Knowledge and attitude towards induced abortion among medical
Knowledge and attitude towards induced abortion among medical interns of Addis Ababa University, 2018 By: Kalkidan Lakew, M. D. , Dawit Worku M. D,
Background • In 2005, the Ethiopian Abortion law was revised resulting in legalization of abortion in certain circumstances. • Ethiopia has become one of the countries that have shown significant reduction in maternal mortality in relation to unsafe abortion. Berhan Y, Berhan A. Causes of maternal mortality in Ethiopia: a significant decline in abortion related death. Ethiopian journal of health sciences. 2014; 24 Suppl(0 Suppl): 15 -28. Pub. Med PMID: 25489180. • Medical interns are the future physicians who will encounter many women in need of safe abortion in their career.
Methods • A cross sectional descriptive study • self-administered questioner that was distributed among all 240 medical interns of AAU, SOM between September and October 2018. • Protocol approval was obtained from the Ethical Review Committee of the Department of OBGYN of AAU • Analysis was performed using SPSS 20. 0 software packages for statistical analysis.
Results and Discussion Table 1 - Demographic data of medical interns AAU, 2018 Demographic variables Marital status Place of Upbringing Frequency % Single 196 95. 6% Married 7 3. 4% Divorced 2 1% Urban 151 73. 7% Semi- Urban 37 18% Rural 17 8. 3% • The participants ranged in age from 22 to 35 with a median age of 24 years (standard deviation 1. 26 years).
Results and Discussion Table 1 - Demographic data of medical interns AAU, 2018 Demographic variables Sex Frequency % Male 133 64. 9% Female 72 35. 1% Orthodox Christian 129 62. 9 % Muslim 36 17. 6% Protestant Christian 17 8. 3% Atheist 12 5. 8 % Catholics 2 1% Jehovah Witness 2 1% Bahai 3 1. 4% Other 2 1% Missing 2 1% Religion
Results and Discussion Knowledge Yes, for only indicated cases Yes, allowed under any circumstance It s not allowed I do not know Figure 1: Knowledge regarding the legal status of abortion in Ethiopia by medical interns, AAU, 2018
Results and Discussion Knowledge • Only 66. 3% knows all the indications which the law permits • 71. 4% were not aware that a woman should get the service within 72 hours • 37. 7% reported the need for evidence for age in minors • 25. 9% reported the need of evidence for rape/incest Revised technical and procedural guidelines for safe abortion in Ethiopia. . 2014.
Attitude Results and Discussion • Ninety six (96%) of the interns believe safe abortion is important similar with Study done in Addis Ababa Facilities: Abdi J, Gebremariam M. Health Providers’ Perception towards Safe Abortion Service at Selected Health Facilities in Addis Ababa 2011. 31 -6 p • But only 53. 7% of interns are willing to provide safe abortion service by themselves. ü 70. 8% among SPMMC among Health Professionals- Sarah D. Rominski 1 JRL, Lia Tadesse 3 and Senait Fisshea 4. Reproductive health providers’ willingness to provide comprehensive abortion services and knowledge of the abortion law in Addis Ababa, Ethiopia. International Journal of Nursing and Midwifery. November 2015; 7(11): 168 -74. ü 25% AA hospitals- Abdi J, Gebremariam M. Health Providers’ Perception towards Safe Abortion Service at Selected Health Facilities in Addis Ababa 2011. 31 -6 p.
ü 72% of midwives and midwifery students of Ethiopia shows willing to provide abortion Sarah Jane Holcombe AB, Amsale Cherie. Professional Mission and Personal Beliefs: Ethiopian Midwives' Role in Expanding Access to Abortion Services in the Wake of Legal Reform. Studies in Family Planning 2015; 46(1): 73 -95. ü 25% SA Medical Students Wheeler SB 1 ZL, Reeve BB, Buga GA, Morroni C. Attitudes and intentions regarding abortion provision among medical school students in South Africa. Int Perspect Sex Reprod Health. 2012; 38(3).
Attitude Results and Discussion • The most common reason given by the interns for not be willing to provide safe abortion service was Religion. • Similar reason was given in a study done at Mekele, Ethiopia and Babol University of Medical Science in Iran ü Zaid Tadesse ABK, Weyzer Tilahun , Kalayou K Berhe. Assessment of Health Care Providers’ Attitude and Associated Factors to Wards Safe Abortion at Public Hospitals, in Mekelle City, Tigray, Ethiopia; A Cross Sectional Study. Global Journal of Medical research: E Gynecology and Obstetrics. 2014; 14(3). ü M. R. Evaluation of the Effect of Religious Beliefs on the Attitude toward Abortion among the Students and Healthcare Personnel of Babol University of Medical Sciences. J Babol Univ Med Sci. 2016; 18(5): 70 -6.
Results and Discussion Table 2: Willingness to provision of safe abortion service among the different religion . Religion of the intern Willingness to provision of safe abortion Total Pearson chisquare Willing Not willing Orthodox Christian 77 (59. 7%) 52(40. 3%) 129(100. 0%) Muslim 10(58. 8%) 7(41. 2%) 17(100. 0%) Catholic Christian 0(0. 0%) 2(100. 0%) Protestant Christian 6(16. 7%) 30(83. 3%) 36(100. 0%) Jehovah Witness 1(50. 0%) 2(100. 0%) Bahai 2(66. 7%) 1(33. 3%) 3(100. 0%) <0. 001 Atheist 9(75. 0%) 3(25. 0%) 12(100. 0%) Others 2(100. 0%) 0(0. 0%) 2(100. 0%) Total 107 96 203
Results and Discussion • Age, Sex, Marital Status, place of upbringing of the interns were found to be statistically insignificant with willingness to provide safe abortion. • Similar finding reported from studies done at Addis Ababa and Mekele: ü Abdi J, Gebremariam M. Health Providers’ Perception towards Safe Abortion Service at Selected Health Facilities in Addis Ababa 2011. 31 -6 p. ü Zaid Tadesse ABK, Weyzer Tilahun , Kalayou K Berhe. Assessment of Health Care Providers’ Attitude and Associated Factors to Wards Safe Abortion at Public Hospitals, in Mekelle City, Tigray, Ethiopia; A Cross Sectional Study. Global Journal of Medical research: E Gynecology and Obstetrics. 2014; 14(3). • In contrast a study done among health care providers in Adama, Ethiopia showed males have had favorable attitude than females (COR=1. 689[1. 121 -2. 546]) ü Yitagesu Sintayehu 1* BHa. KS. Health Care Providers’ Perception and Associated Factors towards Safe Abortion in Selected Health Facilities in Adama, Ethiopia. Journal of Women's Health Care. 2018; 7(2): 428.
Conclusion and Recommendation q. Most are aware of the indications to providing safe abortion using the current Ethiopian abortion law and that most have positive attitude towards the importance of safe abortion services but willingness to provide safe abortion is low. q. There is a palpable knowledge gap regarding the abortion law. q. Qualitative study that addresses the attitude should be done.
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