Wado Yohannes Dibaba, Küng Stephanie, Odwe George, Dessie Yadeta, Habteyesus Dagim, Wandera Bonnie, Rich Caitlin, Kisaakye Peter, Kabiru Caroline W, Obare Francis, Giorgio Margaret
African Population and Health Research Center, APHRC Campus, 2nd floor, Manga Close, P.O. Box 10787-00100, Nairobi, Kenya.
Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA.
Confl Health. 2025 Jul 1;19(1):37. doi: 10.1186/s13031-025-00676-y.
There is little evidence of the magnitude of unintended pregnancy and unsafe abortion in humanitarian settings, but the extent and consequences of unintended pregnancy and unsafe abortion are likely to be exacerbated among refugee populations. This study estimated the incidence of induced abortion among women in refugee settings in Ethiopia.
This study was conducted in 22 of the 24 refugee camps located in Ethiopia. We used data from a Health Facilities Survey (HFS) of 75 health facilities providing postabortion care (PAC) or safe abortion care (SAC) services within or outside the 22 refugee camps and a Knowledgeable Informant Survey (KIS) of 69 individuals knowledgeable about induced abortion among refugee populations. We estimated the annual postabortion caseload, the number of induced abortions, and the induced abortion rate per 1,000 women of reproductive age.
We estimated that 9,044 (95% CI: 6,633 - 11,455) women in refugee settings received PAC across the 75 facilities in 2023, while some 2,946 (95% CI: 1,826-4,066) women received SAC. The overall induced abortion incidence rate among women in refugee settings living in camps in Ethiopia was estimated to be 38.3 per 1,000 women aged 15-49 years, with slight variations by region. The proportion of safe abortions obtained from the formal health system was 11.5% in all camps, with a slightly higher proportion of abortions estimated to take place within facilities in Western camps (12.9%) compared to Eastern and Northeastern camps (9.7%).
The study found that abortion incidence is high among women in refugee settings in Ethiopia, and only a small proportion of induced abortions were conducted through SAC services. There is an urgent need to improve family planning, SAC, and PAC services in refugee camps.
在人道主义环境中，意外怀孕和不安全堕胎的规模几乎没有证据可查，但意外怀孕和不安全堕胎的程度及后果在难民群体中可能会加剧。本研究估计了埃塞俄比亚难民营中女性人工流产的发生率。
本研究在埃塞俄比亚的24个难民营中的22个开展。我们使用了来自75家提供流产后护理（PAC）或安全堕胎护理（SAC）服务的医疗机构的卫生设施调查（HFS）数据，这些机构分布在22个难民营内外，还使用了对69名了解难民营中人工流产情况的知情者的知情者调查（KIS）数据。我们估计了每年的流产后病例数、人工流产数以及每1000名育龄妇女的人工流产率。
我们估计，2023年在75家机构中，难民营中有9044名（95%置信区间：6633 - 11455）妇女接受了PAC，约2946名（95%置信区间：1826 - 4066）妇女接受了SAC。埃塞俄比亚难民营中15至49岁的女性人工流产总发生率估计为每1000名妇女中有38.3例，各地区略有差异。在所有难民营中，通过正规卫生系统进行的安全堕胎比例为11.5%，与东部和东北部难民营（9.7%）相比，估计西部难民营内设施进行的堕胎比例略高（12.9%）。
该研究发现，埃塞俄比亚难民营中女性的堕胎发生率很高，只有一小部分人工流产是通过SAC服务进行的。迫切需要改善难民营中的计划生育、SAC和PAC服务。
