Socio-Demographic Characteristics of Study Population
From the total of 423 mothers who were invited for interview, 412 filled the questionnaires
completely resulting in a response rate of (97.4%). Mean age of the respondents was
25.0 (SD±5.11) years with a minimum and maximum age of 18 and 43 respectively. Majority
of the respondents 133 (32.3%) fall in between 24-27 years age group. Out of the total respondents,
294 (71.4%) of them were born in Addis Ababa and majority 238 (57.8%) of the study participants were orthodox religion followers. From the total participants; 145 (35.2%) had attended up to secondary education followed by college/university
139 (33.7%). Regarding the marital status of the respondents 132 (32%) were married,
while the majority which account 178 (43.2%) were single without relationship. Almost all 386
(93.7%) were live in Addis Ababa where 88 (21.4%) were private employers and out of the total respondents 138 (33.5%) of them had a monthly income of <500 Ethiopian birr (Table
1).
5.2. Socio-demographic background of their parents
Majority 199 (48.3%) of the study participants had illiterate mother, 114 (27.7%)
with primary education, 54 (13.1%) had secondary education and 45 (10.9%) had some forms of college education. On the other hand 180 (43.7%) of their fathers’ were reported to be
illiterate, whereas, 87 (21.1%), had some forms of college education. Regarding the medical related profession in their family, 130 (31.6%) of
the study participants were reported to have medical related profession in their family (Table 2).
5.3. The general knowledge of participants’ on abortion
Majority or more than two thirds of the participants responded as giving birth 281
(68.2%) and 232 (56.2%) said abortion related to their possible outcomes of pregnancy,
Majority 325 (78.9%) of participants were informed of abortion. When asked about the
methods of termination/performing abortion participants replied that; by medication
/drugs 260 (80%), by Surgical procedures 50 (15.4%), and by traditional practitioners
29 (8.9%). More than half 240 (58.3%) of the participants were awared of safe abortion
(Table S1).
Regarding to information source, more than one third of respondents 180 (55.4%) mentioned
friends as followed by health facility 87 (26.8%), and media (television, radio and
newspapers) 59 (18.2%) respectively (Fig 2).
5.4. General Knowledge and attitude of participants on abortion law
Majority of the respondents, 168 (40.8%) reported as abortion is legally allowed in
Ethiopia while 135 (32.8%) believed that abortion is not allowed in the country. From those study
participants who believe abortion is legally allowed in the country (n=168), majority of the participants
mentioned rape or incest 131 (78%) followed woman or fetus lives are threatened 107
(63.6%) as the main reasons in which unintended pregnancy will be happened(figure
1). More than half of the respondents, 247 (60%) support government allowing abortion in Ethiopia. From those who support government to allow abortion (n=247), majority,167 (67.7%) were mentioned to prevent the death of women due to
unsafe abortion followed by to prevent unsafe abortion and it is a human right which
is 103 (41.7%), 64 (25.9%) respectively as a reason abortion to be allowed. Similarly,
from the total (n=165), who do not support the government to allow abortion, majority,
122 (73.9%), reported not allowed in their religion mentioned the main reason followed
by as it encourages many women to have unplanned pregnancy 93 (56.4%), it is crime 45 (27.3%), and it will cause risk on health of women 45 (27.3%)(Table S2).
5.5. Knowledge regarding Medication Abortion
Three fourth 312 (75.7%) reported that as they knew the definition of MA. from those
who defines MA, 221 (70.8%), 51 (16.3%), 33 (10.6%) and 7 (2.2%)) reported as: MA means; by termination of unintended pregnancy by using abortion drugs, using any other medication, by inserting objects through the birth canal and termination by drinking chemicals respectively.
Of 312 respondents that defines MA, 263 (84.3%) also reported as they knew where medication abortion
service will be given. The majority of the respondents 199 (63.8%) do not have knowledge
on medication abortion drugs. However, some of the respondents mentioned drugs that
can be used in case of MA like Misoprostol 86 (27.6%), Mifepristone 67 (21.5%), Amoxicillin 6 (1.9%), Ampicillin 7(2.2%), Methotrexate 8 (2.6%), Gemprost 5 (1.6%)
and Safe-T 5 (1.6%). Majority, 116 (37.2%) of the participants who knew about MA,
did not understand when MA will be provided/taken. But 111 (35.6%) of respondents
reported as it will be taken at the gestational age less than or equal to 9 weeks followed by gestational age less than or equal 63 days 74 (23.7%), and few of them
5 (1.6%) responded MA to be performed at any gestational age (Table S3).
As it has been shown in (Fig 2), out of 312 respondents who knew about MA, 148 (47.4%)
said that they got the information from friends followed by health facility/hospital, 133 (42.6%). From those
who claimed to know where MA will be performed, majority, 181(68.8%) answered health centre followed
by hospital 103 (39.2%) (Fig 3). Though the majority of the respondent knew what MA means and when knowledge
score was done using knowledge questions, it was found that most of the study participants have high knowledge on MA 159 (38.6%) followed by satisfactory
knowledge 138 (33.5%)(Fig S1).
5.6. Attitude towards medication abortion
From the total respondents, 150 (36.4) reported that as they would advise or encourage
someone with unwanted pregnancies to undergo abortion. The most preferred method that they
advise for someone was abortion by medication 131 (87.3%) followed by surgical procedures 18 (12%) and by traditional
practitioner 10 (6.7%). More than half of the respondents, 230 (55.8%) believed that
if they had an unplanned pregnancy, they would consider abortion to terminate it and the reasons that they believe were: inability to raise their child 139 (60.7%) followed by it will affect my education 69 (44.5%). Abortion
by medication /drugs from health facility was the preferred way of abortion 195 (84.8%). Of the respondents who didn’t consider abortion (n=182) if they
had an unplanned pregnancy, majority 146 (80.2%) reported that as their religion cannot allow abortion followed by I don’t want to kill my own baby 94 (51.6%) (Table S4).
5.7. Sexual and medication abortion practice
Nearly half 201 (48.8%) of the respondents know a friend/neighbour who had terminated
pregnancies and almost all 409 (99.3%) of the respondents had sexual intercourse experience,
from those who had sexual intercourse before, 193 (46.8%) of them had history of unwanted
pregnancy. Out of the total study participants, 206 (50%) had a history of termination
of pregnancy and majority of the respondents report as: I know, but I did not use
contraceptives 97 (47.1%) followed by I know and used contraceptives but I faced pregnancy
53 (25.1%) as a reason for termination. From those (n=206) respondents, majority
136 (66.2) used medication/drugs for termination followed by abortion by surgical
procedure 35 (17.2%). Being easy to take 81 (39.71%) is the most given reason for
MA preference (Table S5).
5.8. Determinants of knowledge, attitude and practice towards medication abortion
5.8.1. Socio-economic variables, parent related factors, and reproductive health service
related factors associated with medication abortion knowledge
Binary Logistic regression was performed to assess the association of each independent
variable with medication abortion knowledge. The factors that showed a p-value of
less than 0.2 were added to the multivariate regression model. The result revealed
that on the bivariate analysis: Age group, place of birth, their way of living, their
father’s educational level, medical related profession in their family and history
of unwanted pregnancy were significantly associated with medication abortion knowledge.
In multivariate logistic regression, fathers’ levels of education and their way of
living were significantly associated with medication abortion knowledge at P-value
of <0.05 (table 8). Respondents who have a father learnt up to secondary education
were 2.03 times more knowledgeable on the MA than with a father who is illiterate
(AOR=2.03, 95% CI [1.01, 4.10]. Similarly, those respondents whose father learnt some
forms of college or university education were 2.80 times more likely knowledgeable
on MA than respondents with a father who is illiterate(AOR=2.80, 95% CI[1.42, 5.52].
In addition to this, those respondents living with their relatives (2.34 times), with
their boyfriends (6.08 times), and with their friends (5.35 times) were more likely
knowledge on MA compared with those living with their family (AOR=2.34, 95% CI [1.05,
5.25]), (AOR=6.08, 95% CI [2.41, 15.33]), and (AOR=5.35, 95% CI[2.18, 13.16]) respectively
(Table S6).
5.8.2. Socio-economic variables, parent related factors, obstetric factor and reproductive
health service related factors associated with respondent’s attitude towards medication
abortion
Bivariate and multivariate logistic regression analysis was employed to calculate
odds ratios and corresponding 95% confidence intervals for the predictors of MA attitude. Variables
which were significant in the bivariate analysis of p-value <0.2 were place of birth, religion,
marital status, income, their fathers’ level of education, and medical related profession
in the family. As a result, medical related profession in the family was remained
in the multivariate logistic regression due to its statistical significance. Hence,
the result of multivariate analysis showed that study participants who had a medical
related profession in their family had positive attitude towards MA compared with
those who had no medical related profession in their family(AOR=1.56, 95% CI [1.01,
2.42]] (Table S7).
5.8.3. Socio-economic variables, parent related factors, and reproductive health service
related factors associated with respondent’s practice towards medication abortion
As shown in table 10, variables which show significant association in the bivariate
analysis of p<0.2 (respondents’ level of education, income, knowing a family member/friend/neighbour
who had terminated a pregnancy, respondents who had history of unwanted pregnancy
and respondents who know contraceptives) were entered into multivariate analysis.
The participants’ level of education, income and respondents who had history of unwanted
pregnancy were significantly associated with the respondents MA practice (table 10).
When we compare MA practice among educated and illiterate respondents, respondents
who had learnt secondary education (3.54 times) and college/university (3.49 times)
were more likely to practice MA than illiterates(AOR=3.54, 95% CI[1.02, 12.26]), (AOR=3.49,
95% CI[1.02, 11.92]) respectively. Similarly respondents who had history of unwanted
pregnancy were 11.7 times more likely practice to MA than those respondents who had
no history of unwanted pregnancy (AOR=11.7, 95% CI(1.11, 12.46]) In addition, respondents
who get a monthly salary of greater than 1000 ETB were 2.19 times more likely to practice
MA than those who get monthly salary less than 500 ETB(AOR=2.19, 95% CI[1.02, 4.75])(Table
S8).