Health care providers`attitude and associated factors to safe abortion in Ethiopia, 2023: A systematic review and meta-analysis

• Published in: PloS one Vol. 19; no. 9; p. e0308419
• Main Authors: Bante, Simachew Animen, Balcha, Wondu Feyisa, Chekole, Fentahun Alemnew, Kassahun, Eden Asmare, Getu, Alemwork Abie, Awoke, Amlaku Mulat, Tariku, Mengistie Kassahun, Zerihun, Endalamaw Erkie
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 17.09.2024
• Subjects: Abortion; Abortion, Induced - psychology; Abortion, Induced - statistics & numerical data; Attitude of Health Personnel; Attitudes; Biology and Life Sciences; Cross-sectional studies; Ethiopia - epidemiology; Fatalities; Female; Health care; Health care facilities; Health Knowledge, Attitudes, Practice; Health Personnel - psychology; Health Personnel - statistics & numerical data; Heterogeneity; Humans; Maternal mortality; Medical personnel; Medical Subject Headings-MeSH; Medicine and Health Sciences; Meta-analysis; Mothers; Patient outcomes; People and Places; Physical Sciences; Practice; Pregnancy; Pregnancy, Unwanted; Prevention; Research and Analysis Methods; Risk factors; Science Policy; Social Sciences; Statistical analysis; Statistical tests; Systematic review; Training; Ethiopia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0308419

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.