Prevalence and factors associated with unsafe abortion among women in reproductive age attending Remera Rukoma Hospital, Rwanda.

BACKGROUND: Unsafe abortion remains a critical global health issue, particularly affecting women in low and middle-income countries including Rwanda. In Africa, 99% of abortions are unsafe. Between 2019 and 2023, there has been a reported increased of abortion-related hospitalizations at Remera Rukoma Hospital (RRH), highlighting an urgent need for investigation. Therefore, this study was conducted to determine the prevalence and factors associated with unsafe abortion among women of reproductive age attending RRH. METHODS: This cross-sectional study was conducted among 384 women of reproductive age (15-49 years) attending at RRH in Rwanda. The sample size was obtained using the Cochrane formula and systematic random sampling. Data analysis utilized SPSS Version25, employing descriptive statistics, bivariate and multivariate analyses to determine the factors associated with unsafe abortion at 95% CI, and p-value < 0.05 was considered statistically significant. RESULTS: The majority of participants were married (51.8%), Catholic (32.8%), attained primary education (35.4%), and were housewives (42.2%). The prevalence of unsafe abortion was 35.2%. Multivariate analysis showed unsafe abortion was higher than twice among women married before 18 years (aOR = 2.277, 95% CI: 1.247-4.157, p = 0.007), those with 3 sexual partners in the last 12 months (aOR = 2.285, 95% CI: 1.031-5.066, p = 0.042). Women who experienced gender-based violence had higher odds of engaging in unsafe abortion (aOR = 1.965, 95% CI: 1.128-3.424, p = 0.017). CONCLUSION: This study revealed unsafe abortion as a significant health concern among women of reproductive age, with over one-third of participants reporting unsafe abortions. Early marriage before 18 years, multiple sexual partners, and gender-based violence emerged as key factors associated with unsafe abortion practices. Addressing this issue requires a multifaceted approach, community education, and targeted initiatives to combat gender-based violence and early marriage in Rwanda.