Healthcare providers’ attitude towards abortion service provision in Gulu city, Northern Uganda

Abstract
Background: Although induced abortion is legally allowed on various grounds in several sub-Saharan African countries, health care providers in these countries often persist in viewing induced abortion as immoral. Providers’ attitudes may conflict with the national abortion law or their personal and or religious values. Abortion services are severely restricted and highly contentious in Uganda. This study, therefore, is aimed at determining attitudes among healthcare providers on induced abortion service provision in Gulu City. Procedures: A cross-section survey was conducted among health workers about attitudes toward induced abortion between September and November 2019 using a modified abortion attitudinal score. The study was conducted in the Hospitals and Health centers in Gulu City, in Northern Uganda, the participants were drawn from Public, Private non-for-profit faith-based, Private for Profit and, Private non-for-profit Non-Government Organisation health centers. Findings: A total of 252 health care providers were surveyed. The mean attitudinal score for generally in support, generally not in support, conditional in support, personal attitude, and beliefs against and toward abortion provision were 2.80, 2.71, 2.86, 3.239, and 3.35 respectively. Factors that were positively associated with general support included age 40 years and above; and being employed in private non-for-profit non-governmental health facilities, with coefficients of 0.85 and 0.67 respectively. Factors that were positively associated with conditional support were; age 40years or above; being employed in a non for profit non-governmental health facility; private for-profit and private not-for-profit faith-based health facilities coefficients 0.55, 0.54, 0.40, and 0.37 respectively. However, being a born-again Christian was negatively associated with general support for induced abortion provision. Conclusion: Healthcare providers’ attitude is an important element in the provision of quality stigma-free post-abortion care services. A clear national effort to improve post-abortion and comprehensive abortion care training should include value clarification and attitude transformation among all healthcare providers.