Post-abortion contraceptive uptake among women seeking care for incomplete or induced abortions in Northern Ethiopia: a facility-based cross-sectional study in a humanitarian setting

Introduction Unintended pregnancy after abortion is a major concern in humanitarian settings, where access to contraceptive services is often limited. Increasing access to post-abortion contraceptives is especially vital for women and girls in these contexts. However, evidence from conflict-affected Ethiopia remains limited. This study aimed to assess post-abortion contraceptive uptake and its associated factors among women who received care for incomplete or induced abortions in humanitarian settings in the Amhara region of Ethiopia. Methods A facility-based cross-sectional study was conducted among 1,642 participants at 31 selected public health facilities across seven humanitarian zones affected by the northern Ethiopian conflict in the Amhara Region. A semi-structured questionnaire was used to collect the data. A binary logistic regression model was used to identify factors significantly associated with the outcome; adjusted odds ratios were reported for p -values Result The overall post-abortion contraceptive uptake in the study setting was 27.8% [95% CI: 25.6–30%]. The odds of post-abortion contraceptive uptake were significantly higher among women with single marital status [AOR: 1.96; 95% CI: 1.39–2.75], a previous history of induced abortion [AOR: 2.00; 95% CI: 1.42–2.83], and those who received a high level of person-centered comprehensive abortion care (PC-CAC) services [AOR: 3.39; 95% CI: 2.39–4.82]. In contrast, the odds were significantly lower among women and girls with a history of spontaneous abortion [AOR: 0.73; 95% CI: 0.55–0.97]. Conclusion Post-abortion contraceptive uptake in this humanitarian setting was low, indicating a substantial gap in the provision of post-abortion care. Low uptake of contraception following abortion may increase the risk of repeat unintended pregnancies, with added consequences for women and the health system. Addressing this gap requires strengthening the delivery of high-level PC-CAC, including timely, accurate, and accessible contraceptive counseling and services for all women.