Improving the quality of sexual and reproductive health and rights (SRHR) through pre-service training, research, and evidence-based clinical care delivery in Sub-Saharan Africa

Introduction: Over 60% of unplanned pregnancies end up in abortion, and estimated 45% of these abortions are Unsafe contributing for 13% of all maternal death globally. The study aimed to determine the prevalence and factors associated with unsafe abortion among married women admitted on gynecological ward at Lira Regional Referral Hospital (LRRH) a public facility in Lira City Northern Uganda.
Methodology: We conducted a cross-sectional study among married women admitted with abortion in Gynecological ward at LRRH, lira city, Northern Uganda. From Dec 2022 to April 2023. A consecutive sampling technique was used to recruit 368 participants. Quantitative data was collected using interviewer administered questionnaire, and descriptive statistics analyzed using Statistical Package for Social Sciences (SPSS) version 29.0. Ethical approval was obtained from Gulu University Research Ethics Committee (GUREC). LRRH administration and informed consent from study participants.
Results: Most 203(55.2%) of the respondents were aged 15-24 years, 160(43.5%) were from rural setting, 158(42.9%) were Protestants by religion, 338(91.8%) were Lango by tribe, 111(30.2%) were peasants, and 229(62.2%) had primary level of education. Respondents who had unsafe abortion were 176(47.8%) while 192(52.2%) had safe abortion.
Respondents who were aged 15-24 years were less likely to have unsafe abortion (AOR: 0.685, 95% CI: 0.454-0.725, P=0.020) compared to respondents aged >34 years.
Respondents who were from rural settings were more likely to have unsafe abortion AOR: 2.559, 95% CI: 1.453-4.505, P=0.001) compared to those who were urban settings.
Respondents who had monthly income of <100,000 shillings (AOR: 2.677, 95% CI: 1.426-5.023, P=0.002), 100,000-250,000 shillings (AOR: 2.854, 95% CI: 1.463-5.567, P=0.002) and 250,000-500,000 shillings (AOR: 2.306, 95% CI: 1.031-5.158, P=0.042) were more likely to have unsafe abortion compared to those who had total monthly income of >500,000 shillings.
Conclusions: There was high Prevalence of unsafe abortion in this study. Older age, coming from rural settings and low monthly income were significantly associated with unsafe abortion practices. Ministry of Health should launch a campaign to educate the public about the risks of unsafe abortion and the availability of sexual and reproductive health services, such as family planning services, nationally to prevent unsafe abortion from unplanned pregnancies