The overall magnitude of RIA for this study was 34.9% (95% CI (30.7- 38.8)), the result is found to be comparable with two studies conducted at public and Non –governmental health institutions of Addis Ababa city, Ethiopia, 31% and 33.6%(8, 9).
The figure however is slightly higher than a study done in Kenya and Nigeria with magnitude of RIA 16% and 23% respectively(1, 14). This might be due to the liberalized abortion law in Ethiopia may encourage women to seek for abortion care in a health institution. On the contrary, this study has smaller magnitude compared to the study done in Tunisia (42.2%) (15). This may be due to the long time history of the liberalization of abortion law in Tunisia. Furthermore, this study has a much lower figure compared to two studies conducted in United States of America (USA) in New York (57%) and San Francisco (59%), (16, 17). This may be due to the relatively better development stage of the country may contribute to better reporting of previous abortions.
Our study has found out that participants who had no education and had an educational level of primary and secondary were more likely to undergo a RIA than those who had an educational level of more than secondary. The finding is in consistent with the study in Ethiopia, Kenya, Tunisia, Georgia, and Russia(1, 8, 15, 18, 19). Unplanned pregnancy secondary to poor contraceptive knowledge and use among those with a lower educational level might be the possible reason.
This study has found out urban residents had five time higher risk of having RIA than rural residents. This finding is consistent with the study done in Kenya(20). This may be due to the low institutional service utilization of woman from rural area, and rather than seeking for safe abortion, they may choose to use unsafe abortion to terminate the pregnancy that reduces the figure.
In this study, woman who had multiple sexual partner were 2.68 times more likely to have a RIA than those who did not. This finding is consistent with the study done in Addis Ababa, Ethiopia and in Britain (8, 21). This could be due to; having multiple sexual partner will make those women to be in an unstable relationship, which leads to irregular use of contraceptive that will cause contraceptive failure and unwanted pregnancy.
This study has identified an association between alcohol use and RIA. Those who had used alcohol had a 2.7 times higher risk of having a RIA. This finding is consistent with the research done in San Francisco General Hospital, USA and with the study done in Russia (17, 19). This may be because of the impact of alcohol on logical thinking of women and might lead them to have unprotected sex.
Finally, those who had a history of physical violence by a male partner had a 2.6 times higher risk of having a RIA than those who did not have a history of physical violence. This result is consistent with the studies done in Tunisia (15). This could be due to fear of telling her male partner about the pregnancy and tend to protect themselves by having an induced abortion.