Reproductive-age Women’s Knowledge of Safe Abortion Laws and Associated Factors in Ethiopia: A Systematic Review and Meta-analysis

Background Misinterpretations of safe abortion laws can greatly influence women’s healthcare decisions and their pursuit of services. The availability of safe abortion services has significant consequences for women of reproductive age and is a vital public health concern in developing nations, such as Ethiopia. Studies investigating women’s awareness of safe abortion laws in Ethiopia have produced varied results. Consequently, this review sought to evaluate the understanding of safe abortion laws and the factors related to them among women of reproductive age. Method Articles were retrieved from electronic databases (PubMed, Scopus, Wiley Online Library, ScienceDirect, and African Journal Online) between September 1, 2024 and October 3, 2024. Data extraction was carried out using Excel, and analysis was performed with Stata 11 software. Pooled effect sizes were calculated based on percentages, and pooled odds ratios (POR) with a 95% confidence interval (CI) were utilized to combine the effect measures. The Cochran’s Q test and I 2 statistic were employed to evaluate the heterogeneity among studies. Additionally, a subgroup analysis was conducted based on study years, sample sizes, and sampling techniques. Results Sixteen studies and nine thousand eight hundred four ninety-seven participants were included in this review. Overall, the pooled result showed 43.9% (95% CI: 35.7, 52.1) of the reproductive age women had good knowledge of safe abortion laws. Higher education status (POR = 5.22; 95% CI: 3.02, 9.02), being married (POR = 2.28; 95% CI: 1.35, 3.84), having a history of unplanned pregnancy (POR = 2.16; 95% CI: 1.64, 2.85), knowing the place of safe abortion care (POR = 4.20; 95% CI: 2.75, 6.39), and contraceptive use (POR = 2.78, 95% CI: 2.15, 3.65) were associated factors with outcome variables. Conclusions and Recommendations Overall, less than half of reproductive-age women possessed good knowledge of safe abortion laws, signifying that enhanced awareness of the legal context is essential. Health education initiatives should specifically focus on reproductive-age women. This approach can help reduce unintended pregnancies by offering contraceptive options and access to vital information for women who are unaware of where to find safe abortion services. The findings underscore the urgent need for targeted interventions aimed at addressing the key factors identified in this review.