Repeated induced abortion among women seeking abortion care services in public health facilities in Harar town, Eastern Ethiopia

Repeated induced abortion is a major public health problem that affects an estimated 56 million women worldwide and more than half a million women in Ethiopia each year. There is a scarcity of information on the level of repeated induced abortion and its determinants in the country, particularly in eastern Ethiopia. This study aimed to assess repeated induced abortions and associated factors among women seeking abortion care services in public health facilities in Harar town, eastern Ethiopia. An institution-based cross-sectional study was conducted among 374 women in Harar town from June 01 to July 30, 2022. Data were entered using EpiData version 4.1 and analyzed using SPSS version 27.0. Bivariable and multivariable logistic regression analyses were applied to identify significant factors of repeated induced abortion. The Hosmer and Lemeshow goodness-of-fit test was used to confirm the model's fitness with a p-value > 0.05. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used to report the strength of association, and statistical significance was declared at p-values < 0.05. The magnitude of repeated induced abortion among women seeking abortion care in Harar town was 25.7% (95% CI: 21%, 30%). Living far from health facilities (AOR = 4.61, 95% CI: 2.23, 9.53), using substances (AOR = 3.13, 95% CI: 1.65, 5.95), not utilizing post-abortion family planning (AOR = 3.79, 95% CI: 2.04, 7.05), having short interpregnancy intervals (AOR = 4.42, 95% CI: 2.38, 8.22), having multiple sexual partners (AOR = 4.42, 95% CI: 2.38, 8.22), and having poor knowledge about abortion (AOR = 2.47, 95% CI: 1.35, 4.52) were the significant risk factors of repeated induced abortion. One in every four women seeking induced abortion care had repeated induced abortion in Harar town. Distance from nearby health facilities, substance use, post-abortion family planning, interpregnancy interval, multiple sexual partners, and knowledge about abortion were the determinants of repeated induced abortion. Providing behavioral change counseling about sexual and reproductive health for all reproductive-aged women and enhancing reproductive health service utilization is essential to preventing and reducing the burden of repeat-induced abortion.