{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:20:31Z","timestamp":1786972831070,"version":"build-2736575974"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T00:00:00Z","timestamp":1577664000000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Abortion is one of the major direct causes of maternal death, accounting for 7.9% globally. In Africa, 5.5 million women have unsafe abortions annually. Although maternal deaths due to complications of abortion have declined in Ethiopia, women still die from complications. Few studies have focused on providers\u2019 clinical knowledge. This study investigates the level of health workers\u2019 knowledge of comprehensive abortion care and its determinants in Ethiopia.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Data from the national emergency obstetric and newborn care (EmONC) assessment was used. A total of 3804 facilities that provided institutional deliveries in the 12\u2009months before the assessment were included. Provider knowledge was assessed by interviewing a single provider from each facility. Criteria for selection included: having attended the largest number of deliveries in the last one or two months. A summary knowledge score was generated based on the responses to three knowledge questions related to immediate complications of unsafe abortion, how a woman should be clinically managed and what the counselling content should contain. The score was classified into two categories (&lt;\u200950% and\u2009&gt;\u2009=50%). Logistic regression was used to determine individual and facility-level factors associated with the summary knowledge score.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Result<\/jats:title>\n<jats:p>A total of 3800 providers participated and the majority were midwives, nurses and health officers. On average, providers identified approximately half or fewer of the expected responses. The multivariate model showed that midwives and nurses (compared to health officers), being female, and absence of training or practice of manual vacuum aspiration were associated with lower knowledge levels. Important facility level factors protective against low knowledge levels included employment in Addis Ababa, being male and having internet access in the facility.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>To increase knowledge levels among providers, pre- and in-service training efforts should be particularly sensitive to female providers who scored lower, ensure that more midlevel providers are capable of performing manual vacuum aspiration as well as provide special attention to providers in the Gambella.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12913-019-4857-8","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T12:02:29Z","timestamp":1577707349000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors associated with health care provider knowledge on abortion care in Ethiopia, a further analysis on emergency obstetric and newborn care assessment 2016 data"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2327-136X","authenticated-orcid":false,"given":"Tefera","family":"Taddele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodros","family":"Getachew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girum","family":"Taye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misrak","family":"Getnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atkure","family":"Defar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habtamu","family":"Teklie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geremew","family":"Gonfa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheleme","family":"Humnessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aster","family":"Teshome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenebe","family":"Akale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasahun","family":"Mormu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebe","family":"Bekele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,30]]},"reference":[{"key":"4857_CR1","unstructured":"WHO. Maternal Health and Safe Motherhood Programme. The Prevention and Management of Unsafe Abortion. Report of a Technical Working Group, Geneva, April 1992 [Internet]. 1993. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/59705"},{"key":"4857_CR2","volume-title":"Facts on Unintended Pregnancy and Abortion in Ethiopia [Internet]","author":"Ipas","year":"2005","unstructured":"Ipas. Facts on Unintended Pregnancy and Abortion in Ethiopia [Internet]. 2005. Available from: https:\/\/www.guttmacher.org\/sites\/default\/files\/factsheet\/fb-up-ethiopia.pdf."},{"key":"4857_CR3","unstructured":"Singh S, Wulf D, Hussain R, Bankole A, Sedgh G. Abortion Worldwide: A Decade of Ueven Progress [Internet]. 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Available from: https:\/https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK305149\/pdf\/Bookshelf_NBK305149.pdf."},{"key":"4857_CR6","volume-title":"Technical and Procedural Guidelines for Safe Abortion Services in Ethiopia","author":"FMOH","year":"2013","unstructured":"FMOH. Technical and Procedural Guidelines for Safe Abortion Services in Ethiopia. 2nd ed; 2013.","edition":"2"},{"key":"4857_CR7","first-page":"111","volume-title":"The Estimated Incidence of Induced Abortion in Ethiopia, 2014: Changes in the Provision of Services Since 2008","author":"AM Moore","year":"2017","unstructured":"Moore AM, Gebrehiwot Y, Fetters T, Wado YD, Singh S, Gebreselassie H, et al. The Estimated Incidence of Induced Abortion in Ethiopia, 2014: Changes in the Provision of Services Since 2008. 2017;42(3):111\u2013120."},{"key":"4857_CR8","first-page":"417","volume-title":"Meeting the need for safe abortion care in Ethiopia: Results of a national assessment in 2008","author":"A Abdella","year":"2013","unstructured":"Abdella A, Fetters T, Benson J, Pearson E. Meeting the need for safe abortion care in Ethiopia: Results of a national assessment in 2008. 2013;8(4):417\u2013434."},{"key":"4857_CR9","unstructured":"Democratic Republic of Ethiopia. The Revised Family Code. Federal Negarit Gazetta of the Federal Democratic Republic of Ethiopia [Internet]. 2000;(1). Available from: https:\/\/www.refworld.org\/pdfid\/4c0ccc052.pdf."},{"key":"4857_CR10","unstructured":"FMOH. Ethiopian Health Sector Transformation Plan. 2015\/16\u20132019\/20 [Internet]. 2015. 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Informed oral consent was obtained from each facility and participant.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1014"}}