Abstract:
Back ground: Homeless women are the most vulnerable group for unwanted pregnancy.
However, their issues are not being addressed in government plan. Despite the fact that Ethiopia
has a penal code regarding safe abortion care, studies show that homeless women low access
this service. Therefore, the aim of this study is to assess utilization of safe abortion service and
associated factors among homeless women.
Methods: Community based cross sectional mixed methods study was done in three towns of
southwest Ethiopia (Jimma, Bonga and Mizan-aman) from May 20 to July 2 / 2021 G.C. A total
of 122 participants were included in the quantitative part. Participants were chosen by snow
balling technique and data was collected through face to face interview. To enter and analyze
data, Epi-data 3.1 and SPSS 21 were used, respectively. Descriptive analysis was performed
initially and then binary logistic regression. An AOR with 95% CI and P-value <0.05 was used
to declare significant association. In-depth interviews on 12 key informants were done for
qualitative portion and then data was transcribed and analyzed using thematic content analysis.
Result: The magnitude of safe abortion service utilization among homeless women was found to
be 34 (27.9%). After controlling for confounders in multiple logistic regressions, average daily
income (AOR = 5.873, P-value = 0.003, CI [1.834, 18.801]), poor knowledge towards safe
abortion (AOR = 0.256, P-value = 0.037, CI [0.071, 0.920]) and perceived unaffordability of
cost of abortion at health facility (AOR = 0.108, P-value = 0.000, CI [0.034, 0.345]) were
significantly associated with safe abortion. The qualitative findings of this study revealed that
homeless women’s personal characteristics, health provider related factor and health system
factors all had influence on homeless women’s utilization of safe abortion service.
Conclusion: Safe abortion service utilization among homeless women in the study area was low.
Average daily income, knowledge towards safe abortion and perceived cost of abortion at health
facility were significantly associated with safe abortion.
