Magnitude of Unintended Pregnancy and Its Associated Factors Among Female Sex Workers in Jimma Town, Southwest Ethiopia: A Mixed Method Study

Abstract

Background: Unintended pregnancy is defined by the World Health Organization (WHO) as a pregnancy which is not wanted and/or not planned at the time of conception. Globally, unintended pregnancies are major public health problems among key population such as youths and Female Sex Workers (FSWs) with high rate of sexual risk behavior. Objective: The objective of the study was to assess magnitude of unintended pregnancy and its associated factors among female sex workers in Jimma town, southwest Ethiopia, 2022. Methods: Institutional based explanatory sequential study design was conducted. For quantitative study, participants were selected conveniently at confidentiality clinics in Jimma town from June 09 – July 30, 2022. Binary logistic regression model was used to identify variables associated with unintended pregnancy. For qualitative study, in-depth interviews were conducted until saturation of ideas occurred. Data were analyzed manually using thematic approach and the results were used to support the quantitative findings. Result: The magnitude of unintended pregnancy among female sex workers was 23.8% (95% CI: [19.3%, 28.6%]). FSWs whose age ranges ≤24 years had 4.5 times more likely to have unintended pregnancy compared to those whose age ranges ≥30 years. Those who ever had no formal education had 6.7 times more likely compared to those who completed high school grades. FSWs whose average monthly income range were ≥6,000 ETB had 4.2 times more likely to have unintended pregnancy compared to those whose average monthly income range were <3,000 ETB. FSWs who ever heard about emergency contraceptive were 70% less likely to have unintended pregnancy than those who didn’t. The results of qualitative IDIs were summarized alone for third objective as the services that need to be included being provision of reversible long acting family planning (LAFP) and comprehensive abortion care services (CAC) while the results for second objective were used to support the quantitative findings. Conclusion: Significant magnitude of unintended pregnancy was found among FSWs. Age, educational status, monthly income, male condom use as family planning method, Knowledge of emergency contraceptive and duration of sex work were positively associated with unintended pregnancy. There were needs for LAFP and CAC to be included in services provided by confidentiality clinics.