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      Determinants of abortion among clients coming for abortion service at felegehiwot referral hospital, northwest Ethiopia: a case control study

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          Abstract

          Background

          According to the World Health Organization (WHO) estimate, one-third of pregnancies end in miscarriage, stillbirth, or induced abortion in the world. There are various reasons for a woman to seek induced abortion. However, limited information is available so far in the country and particularly in the study area. Therefore, the aim of the current study was to identify the determinants of induced abortion among clients coming for abortion care services at Bahirdar Felegehiwote referral hospital, Northwest Ethiopia.

          Methods

          Institutional based unmatched case-control study was conducted from September to December 2014. Interview administered questioner was used to collect primary data. Enumeration and systematic random sampling (K = 3) method was used to select 175 cases and 350 controls. A binary logistic regression model was fitted to identify determinant factors. Odds ratio with 95% CI was computed to assess the strength and significance of the association.

          Result

          All sampled cases and controls were actually interviewed. The likelihood of abortion was higher among non-married women [AOR: 18.23, 95% CI: 8.04, 41.32], students [AOR: 11.46, 95% CI: 6.29, 20.87], and women having a monthly income of less than 500 ETB [AOR: 11.46, 95% CI: 6.29, 20.87]. However, the likelihood of abortion was lower among women age greater than 24 years [AOR: 0.29, 95% CI: 0.11, 0.79] and who had the previous history of induced abortion [AOR: 0.31, 95% CI: 0.15, 0.65].

          Conclusion

          The study identified being non-married, student, women age less than 24 years, having the previous history of induced abortion, and low monthly income as an independent determinant of induced abortion. Interventions focused on the identified determinant factors are recommended.

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          Most cited references12

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          Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008

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            Induced abortion in Denmark: effect of socio-economic situation and country of birth.

            Equal access to health care is considered a key in Scandinavian healthcare policy. However, problematic differences between the socio-economic situation of immigrants and that of native Scandinavians are increasingly challenging this aspect of the Scandinavian welfare model. The present study focuses on how socio-economic characteristics and country of birth are associated with induced abortion. A structured questionnaire was used to collect information among 1351 women requesting abortion and a control group of 1306 women intending birth. The strongest factor associated with the decision to have an abortion was being single (OR 39.1; 23.8-64.2), followed by being aged 19 years or below (OR 29.6; 13.4-65.5), having two children or more (OR 7.05; 5.29-9.39) and being unskilled (OR 2.48; 1.49-4.10), student (OR 2.29; 1.52-3.43) or unemployed (OR 1.65; 1.11-2.46). When evaluating the effect of social exposure on abortion among Danish-born and foreign-born women, the higher rate of abortion among non-Westerners was found to be caused by the composition of non-Westerners more often being unemployed, having a low income and having two or more children rather than the fact that they are coming from a non-Western country. Immigrant women comprise a vulnerable group, with a poor socio-economic status. This situation exposes immigrant women to increased risk of induced abortion. In a society with an increasing heterogeneous population, the vulnerable situation of immigrant women has to be addressed, if equal access to health care is to be maintained.
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              Unsafe abortion in 2008: global and regional levels and trends.

              Despite the availability of safe and highly effective methods of abortion, unsafe abortions continue to be widespread, nearly all in developing countries. The latest estimates from the World Health Organization put the figure at 21.6 million unsafe abortions worldwide in 2008, up from 19.7 million in 2003, a rise due almost entirely to the increasing number of women of reproductive age globally. No substantial decline was found in the unsafe abortion rate globally or by major region; the unsafe abortion rate of 14 per 1,000 women aged 15-44 years globally remained the same from 2003 to 2008. Modest reductions in unsafe abortion rates were found in 2008 as compared to 2003 in most sub-regions, however. The upward changes in rates in Middle Africa, Western Asia and Central America were due to better coverage and more reliable information in 2008 than in 2003. Eastern and Middle Africa showed the highest rates of unsafe abortion among all sub-regions. Some 47,000 women per year are estimated to lose their lives from the complications of unsafe abortion, almost all of which could have been prevented through better access to sexuality education, fertility awareness, contraception and especially safe abortion services. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                fikreselassiet@gmail.com
                Fekten@yahoo.com
                gyigezaw@yahoo.com
                Journal
                Contracept Reprod Med
                Contracept Reprod Med
                Contraception and Reproductive Medicine
                BioMed Central (London )
                2055-7426
                14 February 2017
                14 February 2017
                2017
                : 2
                : 11
                Affiliations
                [1 ]Debrebrhan Hospital, Debre Berhan, Ethiopia
                [2 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, ; P.O.Box: 360, Gondar, Ethiopia
                [3 ]College of Medicine and Health Sciences, University of Gondar Hospital, Gondar, Ethiopia
                Article
                38
                10.1186/s40834-017-0038-5
                5683317
                29201416
                572de2f2-209f-477a-b88c-cfbc8b9d193f
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 October 2016
                : 18 January 2017
                Funding
                Funded by: There is no funding source for this study
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                case-control study,induced abortion,ethiopia
                case-control study, induced abortion, ethiopia

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