Induced abortion among internally displaced women in Debre Berhan, Central Ethiopia: Incidence, barriers, and enablers of service utilisation.

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.