Mizan Aman College of Health Science, Southern Region Health Bureau, Mizan, Ethiopia.
Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
PLoS One. 2022 Aug 18;17(8):e0272939. doi: 10.1371/journal.pone.0272939. eCollection 2022.
Insecurely housed women are more vulnerable to physical and mental health issues than the general population, making access to a safe abortion more difficult. Though Ethiopia has a penal code regarding safe abortion care, there has been a dearth of studies investigating the safe abortion care practice among those insecurely housed women. Thus, this study aimed at assessing the magnitude of safe abortion service uptake and its determinants among insecurely housed women who experienced abortion in southwest Ethiopia.
A community-based cross-sectional study was conducted in three towns in southwest Ethiopia from May 20-July 20, 2021. A total of 124 street-involved women were included in the study. They were selected by snowball sampling technique and data was collected through a face-to-face interview. The data were entered into Epi-data Version 3.1 and exported to SPSS 21 for analysis. A bivariable and multivariable logistic regression analyses were performed to determine the association of independent variables with the outcome variable. The level of significance was determined at a p-value <0.05. To determine whether the model is powerful enough in identifying any significant effects that do exist on the dependent variables, a power analysis was performed via a Post-hoc Statistical Power Calculator for Multiple Regressions.
The magnitude of safe abortion service utilization among insecurely housed women was found to be 27.9% [95% CI: 20.1, 34.2]. Average daily income [AOR:3.83, 95% CI: 1.38, 10.60], knowledge of safe abortion services [AOR:3.94; 95% CI: 1.27,9.24], and affordability of the service [AOR: 3.27; 95% CI:1.87, 8.41] were identified as significant predictors of safe abortion service among insecurely housed women.
The magnitude of safe abortion service utilization among insecurely housed women in the study area was low. The respective town health offices and health care providers at the facility level should strive to improve awareness about safe abortion service's legal framework, and its availability. In addition, a concerted effort is needed from local administrators, NGOs, and healthcare managers to engage those insecurely housed women in income-generating activities that allow them to access safe abortion and other reproductive and maternal health services.
无家可归的女性比一般人群更容易受到身心健康问题的影响，这使得获得安全的堕胎服务更加困难。尽管埃塞俄比亚有关于安全堕胎护理的刑法典，但几乎没有研究调查无家可归的女性中安全堕胎护理的实践情况。因此，本研究旨在评估在埃塞俄比亚西南部经历过堕胎的无家可归妇女中，安全堕胎服务的利用程度及其决定因素。
本研究为 2021 年 5 月 20 日至 7 月 20 日在埃塞俄比亚西南部的三个城镇进行的一项基于社区的横断面研究。共有 124 名流浪街头的女性参与了这项研究。她们是通过雪球抽样技术选择的，数据通过面对面访谈收集。数据录入 Epi-data 版本 3.1，并导出到 SPSS 21 进行分析。进行了单变量和多变量逻辑回归分析，以确定自变量与因变量的关联。显著性水平确定为 p 值<0.05。为了确定该模型是否有足够的能力识别依赖变量上存在的任何显著影响，通过后验统计功效计算器对多重回归进行了功效分析。
研究发现，无家可归妇女获得安全堕胎服务的比例为 27.9%[95%CI：20.1, 34.2]。日均收入[OR：3.83, 95%CI：1.38, 10.60]、对安全堕胎服务的了解[OR：3.94;95%CI：1.27,9.24]和服务的负担能力[OR：3.27;95%CI：1.87, 8.41]被确定为无家可归妇女获得安全堕胎服务的重要预测因素。
在所研究地区，无家可归妇女获得安全堕胎服务的比例较低。各自城镇的卫生办公室和医疗机构应努力提高对安全堕胎服务法律框架及其可用性的认识。此外，地方行政人员、非政府组织和医疗保健管理人员需要共同努力，让那些无家可归的妇女参与创收活动，使她们能够获得安全堕胎和其他生殖和孕产妇保健服务。
