Post Abortion Contraceptive Use and Determinant Factors in Ethiopia: A Systematic Review and Meta-analysis

Background: The World health organization's recommendations aim to provide comprehensive post-abortion care for all women coming for abortion services. Different investigations have been conducted in Ethiopia reporting the prevalence and the determinant factors of post-abortion contraception, but they lack consistency and are characterized by discrepancies. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and associated factors of family planning utilization among women receiving abortion services in Ethiopia. Methods: A systematic review and meta-analysis of published and grey literature were conducted. The protocol was registered on PROSPERO at CRD42020162969. PubMed, Google Scholar, Science Direct, HINARI and Cochrane Library and Google were used to review studies starting from January 14, 2020 to March 11, 2020. STATA 14 software was used for analysis. JBI approach was used for critical appraisal, study selection, and data extraction. The possible risk of publication bias was examined using the Funnel plot, Begg's and Egger's test. Statistical heterogeneity was quantified using Cochran's Q and the I-2 test statistic. A random effect model was used as a method of analysis. Results: A total of 8236 women were involved using sixteen studies having 7 to 9 quality scores. The pooled prevalence of family planning utilization among women receiving abortion services in Ethiopia was 69.73% (95% CI: 63.67, 75.79). In addition, subgroup analysis showed the highest prevalence of post-abortion contraception on Addis Ababa city Administration,79.38 (95%-CI;66.87, 91.89). Counseling for contraceptive: (OR=3.48,95% CI: 1.94, 6.25), and history of contraceptive use: (OR=7.62, 95% CI: 3.28:17.69) have shown a positive association with post-abortion family planning utilization in Ethiopia. Conclusion: Family planning utilization among women receiving abortion services is shown to be less than the WHO and national recommendation. Counseling and history of contraceptive use were found to be significantly associated with post-abortion family planning utilization in Ethiopia.