Magnitude and Causes of Unplanned Pregnancy Due to the War in Rural Areas of the Southeastern Zone of Tigray Northern Ethiopia 2024

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Abstract

Unplanned pregnancies, defined as mistimed or unwanted pregnancies, remain a significant public health issue worldwide, particularly in developing countries. An estimated 213 million pregnancies occur annually, with 85 million being unplanned, contributing to elevated maternal and neonatal morbidity and mortality, particularly in Sub-Saharan Africa. The causes of unplanned pregnancies include contraceptive failure, lack of knowledge, and spousal disapproval. Socio-demographic factors, such as illiteracy and family size, also play a crucial role in increasing the risk. Studies from various regions indicated that various factors associated with unplanned pregnancies, such as age, marital status, and functional difficulties. This study, conducted in the Southeastern Zone of Tigray, Ethiopia, assessed the magnitude and causes of unplanned pregnancies in 2024, examining the impact of the war, which disrupted healthcare access and family planning options. The findings aimed to inform post-war reproductive health interventions and policies. Methods : A community based cross-sectional study was conducted in the South Eastern Zone of Tigray, Northern Ethiopia, targeting married reproductive-age women (15–49 years). A multistage sampling technique was used to select 910 participants from 80 tabiyas across the zone. Data were collected through structured questionnaires. Quantitative data were analyzed using STATA version 17, employing descriptive statistics and logistic regression to identify factors associated with abortion. Ethical approval was obtained from Mekelle University IRB, and verbal informed consent was secured from all participants. Result : The prevalence of unplanned pregnancy was 11.3%. Women with a history of abortion had a higher prevalence of unplanned pregnancy (36.5%) than those without (9.9%). Additionally, 12.1% of women who did not use family planning during the Tigray war had an unplanned pregnancy, compared to 4.5% of those who used it. Women not using family planning had 2.08 times higher odds of unplanned pregnancy (AOR = 2.08, 95% CI: 1.33–3.27). Those without a history of abortion had 5.2 times higher odds (AOR = 5.2, 95% CI: 2.88–9.25). Women who did not use family planning during the war had 80% lower odds of unplanned pregnancy (AOR = 0.2, 95% CI: 0.073–0.61). Conclusion : The prevalence of unplanned pregnancy was high. Current use of family planning, history of abortion, and use of family planning methods during the Tigray war were identified as determinant factors of unplanned pregnancy. Recommendation : The analysis recommends raising awareness about family planning through education, increasing accessibility and affordability of services, and providing counseling for post-abortion care. It also emphasizes the importance of continuity and availability of family planning services during conflict situations.

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