Awareness of female students attending higher educational institutions toward legalization of safe abortion and associated factors, Harari Region, Eastern Ethiopia: a cross sectional study

BACKGROUND Unsafe abortion has been recognized as an important public health problem in the world. It accounts for 14% of all maternal deaths in sub-Saharan African countries. In Ethiopia, 32% of all maternal deaths are accounted to unsafe abortion. Taking the problem of unsafe abortion into consideration, the penal code of Ethiopia was amended in 2005, to permit safe abortion under a set of circumstances. However, lack of awareness on the revised penal code is a major barrier that hinders women to seek safe abortion. The aim of this study is to assess awareness of female students attending higher educational institutions toward legalization of safe abortion and associated factors in Harari region, eastern Ethiopia. METHODS Institution-based descriptive cross sectional study was conducted among 762 female students who are attending five higher educational institutions in Harari Region. Systematic sampling method was used to identify study participants from randomly selected colleges. Self administered structured questionnaire was used to collect data. Data were entered in to Epi Info version 6.04 and analyzed by SPSS version 17.0 statistical packages. Frequency, percentage and ratio were used to describe variables. Multivariable logistic regression analysis was done to control confounders and odds ratio with 95% confidence interval was used to identify factors associated with awareness of female students to legalization of abortion. RESULTS 762 study participants completed the survey questionnaire making the response rate 90.2%. Only 272 (35.7%) of the respondents reported that they have good awareness about legalization of safe abortion. Studying other fields than health and medicine [AOR 0.48; 95%CI (0.23, 0.85)], being the only child for their family [AOR 0.28; 95%CI (0.13, 0.86)], having no boy friend [AOR 0.34; 95%CI (0.12, 0.74)], using family planning [AOR 0.50; 95%CI (0.13 and 0.86)], being 25 years or older [AOR 1.64; 95%CI (1.33, 2.80)] were significantly associated with awareness of female students to legalization of safe abortion. CONCLUSIONS Only slightly more than a third of the study participants, 35.7% have good awareness of legalization of safe abortion. Strengthening information dissemination regarding legalization of safe abortion is required for female reproductive age group in general and higher institution female students in particular.