DETERMINANTS OF REPEATED INDUCED ABORTION AMONG REPRODUCTIVE AGE GROUP WOMEN AT HEALTH FACILITIES OF SIDAMA REGION, ETHIOPIA, 2020: Case-control study.

ABSTRACT Introduction: -Many women throughout the world experienced more than one induced abortion in their life. In Ethiopia despite the availability of modern family planning methods, repeated induced abortion remained 30% and previous studies did not address factors fully. Objective:-To identify determinants of repeated induced abortion among reproductive age group women at health facilities of Sidama region, Ethiopia 2020. Methodology:- Health facility based unmatched case-control study was done in Sidama region among 369 women assuming 1:2 case to control ratio and proportional allocation was made. Cases and controls were selected consecutively. Pretest was done at Gedeo zone and order of the questionnaire was corrected after pretest. Interviewer administered method of data collection was used and data was cleaned, coded, entered to Epidata version 3.1 and exported to SPSS version 20 for analysis. Frequencies, percentages, mean and standard deviation were calculated. Bivariate analysis was done to identify associated factors. Variables with p-value of < 0.25 in bivariate analysis were entered to multivariate analysis after checking multicollinearity effect by tolerance and variance inflation factor. Hosmer and Lemeshow test result > 0.05 (p = 0.41) indicated model was fitness to the data. In multivariate analysis model, variables with p-value of < 0.05 were considered as determinants of repeated induced abortion. Result: -A total of 108 cases and 242 controls completed the interview which made a response rate of 94.9%.Mean age of respondents was 29 years (SD ±3.7) for cases and 26 years (SD ±4.5) for controls. After adjusting for confounders being urban residents (AOR, 95% CI =4.9 [2.1 - 11.3] ), attended primary education (AOR, 95% CI = 0.21 [0.06 - 0.8] ),having multiple sexual partner (AOR ,95% CI=2 [1.1 - 3.7] ), not aware of fertility cycle (AOR ,95% CI= 6.8 [2.5 - 18.2] ) ,started sex before age of 18 years old (AOR,95% CI=4 [1.9-8.7] ) and not perceived abortion as painful procedure (AOR, 95% CI =2.5 [1.2 - 5.3] ) were determinant factors. Conclusion & recommendation: -This study identified residence, educational, number of sexual partner, age at first sex, fertility awareness and perception of abortion pain were determinant factors. Education, health information, family free discussion & reproductive health service utilization should be promoted.