrane library, Scopus, CINAHL, Web of Science, and additional searches by using direct Google search, libraries, and preprint were searched. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal.
A total of 17 studies with 13,075 individuals were included. Of these, 14 studies with 5,719 individuals were used to estimate the prevalence. The pooled prevalence of post-abortion contraceptive utilization in Ethiopia was 63.64% (95% CI: 57.75-69.53). The subgroup analysis reported the highest prevalence of post-abortion contraceptive utilization in a study conducted in Addis Ababa (77.40%), a study published in 2015-2021 (66.15%), and among studies with a sample size >400 (66.84%). The pooled odds ratio (OR) of post-abortion contraceptive utilization for the mothers who had post-abortion family planning counseling was 4.15 (95% CI = 1.30, 13.2), and history of family planning utilization was 4.28 (95% CI = 2.66, 6.89).
The pooled prevalence of utilization of post-abortion contraceptives in this meta-analysis remains low. Post-abortion family planning counseling and the history of the utilization of modern family planning methods were significantly associated with the practice of post-abortion contraceptives. The Ministry of Health should encourage post-abortion family planning utilization, making more efforts on post-abortion contraceptive counseling. Health facilities should work hard to strengthen the family planning counseling service, especially focusing on those who had no previous family planning utilization.
流产后避孕是指在流产管理或生育能力恢复之前开始和使用计划生育方法。在埃塞俄比亚，流产后避孕的流行率及其相关因素报告存在显著差异。因此，本系统评价和荟萃分析旨在估计埃塞俄比亚流产后避孕的综合流行率及其相关因素。
采用系统评价和荟萃分析首选报告项目（PRISMA）指南。检索了 PubMed、Google Scholar、Science Direct、Cochrane 图书馆、Scopus、CINAHL、Web of Science 等数据库，并通过直接 Google 搜索、图书馆和预印本进行了额外搜索。采用乔安娜·布里格斯研究所荟萃分析统计评估和审查工具（JBI-MAStARI）进行批判性评价。
共纳入 17 项研究，涉及 13075 人。其中，14 项研究涉及 5719 人，用于估计流行率。埃塞俄比亚流产后避孕的综合流行率为 63.64%（95%CI：57.75-69.53）。亚组分析报告称，在亚的斯亚贝巴进行的研究中，流产后避孕的使用率最高（77.40%），发表于 2015-2021 年的研究中（66.15%），以及样本量>400 的研究中（66.84%）。有流产后计划生育咨询的母亲流产后避孕的合并优势比（OR）为 4.15（95%CI=1.30,13.2），有计划生育利用史的母亲流产后避孕的合并优势比为 4.28（95%CI=2.66,6.89）。
本荟萃分析中流产后避孕药具使用率的综合流行率仍然较低。流产后计划生育咨询和现代计划生育方法利用史与流产后避孕药具的使用显著相关。卫生部应鼓励流产后计划生育的利用，加大流产后避孕咨询的力度。卫生机构应努力加强计划生育咨询服务，特别是针对那些以前没有利用过计划生育的人。
