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Of an estimated 210 million pregnancies that occur in the world each year, 38% are unplanned, out of which 22% end in abortion. In Ethiopia, the estimates of unintended pregnancy indicate that it is one of the major reproductive health problems with all its adverse outcomes. Women risk their lives in by seeking illegal abortions following unintended pregnancies. Thus, this study aims to determine the prevalence of unintended pregnancy and associated factors among pregnant married women residing in Hossana, Southern Ethiopia. A community-based cross-sectional study involving both qualitative and quantitative data collection methods was carried out in Hossana from April 02 to 15, 2011. 385 pregnant married women randomly selected from the census were included for the quantitative data and took in-depth interviews for the qualitative. Descriptive, binary and multiple logistic regression analyses were performed using SPSS version 16. Out of the total pregnancies, 131 (34%) were unintended and 254 (66%) were reported to be intended. A history of previous unintended pregnancy, the husband not wanting to limit family size, a desire for at least two children, the number of pregnancy 3-4 and parity of 5 and above were factors significantly associated with unintended pregnancy. With over one third of pregnancies unintended, having a previous unintended pregnancy, the number of previous pregnancies, and husbands’ disagreement over family size, and the desired number of children are factors that reproductive health programs should aim to focus on to reduce unintended pregnancy. © 2012 Hamdela et al.
A community based cross-sectional study using both quantitative and qualitative methods was carried out in Hadiya zone, Hossana town from April 02–15, 2001. In Hossana there were eight kebeles (lowest administrative unit). Study from southern Ethiopia revealed that only 26.1% and 3.3% of the women received antenatal and delivery care services, respectively [7]. Census was conducted in all kebeles. The population for the quantitative survey included all pregnant married women residing in Hossana for at least six months prior to the survey. For the qualitative survey, health professionals working at reproductive health clinics (safe and post-abortion care health officers and nurses, family planning, antenatal care and urban health extension workers, clinical nurses) were included. The study populations included were purposely selected from the source population for an in-depth interview. For quantitative data, a sample from pregnant married women was considered. To determine the sample size, a single population proportion formula using a prevalence of unintended pregnancy at 35% [6], a confidence level of 95%, and a 5% degree of precision, were used. A non-response rate of 10% was also used. From this, the final sample size calculated was 385. Multi-stage sampling technique was used. A semi-structured and pre-tested questionnaire, guided by interviewer was used to collect the information. It was first prepared in English and then translated to Amharic and then translated back for consistency. Information collected included a questionnaire on demographic factors such as: maternal age; number of children; age at marriage and first sexual intercourse; previous unintended pregnancies; socio-economic and cultural factors such as education and ethnicity; husband desire for family size; desired number of children; experience of sexual violence; access to health services; and, questions on behavioral factors on modern contraceptive practice (including emergency contraceptives and breast feeding) and on reproductive history and unintended pregnancy. Four female college students and supervisor (a degree-holder) who knew the local language participated in data collection. Two days of training was given to data collectors and supervisors on the objectives of the study, the contents of the questionnaire, and particularly on issues related to the confidentiality of the responses and the rights of respondents. One week prior to data collection a pre-test was conducted in another Woreda (Ana Lemo) on 5% of the sample size. Twelve in-depth interviews were conducted with 12 individuals using purposive and convenient techniques. Six health professionals participated in the study (health professionals working at reproductive health clinics: one from safe, one from post-abortion care service, one from family planning services, one from antenatal care and two urban health extension workers). In addition, clients attending antenatal care (four) and family planning (two) were interviewed. Data collected were cleaned, edited, coded and entered to a computer, checked for missing values and outliers and analyzed using SPSS for windows version 16.0 (SPSS Inc. version 16.1., Chicago, Illinois). Simple descriptive frequency tables and then bivariate analyses were carried out. To identify the predictors of unintended pregnancy, a multivariable logistic regression model with unintended pregnancy as a dependent variable was constructed. Variables that showed significant association with unintended pregnancy on the bivariate analyses were entered into the adjusted logistic model. Interaction between variables was checked at the level of significance for the interaction term of P<0.05. The qualitative data were organized by selected themes, summarized manually and the results were triangulated with the quantitative findings. Ethical approval was found from ethical review committee of Jimma University. Written consent was obtained from Hadiya zone health office and Hossana town health office administrations. Verbal informed consent was obtained from each respondent and confidentiality was assured before conducting the data collection, to respect the respondents participating in the study. The following standard and operational definitions were used; Unintended pregnancy is a pregnancy that is either mistimed (occurred earlier than desired) or unwanted (occurred when no children or no more children were desired) at the time of conception.
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