Reducing delays in seeking abortion among women who visit health facilities for safe abortion service in Mekelle city, Ethiopia: Pre-post interventional study

Abstract

Background

In Ethiopia, about half of all health facilities provide safe induced abortion services. Whereas access to second-trimester abortion services is severely limited. To this end, women in the second trimester tend to visit unsafe abortion services to get their pregnancy terminated.

Methods

A pre-post interventional study design with a sample size of 322 women. The study was conducted in 12 health facilities at Mekelle, Tigray, Ethiopia between February 1st through September 30th, 2020. All women who attended safe abortion services in Mekelle health facilities during the time of the data collection period were the study population.  Women's education on the Ethiopian abortion law, availability of abortion services, and optimal time of pregnancy termination using 1000 leaflets, and 20 street posters for 3 months. To analyze the change in gestational age in weeks using ultrasound to terminate the pregnancy an independent t-test was carried out. The result was described using t-test, df, P-value, mean value of both groups (pre-intervention and post-intervention and adjusted risk with its 95% CI.

Results

Compared to the pre-intervention group, a significant change in reducing the gestational age in weeks was observed in the post-intervention period to terminate the pregnancy with a 9.8 decrease per 100 respondents (95% CI 9.25 to 10.36) and a Cohen’s d value of 5.23 was found. Besides, there was a statistically significant difference between the pre and post-intervention on the respondent knowledge of the possibility of termination of pregnancy based on wish according to Ethiopian abortion law at a p-value of < 0.024.

Conclusions

Health education on the availability of safe service and optimal gestational age for termination has led to a significant reduction of the delay in weeks with a large effect size.