Assessment of knowledge, attitude

and

practice towards abortion in women among age

15-49 years at Karmuk Wereda, Assosa
Zone,Benishangul Gumuz Regional State
weastern Ethiopia ;

BY:-mohamedajib almahadi albashire

A RESEARCH PROPOSAL resultsSUBMITTED TO
CENTRAL UNIVERSITY COLLEGE PUBLIC HEALTH
DEPARTMENT IN PARTIAL FULFILLMENT FOR
REQUIRMENT OF THE BACHELAR OF SCIENCE (BSC) IN
PUBLIC health officer /HO/ LANCHA CAMPES

ADVISER DR: AHEMDIN NURHUSSIEN,BSC, MD, MPH

April

2012 GC

Addis Ababa,Ethiopia

ACKNOW LEDGEMENT

I would like to express my sincere appreciation and heart felt gratitude and
thanks to my advisor, Dr Ahemdin Nurhussien for his Illustrative and
consecutive support, advice, suggestions, comments, encouragement and
useful hints to develop this research.
My sincere appreciations also goto Benshangul Gumuz Regionall state
Educational & building office (Akasha Ismael) for providing me with different
reference material to write this research paper.Also my thanks go to Hellen
Aberafor helping me to write this research paper. Last, but not least, I am
grateful to my friends for their kindly cooperation and support through
different ideas.

ABSTRACT
Background: - Abortionis one of the major causes of maternal morbidly and
mortality in the world,especially in the developing countries where the concern
isabortion is not, yet, disseminated to the community. Abortion, most
usually,ends up in death in the absence of information onuses family
painingand unwanted pregnancy. So, to limit, this abortion problems reduce its
recurrence/ repetition, we must to promote immediate contraception uses.
Therefore as abortion complications range from short to long- term morbidity,
they can finally leadsto infertility and death. Also, in addition to health
problems, abortion contributes to social, psychological and overall economic
negative impacts. The burden of abortion can be controlled by the use of
contraceptive methods. But, some studies haveshown that contraceptive use
prevalence rate in this country isonly about 14.7% and there is 34.8% of unmet need in contraception for both child spacing and limiting family size (WHO
2007).
Objective- The objective of the study is to assessthe prevalence of knowledge
altitude, and practice of abortion among Kurmuk Wereda, Assosa zone
Benishangule Gumuz Region.
Method: - a cross sectional retrospective study will be undertaken from
January 2012 to July 2012.

Work planand Budget: all the activities will be carried out by the supervision
of the investigator and assistance. It will involve also the study population
including women who receive abortion care services , not received abortion care

services. And who will be willing to participate in the study of kumurk wareda
will be include. The cost of investigator will be end up for about 64,787
Ethiopian local Birr, with the time of a few months respectively.

III

content

Table of contents

page

Acknowledgement..
i
Table of contents
ii
Abstract
iii

ChapterOne
1. Introduction

1.1.
Background
ofthe Study ..
1
1.2.
Statement ofthe
Problem. . . . 4
1.3.
Significance
ofthe Study ..
7

ChapterTwo
2. Literature

Review

Chapter Three

3. Objectives .. 10
3.1.
Objectives
3.2.
Objectives

General

.. 10
Specific

Chapter Four

10

4. Methods and Materials .

11

4.1. Study Design 11

4.2. Study Period

11

4.2. Study Area

...11

4.3. Population

12

4.3.1. Source Population

.
12

4.3.2.

4.4.

4.4.1.

Study

Population

.
12

Selection

Criteria

..
13

Inclusion

Criteria

.
13
II

4.4.2.

Exclusion

Criteria

..
13

4.5. Sample Size and Sampling Technique

13

4.5.1. Sample Size

. 13

4.5.2.

Technique

Sampling

14

4.6. Study Variables

14

4.6.1.

Dependent

Variables

4.6.2.

Independent

14

Variables...

14

Clearance

.
14

4.8.3. Quality Assurance

..
14

4.7.3.

Ethical

4.9.3. Data Processing and Analysis

..
15

4.10. 3. Validity and Reliability

..
15

4.11.3.

..
15

Ethical

Considerations

4.12. 3. Operational Definitions

4.13. Dissemination ofthe Result

4.14. Limitation of Study

.
15
..
16

16

Chapter Five
Work Plan ...
Budget

Breakdown

Dummy Table

Required

17

.
18

. 19

Reference 27

Annex
Questionnaire 31
Acronyms 43

Chapter One
1. Introduction
1.1. Background Of The Study

Abortion is an important cause of bleeding during pregnancy. It is one of the

five leading causes of maternal deaths. The others, obstructed labor,
hypertensive disorder of pregnancy, hemorrhage and infection by occurrence
spontaneous or induced abortion are occurs with no intervention. So,
Incidence 10-20% of all pregnancy it is most commonly due to fetal
chromosomal defect such as trisomies, monosomies, polyploidy- usually
occurred during 1st trimester(62,1,11).
It is results from medical or surgical intervention that can cause abortion. It
could be safe or unsafe. Unsafe abortion is characterized by lack or inadequacy
of skill of the provider hazardous technique and unsanitary facilities or both. It
accounts for the majority proportion of abortion. Is cause of considerable
maternal morbidity and mortality. Abortion is related to unwanted pregnancy
and unawareness of reproductive physiology by the women. It can largely be
prevented if there is provision of contraceptive service and making the women
aware of her reproductive physiology(19.53).
More than 50% of the world population is less than 25 years old, with one in
three people aged 10-24 years (1). In many countries, more than 50% of the
population has unprotected sex before the age of 16, without contemplating the
consequences,

and

without

accurate

information

on

abortion

verses

contraceptive protection. Five million out of an estimated total of 50 million

induced abortions worldwide occurs in women aged 15-19 years (2).
More than half of women in African countries have their first marriage and
being child bearing before the age of 20(3).
In sub-Saharan Africa abortion is among the five leading causes of maternal
deaths (4). Studies conducted in Ethiopia also show that women get married

before the age of 20(5). More than 50% of the people who are infected with
HIV/AIDS in the world are under age 25(6).
Puberty and post- puberty youth undergo a host of normal, physiological and
psychological changes that cause them to desire sexual intercourse and take
risks, with limited access to information about sex and sexual development
and lack of access to counseling on family planning services as well as abortion
and sexually transmitted infection (STIS): Adolescents end up with unwanted
pregnancies .They contract abortion which lead them to have show early
bleeding before 28weeks of Pregnancy.
Pregnancy and child birth are more hazardous for girls under 16 years of age.
Hypertension, Anemia, Obstructed labor, Toxemia, Hemorrhage and Infections
are more common among teenagers than among women aged 20-34 years.
Teenagers seeking abortion are more likely to delay findings and inducing the
abortion themselves. Pregnant teenagers often leave school early and are more
likely to be poor (8). women who first give birth as teenagers are more likely to
school dropouts than those who delay motherhood due to lack of education,
family instability and lower incomes. This situation leads to more adolescents
to form the child bearings age in successive generation and, have, maintaining
a vicious cycle(6,9).
An urgent need, therefore, exists for young people to protect themselves against
HIV/AIDS, other STIs; unwanted pregnancy(abortion) and experience safe and
healthy sexual development. [Information, education, and communication (IEC)
programs aimed at achieving behavior and attitude changes among young
peoples are among the strategies designed to protect young people from STDs.
Unintended pregnancy and abortion(67).

In order to design optimal IEC programs,research on the reproductive health of

adolescents is needed the results of which could be used to carry out
intervention programs that are appropriate.This calls for investigation of the
needs and concerns of young people. There is policy of information on
knowledge of contraceptives sexual practices for adolescents. Although there
are few educational activities on reproductive health for the young people, they
are not research based (10).
The government health system in Ethiopia emphasizes the provision of
essential services at the community level. To advance family planning and
other services in keeping with this goal, the government is developing a corps
of30,000 health extension workers (HEWs) to staff 15,000 health posts and
conduct household visits at the village level. For instance, in Benishangul
region, the coverage of health extension workers is estimated of around 97% to
reach each kabale level(23,71).
These

government-paid

workers

are

distinct

from

volunteers

such

as

community-based reproductive health agents. So In Benishangule Region, the

way we talk about family planning to the

health of the mother and

reproductive age group (15-49) is sustained or every kebele and town of the
Region.
But surprisingly enough,
knowledge

the community based RH groups

regarding the burden of unwanted Pregnancy

limited of IEC
there leads to

abortion, morbidly and mortally. Because this age group is parching unsafe
sex before 20 years this shows less knowledge,attitude and Practices. Kurmuk
wereda a forgotten waredas. House, research concerning abortion and its
complication as well as associated risk factor is needed thus,

after the end of

this initial researched sample I hope the decimated burden of abortion in this

study area will be putted under control to reduces even the risk as much as
possible (10,12).

1.2. Statement Of The Problem

About 210 million pregnancies occur each year and about 46 million end in
abortion out of which 20 million are unsafe abortion. About 70,000 women die
as a result of unsafe abortion. More than 95% of such deaths and injuries
occur in due developing countries. In Ethiopia, maternal losses from abortion
and its complication is 20-50% of modermd of deaths. Such death result from
hemorrhagic shock and sepsis (11, 12, 13).
The health status of the Benishangule region is very poor compared to the
other regions in the country. (2002). A study by MOFED the infant and under
five mortality rates for the region 117 and 173 per 1,000 people against the
national average 98.6 and 140.1 respectively. (MOH 2003). The maternal
mortality rate of 950 per 100,000 live births is also higher than we national
average (871/100,000 live births) (MOH, 2003; RHB, 2004).The major causes of
maternal mortality in the region are obstructed labor, hemorrhage, sepsis,
abortion and eclampsia(51,67).
During late 1970s and 1980s, the developing countries underwent severe
economic crisis at the best of the external creditors and Donor. The crisis
represented a sharp reversal of the gain made earlier. The creditors were
organizations like the World Bank and the International Monetary Found (IMF)
(44).
Donors have insisted on Structural Adjustment Programmed (SAP)which
affected the developing countries social and economic polices adversely.Kibirige
(1977) also stated as one of the explanations for the money problem that faced

Africa is population growth. Africa has the highest mortality rate in the world
and the rate of population growth is higher than in any other region (15).

Because the Ethiopia population growth is at the rate of 2.9% annually

suggests that the population will double in less than 23 years and the current
fertility rate of 7.7 children per women also threatens the prospect of rapid
economic growth (16).
There are an estimated 200 million pregnancies around the world per year.
Approximately one third of these or 78 million are unwanted. These
pregnancies contribute to maternal health problems in two ways. First,
pregnancies are unwanted for reasons that can threaten the womens health
due to abortion or lack the support and resources she needs to consume with a
healthy pregnancy and raise a healthy child.
Second, where women do not have access to safe abortion services, every year
approximately 50/46 million unwanted pregnancies are terminated. Some 20
million of this abortions are unsafe. About 95% of unsafe abortions take place
in developing countries causing deaths of at least 200 women each day
(17)thus. The use of contraceptives among unmarried young women is
considerably high in developed countries than developing countries. In Africa
contraceptives are used by more than 15% only in few countries by married
women of reproductive age group (18).

Also, many underlying traditional values and practices continue as a persistent

influencer attitude which may lead to negative reactionstowards family
planning agomernie universal desire among Africans for many children (19) In
1994,21% of married women of reproductive age (one third of a contraceptive)

stated that they were relying on traditional methods, primarily withdrawal or

the calendar method for contraception (VNICDs 1995).At least one study has
demonstrated that the preparation of women in both urban and rural is
increasing in recent years (20).

Unwanted pregnancy and abortion are big problems in Ethiopia. For instance,
the current report from Yekatit 12, Blak Lion ,Zeutidu Memorial Hospital
regarding abortion and unwouled prewar relaed are alarming figures. More
than 60% of pregnancies of adolescents are unwanted which is offer an
alarming figure.Most of these pregnancies end up as unsafe abortions(41,1).

A community based survey in BGRS showed that 0.7 % of maternal deaths

result from unsafe abortion. In Ethiopia, 20% of abortions occur in girls
between 15-19 years of age (6). Besides, others develop different many
implications; which affect the life of women. Gender-based violence like
abduction, rape and sexual violence are common sexual reproductive health
problems which need to be addressed accordingly.

The practice of modern contraceptive method to prevent unwanted pregnancy

among college and preparatory student in benishangul region was low;
although awareness is high.On the other hand, lack of Knowledge among
health providers is a problem and negative attitudes toward providing
adolescents with knowledge of abortion and modern contraceptive method
poses equal challenges, since most preparatory students are from rural areas,
the chance of getting information is limited. Living alone without parents
supervision may worsen the exposure to unintended sex and unwanted
pregnancy bud abortions (22, 23, and 1).

1.3. significance of the study

Knowing the level of the prevalence ofabortion in the population of kurmuk
wereda will help decision makers to plan and implement programs related to
womens need concerning abortion. Abortion, both safe andunsafe is not
studied or researchedin kurmuk wereda population. Thus, this studys results
will help as base line data for Benishangul Gumuz Regional HealthBureau and
for further other related studies (22,25).

There were high maternal and child mortality rates, relatively low life
expectancy rates, high infant and maternal mortality rates ,low literacy
rates,high infant and malnutrition are rampant under such circumstances as
the vulnerable groups are women and children who suffer the most mother
death from unwanted pregnancy, abortion, anemia and infants from sever
acute malnutrition more in developing countries (14).

Chapter Two
2. Literature Review
The world health organization WHO,(1994) showed that unwanted pregnancies
and abortions were more common in teenagers, particularly in Africa and Latin
America. Hence, young groups were at great need concerning agencies to solve
their problems. As to Ethiopian situation, the establishment of the Family
Guidance Association of Ethiopia (FGAE) in 1966, as a non-governmental and
non- profitmoking association to provide services information to families who
are volunteer to space their children was a good start. The FGAE also involved
many governmental and public agencies as to reduce maternal deaths through
education and motivation (11,33).
The contribution of Africa for population increase is especially from large and
fast growing population of adolescents. Studies conducted of Okinfu F.E and
Snow R.C showed that several countries in Sub-Sahara Africa have large and
increasing adolescent populations that exceed those from other parts of the
world. Studies in Botswana and Kenya showed that even if college women are
high school dropouts. They were allowed to return to school a year later in
Liberia, are also permitted to transfer to night school (13).
As experience and observation in some health institutions in Ethiopia have
Shown that unwanted pregnancies and abortionswere common among school
students and most of them lack the knowledge about contraceptives verses

abortion; further the most commonly given reason, in about 45% of cases for
not using contraceptive method is perceived lack of exposure to pregnancy, fear
of side effect and cost are for non use in about 1/3 of cases. Therefore/ many
women are easily faced by un wanted pregnancies that lead to abortion (15).
A survey on abortion was carried out among 1674 subjects (age group 15-49
years) in Harer Town, Eastern Ethiopia. About 54 present of students
mentioned about unwanted pregnancy.
However, large number of students did not know answers to specific question;
about prevention of pregnancy. The students were receptive to more
information in school on sexually and unwanted pregnancy. Overall, 20%, of
females and 65% of males admitted having sexual intercourse at least once
(55).
Among sexually active females, 60% said they were using a contraceptive
method, 20% of the sexually experienced students had been pregnant and of
these 50%were exposed to induced abortion. If only unmarried students were
considered, 75% of those who had been pregnant had an induced abortion.
Since induced abortion is not legal in Ethiopia, these students were at high
risk for complications of abortion (17). Therefore, this clearly showed that the
need for knowledge about abortion and its complications

is great that invites

the health organizations and the communities to focus on the establishment of

education on reproductive health and family planning programs to prevent
unsafe abortion (56).

Similarly, in a study that was conducted in Kenya, among a sample of urban

youth, age 15-29 years, indicated that, thought most of the youth seemed to
have some sort of information, the methods known by the respondents were
few in that the most widely know method in the sexually active, about

prevention of un safe abortion in 87% have answered. Attitude towards

cultural behavior also influenced the reduction of abortion.When information
was available on contraceptive and different family planning methods,were
accessible for utilization to adolescent, their attitudes towards abortion the well
in the positive direction and have, more knowledge acquisition on the
prevention, of abortion (77).

A study done in Gonder among boys and girls felt the need for sex education
including information about unsafe abortion; they a greed that ignorance was a
major reason for pregnancy among school girls. (59).

Chapter Three
3. Objectives
3.1. General Objective:

To Assess the knowledge, attitude and

practice towards abortion in women of Karmuk Wereda, Assosa

Zone,Benishangul Gumuz Region State;

3.2. Specific Objectives

1.1.1
1.1.2
1.1.3
1.1.4
1.1.5

To assess knowledge about abortion.

To assess attitude about abortion.
To assess practices about the cause of abortion
To assess awareness towards the severity of induced abortion.
To give relevant recommendation and suggestion based on finding.

Chapter Four
4. Methods and Materials
4.1. Study Design
A cross sectional quantitative study will be conducted to assess the KAP
Of abortion among a community in Kurmuk Wereda Asosa Zone Benishangule
Gumuz Regional State.

4. 2. Study Period
This study will be conducted from March 19/2/12 to July 12 /O7/12

4.2. Study Area

Benishangul- Gumuz Regional state is one of the nine regional states
established in 1994 by the new constitution of Ethiopia that created a federal
system of governance. The region is located in the western part of the country
between 09.170- 12960 North latitude and 34.100 -37.040 east longitude. The
region has international boundary with the Sudan in the west and is bordered
by the Amahara Region in the north and northeast, Oromiya in the Southeast

and Gambella in the South (see fig.1). the regional capital, Asossa is located at
a distance of 687 km west of Addis Ababa.
The region has a total area of approximately 50,380km 2 with an altitude
ranging from 580 to 2,731 meters above sea level (masl). Agro- ecologically, it is
divided into kola about 75% (lowlands below 1500 masl), woina Dega about
24& (midland between 500-2,500mas) and dega about 1% (highland above
2,500 masl). Annual rainfall varies from 800 to 200) mm. The temperature
reaches a daily maximum of 200c to 250c in the rainy season and rises to 35 0c to
40c in the dry season. The hottest period is from Feb. to April. The minimum
daily temperate ranges from 120c t 200c depending on season and altitude.
Based on CSA abstract of 2003 the total population of the region as of July
2003, is about 980,000 (49.7% Female & 50.3% Male).
This indicates a population density of 11.5 persons /km. he average number of
family members of a householder in the region is 7.0 the. The population
composition of the order of population number is Berta (50%) Gumuz (22%)
Shinasha (10%) Mao (5%) and Komo (2% significant numbers of Amhara 10%)
Oromo (3%) and others (0,7%). Significant numbers of resettlers brought to the
region from different parts of the country, as a result of the national
resettlement program conducted by the past government, are also to be found.
Religion wise about 85% are Muslim, 10% orhodox chrstian, 1% catholic, etc
.
This study will be conducted in a community in Kurmuk Wareda Asossa Zone
Benishangule Gumuz Regional State (BGRS) which is located in Western
Ethiopia. BGRS is one from nine regions of Ethiopia. It has a total population
of about 930,000. There are 2 governmental hospitals 35 health centers, 45
high school 340 elementary school, 01 nursing school, 5 DVT collage, 01
university, 6 private collages, 01 private high school, and 5 private elementary

schools. In this wereda. Asossa Zone has a total of 1o,883 women and kurmuk
has a total of 4,774 estimated women(2012 BGRS SURVEY)

Figer 1.Show the Benishangul Gumuz Region(13)

Most of Benishangul Gumuz is sparsely populated. This map shows

Benishangul-Gumuz Weredas by their location in mid-2008.

4.3. Population
4.3.1. Source Population
All female population of the kurmuk Warda

Asossa Zone, BGRS, during

during the study period March. 2012 to July 2012 will serve as the study
source population

4.3.2. Study Population

All females in the reproductive age group at Kurmuk Wereda Asossa Zone
Benishangul-Gumuz Region, based on is the population proportion.

4.4. Selection Criteria

4.4.1. Inclusion Criteria
All females in the reproductive age group at Kurmuk Wareda Asosa Zone who
will be willing to participate in the study will be include.

4.4.2. Exclusion Criteria

All Females in the reprotducfuie age group who will not be willing to participate
in the study will be exuded.Also those who have problems associated with
hearing understanding the language will be excluded

4.5. Sample Size and Sampling Technique

4.5.1. Sample Size
The sample size will be determined by the formula
n=Z (1 d) P (1-P)
D2
Where n= number of minimum sample
Z=confidence interval =95% (CI-1.96)
P=population proportion of the same character (abortion proportion)
D= margin of error allowed to occur (0.1)
Due to lack of previous study to show the prevalence abortion
among female of study population. The investigator has used the
maximum for p=0.5
n= [(z2) p (1-p)]
d2
n=(1.96)2 x 0.5(1-0.5)]
(0.1)2
[3.84 x 0.5(0.5)]
0.01
3.84 x 0.25
0.01
N= 96

4.5.2 Sampling Technique

Probability sampling method will be employed. A sample size will be

calculated among female population

using stratified random sampling

technique. The calculated sample size will be allocated to each educational level
as proportional to size method. Then, after preparing a frame list of female
students for each woman, sample unit (one female popn) will be selected
by simple random sampling method.

4.6. Study Variables

4.6.1 Dependent Variables
Knowledge: of female population at the k/k (Kurmuk) wareda Asossa zone
BGRS towards burden of abortion.

4.6.2. Independent Variables

1. Age
2. Marital status
3. Religion
4. Educational level
5. Educational level of parents
6. Ethnicity
7. Parents income
8. Occupational status of parents
9. Others/specify

4.7. Ethical Clearance

A structured questionnaire developed by the principal investigator in English
Language will be used to collect information via self administrated technique.A
formal

and

official

letter

of

permission

will

be

obtained

from

the

CentralUniversity College Lancha Campus, public health department and

writteninformed consent will be obtained from respondents or participant.

4.8. Quality Assurance

The researcher will perform regulation of the questionnaire and will conduct for
Data collectors and well carry out supervision during interview

4.9 Data collection

A self administers semi-structured English guestioneries was used.

4.10. Data Processing and Analysis

The collected data will be compiled and analyzed using a scientific calculator
Chi-square test will be employed. The results will be presented using
Appropriate tables, graphs; pie charts and further more interpretation will be
Made based on the findings.

4.11. Validity and Reliability

Pre-test will be conducted to check the validity of the instrument and the
collected will be checked for completeness, accuracy, clarity and consistency.
Any error, ambiguity or incompleteness will be identified and corrected
Validity, a quality of an instrument important to evaluating its worth. For
actual data collection, the questionnaires will be tested for their accuracy and
increased data quality assurance; Pre testing will also be done among non
study participants before the actual data collection.
.4.12.

Operational Definitions

Knowledgeis awareness of the presence of abortion and other UTI, STI

unprotected sex, its sources, and ability to identify when abortion should be
happen after unprotected sex, its complication, its seriousness , its severity,
distribution and whether dangerous is happens in the effective after a lady
has unsafe sex. good knowledge:- If a respondent answer correctly more than
80% for knowledge questions.
_ Fair knowledge:- b/n 50% and 60%
_ Poor knowledge:- below 50%
Attitude;- Is individual behavior toward action of unwanted pregnancy which
leads abortion problems.
Good attitude; - if respondant answer correctly more than 80% forquestions
Fair attitude;-b/n 50% and 60%
Poor attitude;-below 50%

. Abortion practice: Ever had sexual intercourse/abortion.

Forced sex: Sexual practice performed without informed consent of the
Partner, sexual assault (usually females) abortion /any miscarriage is
becoming pregnancy of less than 28wks (below 7 month).
Good practices;- if respondent answer more than 80%
Fair practices ;- if b/n50-60%
Poor practices;-less than 50%

Abortion classification: -

Type of abortion and its seriousness understanding are better to prevent

unwantedPregnancy following an unprotected/un intended act of sexual
intercourse..
Induced abortion; Termination of pregnant women before the fetal viability.
Safe abortion; abortion done by health workers and any health professionals.
Unsafe abortion; done by people which are out of medical skilled personnel.
Spontaneous abortion; is a loss of pregnancy before 28 weeks of gestation.
Threatened abortion; a type of abortion in which the pregnancymay have a
chance of continuing normal pregnancy. Also not responds medical treatments.
I, e not necessary.
Inevitable abortion;a pregnancy will be naturally continued and will proceeds
to either complete or incomplete abortion.
Incomplete abortion; a partially expulsion of fetus from the uterus.
Complete abortion; the products of conception are completely expelled.
Septic abortion; abortion complicated by infection.
Missed abortion; abortion occur in the form of fetal death within four month
in the uterus and not known by women herself /confuse

4.13. Dissemination ofthe Result.

The study results will be disseminated to the Central University College.

4.14. Limitation of Study

Lack of finance
Shortage of time
Shortage of information (data)

 Remote of the study place

Lack of accesses. to what
transportation
stationery
equipment
resource

Budget Breakdown
All The Resources Required are Presented by Unit and Total Cost as
Follows.

Description

Measurement

Required

Materials /Item/
-Stationary

(unit)
Pack(500sheets)

quantity
2

Birr
150.00

Cost in Birr
300.00

-Duplication paper

Piece

7.00

14.00

- Pen

Piece

1.00

- Pencil/plaster

Piece

3.00

6.00

- Marker

Piece

1+1

10+5

15.00

Printing

Piece

4*

40.00

160.00

Human power

Per day

70. per day

560.00

Transportation cost

Per day

15

Cover psg

piece

10.00

Secretarial work

once

100

400.00

134.8

800.00

300.00

200.00

3000,00

Contingency (10% )
Advisor

addition
once

Internet
Cd reader/filash
Ration stock out

Unit cost in

2000

Total

3000

Grand total

22,372

5. Dummy Table
Table1:- Distribution of Respondents by Demographic Characteristics In,
Female Population Kurmuk Warda Asosa Zone
Variable
Age 15-49
15-19 years
20-24
25-29
30-35
>36
Total
Religion
Muslim
Protestant
Catholic
Orthodox
Others
Total
Educational Level
Illiterate
Read &write only
Elementaryschool
High school complete
Total
Marital status
Single
Married
Divorced
widowed
Total
Ethnicity
Arabic

No

Remark

Berta
gumuz
Shinasha
mao-como
Amhara
Oromo
Tigrai
Somali
Others
Total
Table 2:- Distribution of Respondents Parents by Their Educational Level in
Female Population, of Kurmuk Wereda Asossa Zone, BGRS, 2012
Educational level of parents
Father not read & write
Only read & write
1-6 grade
7-12 grade
12+
Total
Mother Not read & write
Only read & write
1-6 grade
7-12 grade
12+
Total

No

Remark

Table 3:- Distribution of Respondents Parents by Their Occupation, in

Female Population of Kurmuk Wereda, Asossa Zone BGRS, 2012
No

Occupation of parents
Father
Government employee
Merchant
Farmer
Daily labor

Remark

No work
Total
Mother
Government employee
Merchant
Farmer
Daily labor
No work
Total
Table 4: Distribution of Respondents By Knowledge of Their Source of
Information On Abortion, Female Population of Kurmuk Wereda, Asossa
Zone, 2012.
Source of
nformation
Television
Radio
Book
News paper
Pamphlets
Magazines
Teachers in class
Parents or relatives
Friends
Notice board
Other(specify)
Total

No

Remark

Table 5:- Distribution of Respondents By Their Knowledge about Abortion

in Female Population of Kurmuk Wereda Asossa Zone, BGRS, 2012
No

Know ledge of type of abortion

1. Abortion
2. therapeutic abortion
3. Spontaneous abortion
4. Complete abortion
5. Incomplete abortion
6. Induce abortion
7. Missed abortion
8. Threatened abortion
9. Inevitable abortion
10.
Recurrent abortion

Remark

Table 6:-distribution ofRespondents knowledge for understanding of

Abortion problem

among community of Kurmuk Wereda, Asossa Zone

BGRS, 2012
No

Variable
Unwanted pregnancy
Heath problem
Drugs
Early marriage
Child spacing
Poverty
Rape
Abduction

Remark

Table 7:- distribution ofRespondents by knowledge about impacts of

Abortion problem

toward maternal health among community of Kurmuk

Wereda, Asossa Zone BGRS, 2012

Variable

No

Remark

Still birth
Death
Anemia
Server bleeding
Shock
Hypotension
Infertility
Cervical cancer
Other/ specify
Table 8:- Distribution ofRespondents knowledge on clinically common
type of Abortion problem among community of Kurmuk Wereda, Asossa
Zone BGRS, 2012
No

Variable

Unsafe abortion
Safe abortion
Table 9:- Distribution ofRespondents

by knowledge abuot common

classification of abortion problem among community of Kurmuk Wereda,

Asossa Zone BGRS, 2012.
Variable
Induced abortion
Complete abortion
Incomplete abortion
Therapeutic abortion
Septic abortion
Molar pregnancy

No

Remark

Table 10:-Distributions ofRespondents by Attitude towards Abortion

problem

among community of Kurmuk Wereda, Asossa Zone BGRS, 2012

Variable
N
Absence of family

No

Yes
o

Total
%

planning
Cause of anemia
Cause infertility
Cause poverty /ill health
Cause of death
Other
Total

Table 11:-Distribution ofRespondents by Attitude towards predisposing

factors for Abortion problem

among community of Kurmuk Wereda,

Asossa Zone BGRS, 2012

Variable

Yes

No

Remark

Health problem
Divorce
Widowed
Drugs induce
Rape
Lack of
contraceptive
Injuries /tumor
Others

Table

12:-Distortion

of

Respondents

by

Practice

about

Abortion

Prevention by Their Religion, Female Population of Kurmuk Wereda,

Asossa Zone BGRS, 2012
Religion

Practice of contraceptive method

Yes
No
No
%
No
%

Total
No
%

Remark

Muslim
Protestant
Catholic
Orthodox
Others
Table 13:- Distributions of Respondents by Practice toward Abortion care
service among Female Population of Kurmuk Wereda, Asossa Zone BGRS,
2012
No

Variable

Remark

Governmental health service

Non governmental health service
Private health service
Traditional birth attendant
Other
Table 14:- Distributions of Respondents by Practice

towards prevention of

abortion Family planning service of Kurmuk Wereda, Asossa Zone BGRS, 2012

Variable

No

Remark

Pills
Injection
Norplant
IUCD
Condom
Others

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human reproductive 1sted,USA\UK,1990;12:200.
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of

awareness

on

reproductive
3. Health among yoth. Evidence from,Hara,Eastern Ethiopia, Eth.J.H.
4. Dut, 1999,13(2):107-113.
5. UNICEF, children and women in Uganda:A situation Abnalysis UNLCEF
Ug and 1997.

6. Tesfaya G/selassiae: Deferminants of contraceptives use among

7. Urban youth in Ethiopia, ETH,J,H&DUT, AUG 1996: 10(2): 97-98.
8. Ethiopian Societies of Obstetricians and Gynaecologists (ESOG).
Guideline
9. On Management of sexual Assault. 2004 Addis Ababa, Ethiopia.
10.
International federations of obstetrics and gynecology (FIGO) and
11.
Ethiopian society of Obstetricians and gynecologists (ESOG).
Sexual and
12.
Reproductive health right project, Human right code of ethics fore
13.
productive health workers practicing in Ethiopia,2004. Addis
Ababa,Ethiopia
14.
CORHA. Assessment of the reproductive health situation/problems of
the
15.
students inAddis Ababa, Bahir Dar, Jimma, and Mekele Universities,
16.
Addis Ababa. benishanoule
17.
Mulugeta E, Kassaye M, Berhane Y. Prevalence & outcomes of sexual
18.
violence among high School students. Ethiopian Med. Journal 36(3) 167
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Addis Ababa, Ethiopia. 1998
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A. Worku, M. Addisie. Sexual violence among female high school
students
21.
in Debark, North-West Ethiopia. East-African Medical journal.2002
22.
Y. Gossaye, N. Deyessa, Y. Berhane Et al. Womens health & life
events
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study

in

rural

Ethiopia.

The

Ethiopian

journal

of

health

development.
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Vol.17,second special issue 2003
25.
Adugna, et al. (1999). A Study on the Prevalence of HIV/AIDS in Assossa
Hospital, Assossa
26.
Assessment on Institutional Arrangement and Functioning
Mechanisms for Food Security Program, Oxfam Canada/Population
Settlement and Food Security Office, Assossa, August 2004
27.
Benishangul-Gumuz Region/Oxfam Canada (2003) Report on
Institutional Capacity Assessment, Asossa
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Benishangul-Gumuz Region Rural Development Coordination
Office (2004) Three-year Strategic Plan (2003/04-2005/06)
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Benishangul-Gumuz Region Capacity Building Coordination Office
(2004) Three-year Strategic Plan (2003/04-2005/06)
30.
Benishangul-Gumuz Region Bureau of Health (2004). Annual
Report, Assossa

31.
Dutch Interchurch AID (2000). Assessment of Nutritional Status
and Household Food Security Situation in Assossa Zone, BenishangulGumuz Region.
32.
Ethno-veterinary Survey (2004). Benihsangul-Gumuz Region,
Assossa
33.
Household Food Security Baseline Survey (2004), BenishangulGumuz Region, Assossa
34.
Ministry of Finance and Economic Development, (2002), Untitled,
Wealth Monitoring Unit, Addis Ababa
35.
Ministry of Health (2003) Health and Health Related Indicators
36.
Oxfam GB (2000). Household Baseline Survey of Menge Woreda,
Benishangul-Gumuz
37.
Region Assossa
38.
Rapid Food System Scan (2003). Benishangul-Gumuz Region,
Assossa
39.
Regional Bureau of Health (2004). Causes of Maternal Mortality in
Assossa and Dibate
40.
Woredas, Assossa
41.
Regional HIV/AIDS Secretariat (2004). Prevalence of HIV/AIDS in
Benishangul-Gumuz
42.
Region, Assossa
43.
Survey on Income Generation and Market Potential (2004).
Benishangul-Gumuz Region,
44.
Assossa
45.
World Bank (2003). Risk and Vulnerability Analysis, Addis Ababa,
Ethiopia
a. October 2004 52
46.
Population reference Bureau world population Data sheet
Washington
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population reference Bureau 1996.
48.
. Tasfu N, 1998, sexual activity of school youth and their
knowledge and
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attitude about STD and HIV/AIDS in southern Ethiopia, Ethio, J,
health
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Dev 12:17-22.
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Fantahune M.chala fand loham 1995 knowledge Attitude and
practice of
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family planning among senior high school students in Northern
Gonder,

53.
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Ethio,Medg,33;21-29.
Karra A and Haine M.1994;sexual behavior and level of awareness

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reproductive health among youth s evidence and ram hara, eastern

Ethiopia, Ethio.J Health Dec13,107-113.
Mccavely Ap and salter c,1995,meeting the needs of young adults
growing number diverse needs, population report 41;3-9.
Loofredos Adole, 1995,sexuality pop Boll; 50;24.
Dick B and lotterd 5.1994 young people first AIDS Action 25:-1-2
Persude V and path FC 1994 The sexual health needs of

Adolescents
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which are threathned by the lack of service world wide west
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Fisher A.John L and Johns 1983: hansbook for family planning
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Waren V and Drumm and N.1994 Contuese among teenagers
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seeking abortion a survey from grampia, BRS Fam plan 20:76-78
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developing countries, Geneva, 1994.
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WHO, Mother baby package implementing safe mother hood in
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developing countries, safe mother hood Geneva.
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office of population. A special review prepared on the 25th A never
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PMID:7895 143 (Pub Med Indexed for medline).

Annex 1

Questionnaire

My name is Mohamedajib Almahadi; currently,I am a public health student at

the Central University College, Department of Public health, and Lancha
Campus. The main purpose of this study is to collect information necessary for
developing appropriate strategies and programs to prevent abortions due to
/unwanted /unplanned pregnancies and their consequences. To attain this

purpose,youre your name or any identity of yours will no he documented

participation is very important and highly appreciable.
Therefore, would you like to participate in this study?
Thank you in advance for sharing your precious time in filling this
questionnaire.
Agree
Do not agree

Instruction
There is no need of writing your name.
Put the mark in the space provided according to your choice.
Part 1. Socio Demographic Characteristics
1.1. Age 15-19

20-24

25-2930-35

>/36

1.2. Religion
Muslim

Orthodox

Protestant

Catholic

Others (specify)
1.3. Educational level: Illiterate
Primary school

Read and write only

secondary school

Diploma

other (specify)
1.4. Marital status

Single

divorced

Married

widow

Other (specify)

1.5. Ethnicity
Arab
Berta

Amhara
Gumuz

Degree

Oromo

Shinasha

Tigiri

Mao- komagna

others/specify

Gurage
1.6. Fathers educational level
Illiterate

Read and writes only

12+

1-6
1.7. Mothers educational level
Illiterate Read and Write

d) 7-12

Read and write only

e) 12+

1-6
1.8. Family income in Birr per month ____
<1000

3000-4999

1000-2999

5000+

1.9. Occupation of father

a) Government employee
b) Merchant
c) Farmer
d) Daily labor or
e) No work
1.10. Occupation of mother
Governmental Employee
Merchant
Farmer
Daily Labor
No Work

7-12

Part 2. Knowledge: - on Abortion and Source(s) Of Information

2.1.
2.2.

Have you ever heard about abortion?

Yes
No
If yes to question number one, indicate the source (you can check more
than one)
Television
Radio
Books
Parents or Relatives
News Paper
Pamphlets

Magazine
Teachers in Class
Friends
Notice Board
Other (Specify)

2.3 Which type of abortion do you know? (You can check more than one)
Campmate abortion

inevitable abortion

spontaneous abortion

Threatened
Incomplete abortion

septic abortion

induced abortion other

(specify)
2.4 What is the advantage of importances to understandabout abortion? (You
can indicate more than one)
To prevent deaths
To space child earths
To prevents STIS, including HIV/AIDS
To prevent unwanted pregnancy
Other/ specify
2.5. Do you know how to prevent abortion?
Yes

No

other (specify)

2.5.1. If yes to question No 2.3. Which one do you know?

- Family planning
- Abstained
- be faith full
- use condom
other (specify)
2.5.2What was the result of care you have received ?

Abortion
Still birth
Ectopic pregnancy
Molar pregnancy
Other (specify)

APH

Part 3: - Attitude towards abortion

2.1 What do you think about abortion? (This is attitude question)
It is bad

It is good

2.2 what do you think about induced abortion different from other?
It is a danger on type of abortion
It is abortion done out of health institution
It is un hygienic abortion

Other/specify

It is home care abortion

2.3 What do you say about severity of abortion?
It is the a most Killer type of abortion
It is the mostly prevailing in developing country
It is the most common known type of abortion in the world
It is done out of health institution
Other/specify
2.4. what do you think abortion effect can result?
- Death
- Disability
- Poor heath
- Social economic problem
- Anemia

Part 4- practicesrelated to abortion

1. Have you ever experienced vaginal bleeding in the 1st 28 weeks?
Yes
No
1.1 If yes to questions number 1 have you ever visited health intuition
Yes

No

1.1.2 If yes, to question 1.1 which type of health institution?

Health intuition
Government health intuition
other /specify

NGO

1.1.3 for questions, 1, 2, if your answer were abortion which type?

Spontaneous abrasion
Threatened abrasion
Incomplete abortion
Induced abortion

inevitable abortion
complete abortion
septic abortion
other (specify)

2 Where did you have admitted for this problem?

Yes

No

2.1 if yes for question no 1.4, indicate which type of delivery did you have?
Normal delivery / spontaneous vaginal delivery
Cesarean section
Manual vacum aspiration
Instrument delivery
Forceps delivery
Other (Specify)
3 What was the outcome of your delivery?
Live birth
Still birth
Abortion

other (specify)

4 Have you ever tried to terminate pregnancy?

Yes

No

5 If yes to question, what was the reason?

Raped

Unwanted pregnancy

Health Problempouency

Other

(Specify)
6. Have you ever used Family Planning?
Yes

No

other (specify)

6.1. If your answer is yes to g 2.4 which one did you have?
- Oral contraceptive
- Inspective form
- LUP
- IUCD
- NORPLANT
6.2. If one of the above is your answer, which one is your choice?
- Oral contraceptive
- Estrogen
- Progesterone
- Both
- Injectable Depo-Provera
- Condom

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Annex 3

Acronyms

AIDS Aguirre inmmuno deficiency syndrome

HIV Human imnwno Virus
STI/STD- Sexual Transmitted infection/ disease
WK- week
IEC- Information, Education, Communication
HEW- Health Extension Worker
MOFED Ministry of Federal & Education Development
MOH- - Ministry of Health
IMF- International monastery found
SAF- Structural Adjustment programmed
BGRS- Benishangul Gumus Regional state
KKU- Kurmul Worda
WHO- World Health organization
FGAE- Family guidance Association of Ethiopian
MASI- Meter about the sea level
AZKW- Assosa Zone Kurmuk worda
BGR- Arks Bensihangule gumuze region Assosa Zone Kurmuk worda
CSW-commercial sex workers