Risk factors associated with induced abortion among women attending public health facilities in Hawassa city, Sidama Region, Ethiopia: a case-control study

Background: Unsafe induced abortion contributes a significant public health concern in Ethiopia and is one of the leading causes of maternal morbidity and mortality. Previous studies have explored the burden of induced abortion. However, little evidence exists in the context of Hawassa city. Objective: To identify the Risk factors associated with induced abortion among women attending health facilities in Hawassa city, Sidama Region, southern Ethiopia, 2024. Design: An institution-based unmatched case-control study design. Methods: A multistage sampling technique was employed to select 513 women of reproductive age attending public health facilities in Hawassa city from June 25 to August 25, 2024. Data were collected electronically through face-to-face interviews via a structured questionnaire adapted from previous studies. Descriptive analysis was conducted to describe the participants. Bivariable and multivariable binary logistic regression were used to identify risk factors associated with induced abortion. Results: In this study, 513 (172 cases and 341 controls) women were included, for a response rate of 95.4%. Primary education (adjusted odds ratio (AOR) = 2.58, 95% CI: 1.20, 5.53), early sexual debut before age 18 (AOR = 5.40, 95% CI: 2.80, 10.41), previous history of abortion (AOR = 3.50, 95% CI: 1.78, 6.90), poor knowledge about contraceptives (AOR = 5.11, 95% CI: 2.69, 9.72), and alcohol consumption (AOR = 2.76, 95% CI: 1.53, 4.98) were associated with increased odds of induced abortion. Conversely, ever use of contraceptives was associated with lower odds of induced abortion (AOR = 0.38, 95% CI: 0.21, 0.72). Conclusion: The current study points out that early sexual debut before age 18, previous history of abortion, poor knowledge about contraceptives, and alcohol consumption were factors associated with induced abortion. These findings highlight further investigation in longitudinal studies.