Post-abortion family planning use, method preference, and its determinant factors in Eastern Africa: a systematic review and meta-analysis.

BACKGROUND: Utilization of post-abortion family planning is very critical to reduce high levels of unintended pregnancy, which is the root cause of induced abortion. In Eastern Africa, it is estimated that as many as 95% of unintended pregnancies occurred among women who do not practice contraception at all. Therefore, this meta-analysis aimed to assess post-abortion family planning utilization and its determinant factors in Eastern Africa.

METHODS: Published papers from Scopus, HINARI, PubMed, Google Scholar, and Web of Science electronic databases and grey literature repository were searched from database inception to January 30, 2020, with no restriction by design and date of publishing. We screened records, extracted data, and assessed risk of bias in duplicate. Cochrane I2 statistics were used to check the heterogeneity of the studies. Publication bias was assessed by Egger and Biggs test with a funnel plot. A random-effects model was calculated to estimate the pooled prevalence of post-abortion family planning utilization.

RESULTS: A total of twenty-nine cross-sectional studies with 70,037 study participants were included. The overall pooled prevalence of post-abortion family planning utilization was 67.86% (95% CI 63.59-72.12). The most widely utilized post-abortion family methods were injectable 33.23% (95% CI 22.12-44.34), followed by implants 24.71% (95% CI 13.53-35.89) and oral contraceptive pills 23.42% (95% CI 19.95-26.89). Married marital status (AOR=3.20; 95% CI 2.02-5.05), multiparity (AOR=3.84; 95% CI 1.43-10.33), having a history of abortion (AOR=2.33; 95% CI 1.44-3.75), getting counselling on post-abortion family planning (AOR=4.63; 95% CI 3.27-6.56), and ever use of contraceptives (AOR=4.63; 95% CI 2.27-5.21) were factors associated with post-abortion family planning utilization in Eastern Africa.

CONCLUSIONS: This study revealed that the marital status of the women, multiparity, having a history of abortion, getting counselling on post-abortion family planning, and ever used contraceptives were found to be significantly associated with post-abortion family planning utilization.