Health care Providersàttitude and associated factors to safe abortion in Ethiopia, 2023: A systematic review and meta-analysis

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Abstract Background Maternal deaths due to unsafe abortion have increased steadily in sub- Saharan Africa. In Ethiopia, 25% of the pregnancy is unintended pregnancy. This contributes from 6–9% maternal deaths from unsafe abortion .Previously, many fragmented cross-sectional studies were conducted but there is no cumulative evidence on health care providers’ attitude and associated factors to safe abortion in Ethiopia. This study aimed to measure pooled health care Providers’ attitude and determinants of safe abortion in EthiopiaMethods In this review the databases used were Google Scholar, Medline/PubMed, EMBASE, Science Direct, HINARI and African Journals Online. The quality of articles that met the inclusion criteria was assessed. The studies were critically appraised by using the Joanna Briggs Critical Appraisal tools and the preferred reporting item for systematic review was used for quality assessment. Data were extracted in an excel spreadsheet and imported to STATA version 17 software for meta-analysis. The random- effect model was used to pooled the health care Providers’ attitude to safe abortion. The I2 statistics were used to test heterogeneity and Egger’s tests were used to assess publication bias. Forest plot were used to present the odds ratio (OR) with a 95% confidence interval (CI).Results A total of eight studies with a total sample size of 2,826 were included for this review and meta-analysis. The overall pooled health care providers’ favorable attitude towards safe abortion in Ethiopia was 65.49% (95%CI; 49.64, 81.34; I2 = 99.20%, P = 0.000). Familiarize with abortion law, OR = 2.25 (95% CI: 1.06, 3.43), being male provider, OR = 1.89 (95% CI: 1.23, 2.54), taking training on abortion, OR = 2.91 (95% CI: 1.17, 4.65), being midwives profession, OR = 3.029 (95% CI: 1.605, 4.453) and practicing abortion procedure, OR = 2.55 (95% CI: 1.32, 3.78) were positively associated with providers’ favorable attitude to safe abortion.Conclusion Health care provider who trained on abortion service and who were familiarized with abortion law were more likely to have favorable attitude to safe abortion services in Ethiopia. Therefore, all health institutions and other stakeholders should facilitate training on safe abortion services and enable providers familiarize with abortion law in Ethiopia.

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