Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Department of public health, College of Medicine and Health Sciences, Debre Markose University, Debre Markose, Ethiopia.
PLoS One. 2024 Sep 17;19(9):e0308419. doi: 10.1371/journal.pone.0308419. eCollection 2024.
In sub-Saharan Africa, the number of maternal deaths due to unsafe abortions has been gradually rising. In Ethiopia, unplanned pregnancies contribute to 25% of births, accounting for 6%-9% of the maternal deaths resulting from unsafe abortions. Despite several disjointed cross-sectional studies that have been carried out in the past, there is no comprehensive data on the attitudes of healthcare practitioners and other related aspects regarding safe abortion in Ethiopia. This study attempted to measure pooled health care providers' attitudes and determinants of safe abortion in Ethiopia.
African Journals Online, Medline/PubMed, EMBASE, Science Direct, Hinari, and Google Scholar were the databases that were accessed. The studies were evaluated critically by using the Joanna Briggs Critical Appraisal methods. The study followed the recommendations set forth by Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Data were extracted in an Excel spreadsheet and imported to STATA versions 17 software for meta-analysis. The random- effects model was used to pooled the health care providers' attitudes toward safe abortion. Heterogeneity between studies was evaluated using the Cochrane Q-test and I2 statistics (I squared statistics). To evaluate publication bias, egger's tests and funnel plots were employed. Forest plot was used to present the odds ratio (OR) with a 95% confidence interval.
In this review and meta-analysis, a total of eight papers with a 2,826 sample size were considered. Overall, 65.49% of Ethiopian health care professionals had a positive attitude towards safe abortion (95%CI: 49.64, 81.34; I2 = 99.20%, P = 0.000). Knowledge of the abortion law (OR = 2.25, 95% CI: 1.06, 3.43), being a male provider (OR = 1.89, 95% CI: 1.23, 2.54), receiving training on abortion (OR = 2.91, 95% CI: 1.17, 4.65), working as a midwife (OR = 3.029, 95% CI: 1.605, 4.453) and practicing abortion procedures (OR = 2.55, 95% CI: 1.32, 3.78) were positively associated with the attitudes of the providers regarding safe abortion in Ethiopia.
In Ethiopia, there was a low pooled prevalence of positive attitude towards safe abortion. Safe abortion services in Ethiopia are more likely to be viewed favorably by health care professionals who have received abortion service training and are familiar with abortion laws. As a result, it is imperative that all healthcare facilities and other relevant parties ensure that health professionals receive training on safe abortion services and are aware of Ethiopia's abortion laws.
在撒哈拉以南非洲地区，由于不安全堕胎而导致的产妇死亡人数逐渐上升。在埃塞俄比亚，意外怀孕导致了 25%的分娩，占因不安全堕胎而导致的产妇死亡人数的 6%-9%。尽管过去已经进行了几次不连贯的横断面研究，但埃塞俄比亚在安全堕胎方面，医护人员的态度和其他相关方面仍没有全面的数据。本研究试图衡量埃塞俄比亚医护人员对安全堕胎的态度和决定因素。
本研究检索了非洲期刊在线、Medline/PubMed、EMBASE、Science Direct、Hinari 和 Google Scholar 数据库。使用 Joanna Briggs 批判性评估方法对研究进行了批判性评估。研究遵循了系统评价和荟萃分析（PRISMA）推荐的报告条目。使用 Excel 电子表格提取数据，并将其导入 STATA 版本 17 软件进行荟萃分析。使用随机效应模型对医护人员对安全堕胎的态度进行汇总。使用 Cochrane Q 检验和 I2 统计量（I 平方统计量）评估研究之间的异质性。使用 egger 检验和漏斗图评估发表偏倚。森林图用于呈现优势比（OR）及其 95%置信区间。
在本次综述和荟萃分析中，共纳入了 8 篇论文，样本量为 2826 人。总体而言，65.49%的埃塞俄比亚医疗保健专业人员对安全堕胎持积极态度（95%CI：49.64，81.34；I2=99.20%，P=0.000）。对堕胎法的了解（OR=2.25，95%CI：1.06，3.43）、男性提供者（OR=1.89，95%CI：1.23，2.54）、接受堕胎培训（OR=2.91，95%CI：1.17，4.65）、担任助产士（OR=3.029，95%CI：1.605，4.453）和实施堕胎程序（OR=2.55，95%CI：1.32，3.78）与埃塞俄比亚医护人员对安全堕胎的态度呈正相关。
在埃塞俄比亚，对安全堕胎持积极态度的总体比例较低。在埃塞俄比亚，接受过堕胎服务培训且熟悉堕胎法的医疗保健专业人员更有可能对堕胎服务持积极态度。因此，所有医疗保健机构和其他相关方都必须确保卫生专业人员接受安全堕胎服务培训，并了解埃塞俄比亚的堕胎法。
