Comprehensive abortion care in Eastern Ethiopia: Facility readiness, service availability, and barriers in Eastern...

Unsafe abortion remains a major public health problem in Ethiopia due to persistent factors such as poor health facility infrastructure, limited service availability, and barriers that impede providers' ability to deliver the care. Thus, the objective of this study was to assess health facilities' readiness, service availability, and challenges in providing abortion care. A facility-based mixed approach with descriptive cross-sectional and phenomenological study design was conducted in 16 public health facilities in eastern Ethiopia. A simple random sampling technique was employed to recruit the health facilities. Data were collected using KoboToolbox with the WHO Service Availability and Readiness Assessment (SARA) tool. The collected data were exported to Stata 17 for descriptive analysis. The interviews of 17 health professionals were audio-recorded, transcribed, and translated verbatim. The translated data were analyzed thematically. Thirteen (82.3%) health facilities met the minimum requirements (>75%) for readiness, and the service was available in all hospitals and 8 (66.7%) health centers. Key barriers in providing abortion care were the attitude of health professionals, stigma and discrimination, religious and cultural beliefs, and shortage of trained professionals from a qualitative perspective. Access to comprehensive abortion care was impeded by facility readiness, health professionals' personal beliefs, and cultural and religious beliefs. Strengthening the health care system and ensuring professionals know abortion policy and are willing to provide quality care are crucial steps in improving the provision of comprehensive abortion care.