The level and deriving factors of repeat-induced abortion in Ethiopia: A systematic review and meta-analysis

BACKGROUND: Despite repeat induced abortion is a growing challenge for both developing as well as developed countries, abortion-related complications are found to be higher among women in developing countries. This systematic review and meta-analysis was intended to assess the level of repeat-induced abortion and its deriving factors in Ethiopia. METHODS: Different data sources such as PubMed, EMBASE, Google Scholar, and University online data bases were used to identify candidate articles for this systematic review and meta-analysis. The article search was conducted from June 10 to 26, 2020. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to assess the quality of the included studies. Data extraction was performed through a format prepared on Microsoft excel work book and exported to Stata 11 for analysis. The heterogeneity of the studies was tested using Cochran (Q test) and I(2) test statistics. Publication bias was assessed by funnel plot and Egger's regression asymmetry test. Subgroup-analysis was conducted based on sample size and study Regions. RESULTS: Five studies with 2000 participants who visited health facilities for abortion services were included in this systematic review and meta-analysis. The pooled level of repeat-induced abortion was found to be 29.93% (95%, CI 23.15%, 36.71%). Urban residence (OR = 5.10, 95%, CI 2.51, 10.33), illiteracy (OR = 4.12, 95%, CI 2.40, 7.07), having multiple sexual partners (OR = 6.28, 95% CI 4.28, 9.22), and early sexual initiation (OR = 3.80, 95%, CI1.76, 8.19) were found to be the deriving factors for experiencing repeat induced abortion. However, there was no significant association between ever use of family planning and repeat induced abortion (OR = 1.03, 95%, CI 0.09, 11.59). CONCLUSION: The level of repeat-induced abortion was found to be high in Ethiopia. High risk of experiencing repeat-induced abortion was reported among participants who were urban residents, illiterate, who had multiple sexual partners, and early sexual initiation. However, a statistically significant association was not found between ever use of family planning and repeat-induced abortion. Health education shall be given about the risk of subsequent abortion and the relevance of avoiding unintended pregnancy, multiple sexual partners, and early sexual initiations through various mechanisms.