African journal of reproductive health最新文献

{"title":"Barriers to safe abortion care in internally displaced persons camps in Ethiopia: a qualitative study.","authors":"Samrawit S Ethiopia, Andamlak G Alamdo, Fanna A Debele, Ferid A Abubeker, Mitikie M Sisay","doi":"10.29063/ajrh2025/v29is.10","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29is.10","url":null,"abstract":"<p><p>This qualitative study examines barriers to safe abortion care among women in Internally Displaced Persons (IDP) camps in Ethiopia using the Social Ecological Model (SEM). Data were collected through in-depth and key informant interviews with displaced women, healthcare providers, community leaders, NGO representatives, and policymakers. The findings reveal multi-level challenges, including personal and structural barriers, where cultural and religious beliefs, financial constraints, and limited education prevent women from access to safe abortion care. Social networks and healthcare providers play a critical role, with unsupportive partners and providers' moral objections worsening the situation. Community stigma and social norms perpetuate misinformation and isolation, while societal barriers such as inadequate healthcare infrastructure and policy gaps further limit access. Urgent, coordinated action is critical. The Ministry of Health, humanitarian organizations, and local leaders must expand healthcare access, ensure legal protections, combat Sexual and Gender Based violence, and dismantle stigma. Without urgent intervention, displaced women will continue facing life-threatening risks.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"121-131"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude and determinants of common mental disorders following abortion among women of reproductive age recruited from health institutions in Addis Ababa, Ethiopia: A cross-sectional study.","authors":"Berhanu Wordofa Giru, Solomon Teferra, Mekdes Demissie, Delayehu Bekele","doi":"10.29063/ajrh2025/v29i9s.6","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.6","url":null,"abstract":"<p><p>The prevalence of common mental disorders (CMDs) among women who have had abortions is not well understood. The scope of this paper concerns the onset of CMDs after an abortion, with a focus on sub-Saharan Africa, particularly Ethiopia, where knowledge on the incidence of CMDs after an abortion, as well as their determinants, are limited. The aim of the study was to assess the magnitude and determinants of CMDs following abortion. The study was conducted in five health institutions in Addis Ababa among 460 women aged 18-49 years who had had at least one abortion. The single population proportion formula was used to calculate sample size. Purposive sampling techniques were used to select the health facilities, and consecutive sampling was used to enrol participants into the study. We collected, cleaned, reviewed, and checked the data for completeness using Kobo Toolbox before exporting into SPSS version 27 software for analysis. Descriptive statistics and binary and multiple logistic regressions were computed using a 95% confidence level. The magnitude of CMDs was 18.2% at a confidence interval (CI) of (0.15, 0.22). Being not co-habited with a partner (AOR= 3.18; 95% CI (1.03, 9.84)), belonging in the category of non-paying occupations (AOR= 2.17; 95% CI (1.11, 4.24)), having a living child (AOR= 0.46; 95% CI (0.22, 0.98)), contraceptive use before conception (AOR= 0.46; 95% CI (0.22, 0.96)), substance use (AOR= 3.93; 95% CI (1.92, 8.03)), intimate partner emotional violence (AOR= 5.09; 95% CI (1.06, 24.33)), stigma and discrimination (negative stereotyping (AOR= 1.11; 95% CI (1.05, 1.16)) and discrimination and exclusion (AOR= 1.86; 95% CI (1.78, 2.94)) were factors associated with CMDs after abortion among the women. Therefore, one in five women who have had an abortion experience CMDs. This highlights the need for comprehensive counseling services as an addition to abortion services and increase awareness on the problem among healthcare providers and service users.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"67-81"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of induction-to-expulsion time and adverse maternal outcomes of second trimester medical abortion in Amhara Region, Ethiopia: Prospective follow-up study.","authors":"Eyasu F Yitina, Getasew S Mihrete, Mequanint M Bicha, Balemlay S Andualem, Nigat A Addis, Olomon M Abebe, Lemi B Tolu, Ayenew M Lakew","doi":"10.29063/ajrh2025/v29i9s.14","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.14","url":null,"abstract":"<p><p>Second-trimester medical abortion (STMA) accounts for 20-40% of abortions in Ethiopia and is associated with risks including uterine rupture, hemorrhage, infection, incomplete abortion, and prolonged hospitalization. This multicenter prospective study included 617 women undergoing STMA in three referral hospitals in the Amhara region from January to October 2024. Induction to-expulsion time and associated factors were analyzed using Cox proportional hazard modeling. Median fetal and placental expulsion times were 10 and 10.5 hours, respectively, with an 81.2% complete expulsion rate. Prolonged expulsion was associated with higher gestational age, wider misoprostol dosing intervals, and younger maternal age. Reported complications included vaginal bleeding (34.8%), pain (44%), diarrhea (24.1%), vomiting (24%), fever (11.5%), infection (2.4%), incomplete abortion (19.8%), cervical tear (0.49%), and uterine rupture (0.16%). optimizing misoprostol regimens, improving pain management, strengthening follow-up, and ensuring surgical readiness are essential to enhance STMA safety and effectiveness.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"162-180"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induced abortion among internally displaced women in Debre Berhan, Central Ethiopia: Incidence, barriers, and enablers of service utilisation.","authors":"Kindie M Kebede, Sisay S Yehualashet, Solomon S Yesuf","doi":"10.29063/ajrh2025/v29i9s.8","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.8","url":null,"abstract":"<p><p>This study examined the incidence of induced abortion and factors influencing access to abortion services among internally displaced women in Debre Berhan, Ethiopia, using a mixed-method cross-sectional design. Quantitative data were collected from 1,863 women, and qualitative data from 16 participants. The annual rates of self-reported, unadjusted, and adjusted best friend abortion were 5.4, 8.8, and 42.2 per 1,000 women, respectively. Barriers to access included stigma, lack of support, medical and non-medical costs, fear of prosecution and privacy breaches, poor infrastructure, and limited awareness. Key facilitators included free abortion care in public facilities, NGO support, flexible provider interpretation of abortion law, referral networks, and counselling. Although the confidence intervals overlapped, the best friend method indicated a higher incidence than self-reports. The inflated adjusted figure shows significant underreporting. Addressing barriers requires initiatives to reduce stigma, lower costs, improve service quality, and raise awareness among displaced women and the broader camp population.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"91-106"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the incidence of abortion-related complications using the prospective morbidity survey method in Southern Ethiopia.","authors":"Jenenu G Bekele, Bedilu A Ejigu, Damen H Mariam, Tadiwos U Urkashe","doi":"10.29063/ajrh2025/v29i9s.2","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.2","url":null,"abstract":"<p><p>Despite legal reforms, unsafe abortion remains a significant public health problem in Ethiopia, straining healthcare systems and impacting women's well-being. Recent data on the magnitude of this problem are scarce. Therefore, this study aimed to assess the incidence and factors associated with abortion-related complications in public hospitals in Southern Ethiopia. Using the prospective morbidity survey (PMS) methodology, data were obtained from 322 women who presented in 10 public hospitals over a two months period (December 2023 - February 2024). The results show that the projected annual estimate of abortion related complications was 1,986 (95% CI: 1741, 2142), translating to a complications ratio of 153 per 1,000 live births. Out of the 322 women, 67 (20.8%) were classified as having near-miss morbidity (MNM), 167 (50.8%) had potentially life threatening complications (PLTC), while 35 (10.9%) and 57 (17.7%) women had moderate and mild morbidities respectively. Ordinal logistic regression identified younger age, rural residence, unemployment, later trimester abortion, lack of contraception use, unintended pregnancy, and expulsion of some products of conception as factors associated with increased severity of complications. These findings highlight the high burden of severe abortion complications and underscore the critical need for improved access to comprehensive family planning, safe abortion services, and timely, quality post-abortion care, particularly for vulnerable populations in Southern Ethiopia.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"15-31"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation and validation of the abortion provider stigma scale in Ethiopia.","authors":"Kidist L Gizachew, Yared Dagnew, Sarah W Prager, Lemi Belay Tolu, Mekitie Wondafrash","doi":"10.29063/ajrh2025/v29i9s.7","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.7","url":null,"abstract":"<p><p>Abortion care providers often face stigma from their communities and colleagues, which may compromise the quality of service they provide. This study aimed to adapt and validate the revised Abortion Provider Stigma Scale (APSS) for use in the Ethiopian context. A cross-sectional psychometric study was conducted among 98 providers in reproductive clinics across Ethiopia. The original 35-item APSS was reviewed by experts, culturally adapted and expanded to 44 items across five domains: disclosure management, internalized states, judgement, social isolation, and discrimination. The scale was then translated into Amharic and pilot tested before administration. Internal consistency was high across most domains (Cronbach's alpha > 0.70), and Confirmatory Factor Analysis supported the five-domain structure, though model fit indices were suboptimal. Nearly half of participants reported stigma, with internalized and disclosure-related stigma being most prevalent. The adapted APSS demonstrated potential for assessing abortion provider stigma and tracking intervention outcomes in Ethiopia.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"82-90"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New findings on induced abortion in Ethiopia: Evidence from an abortion research capacity building project.","authors":"Abraham Fessehaye Sium, Delayehu Bekele","doi":"10.29063/ajrh2025/v29i9s.1","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.1","url":null,"abstract":"<p><p>Countries in sub-Saharan Africa continue to experience some of the highest maternal mortality rates in the World.1,2 Unsafe abortion is reported to be among the leading causes of maternal deaths in some countries in this region.3,4 A significant barrier to advancing legal and policy reforms that ensure women's and girls' access to safe comprehensive abortion care in the region is the lack of relevant and timely evidence.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"9-14"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health system barriers affecting the provision of comprehensive abortion care in pastoralist communities of Oromia Regional State, Ethiopia.","authors":"Tolasa Yadate, Abel Negussie, Finina Abebe, Chala Damena, Menen Tsegaw, Niguse Tadele, Assefa Seme","doi":"10.29063/ajrh2025/v29i9s.4","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.4","url":null,"abstract":"<p><p>This study aimed to explore health system-level barriers affecting the provision of comprehensive abortion care (CAC) in pastoralist communities of Oromia regional state, Ethiopia. A total of 23 key informant interviews were conducted with healthcare providers at 14 selected health facilities, as well as with reproductive health officers at the woreda, zonal, and regional levels. Verbatim transcripts were analyzed using thematic analysis with Open Code 4.03 software. The findings were thoroughly described and supported with direct quotes. Various systemic issues affecting abortion service delivery, including gaps in access and availability, shortage of skilled medical providers, financial constraints, poor management commitment, and gaps in legal framework implementation, were identified. Addressing these issues requires a multifaceted approach that involves improving infrastructure, enhancing provider training, increasing community education, implementing policies effectively, and conducting advocacy efforts at all levels.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"46-59"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"They come when you build it\": the impact of introducing a model abortion clinic on safe abortion care access expansion in Ethiopia.","authors":"Abraham Fessehaye Sium, Abrham Getachew, Lemi B Tolu, Sarah Prager","doi":"10.29063/ajrh2025/v29i9s.11","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.11","url":null,"abstract":"<p><p>Current strong evidence supports that making abortion legal, safe, and accessible significantly reduces unsafe abortion-related maternal morbidity and mortality. We conducted a decade-long (2009 - 2019) trend-analysis study of safe abortion care and post abortion care services in relation to introduction of a new abortion clinic at St. Paul's Hospital in Ethiopia. There were 9491 total abortions (6449 post-abortion care cases and 3042 safe abortion cases) during the study period (between September 2009 to August 2019). Following the opening of a model abortion clinic, access to safe abortion care significantly increased, and post-abortion care abortion service dominance was replaced by safe abortion care. Before the introduction of the clinic in 2016, only 1 in 3 abortions were safe abortions, the rest being post-abortion care cases. During the years 2017-2018 and 2018-2019, safe abortion care increased to 6 in 10 and 7 in 10 of all comprehensive abortion care provided, respectively. This \"They come when you build it\" effect on the trends of safe abortion - a paradigm shift of post-abortion care into safe abortion care - can be implemented in other Sub-Saharan settings.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"132-136"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to safe abortion care among internally displaced persons in Ethiopia: A cross-sectional study.","authors":"Samrawit Solomon, Andamlak Gizaw, Fanna Adugna, Ferid Abas, Mitikie M Sisay","doi":"10.29063/ajrh2025/v29i9s.9","DOIUrl":"https://doi.org/10.29063/ajrh2025/v29i9s.9","url":null,"abstract":"<p><p>Internally Displaced Persons (IDPs) in Ethiopia face significant barriers to safe abortion care, influenced by socio-cultural, economic, and structural factors, alongside widespread sexual and gender-based violence (SGBV). A cross-sectional study was conducted in four IDP camps in the Amhara and Oromia regions from April to July 2024, involving 1,452 randomly selected women. SGBV was reported by 16.6%, with 36.9% of cases perpetrated by security forces. Of the participants, 5.8% had undergone abortion, and 1.7% had induced abortions in the camps. Fewer than half of women in IDP camps reported using a contraceptive method (41.7%), though 80.7% also reported that they had a history of discontinuing use due to access issues. Barriers to abortion care included religious beliefs (67.7%), cultural norms (63.8%), and the lack of service awareness (56.3%). Urgent Action is Needed. We recommend that the Ministry of Health of Ethiopia and stakeholders should prioritize appropriately tailored interventions to break down barriers, improve access to safe abortion care, and address the pressing needs of women in IDP camps.</p>","PeriodicalId":7551,"journal":{"name":"African journal of reproductive health","volume":"29 9s","pages":"107-120"},"PeriodicalIF":1.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}