An Investigation Into the Knowledge, Attitude and Predictors of Safe Abortion Among Female Students in the Eastern Cape, South Africa

Background: Safe abortions are performed throughout the world. In South Africa, abortion is legal but over half of abortions remain unsafe and there is a dearth of studies on safe abortion among students. The aim of this study was to investigate into the knowledge, attitude, and predictors of safe abortion among female students in the Eastern Cape Province, South Africa. Methods: The study was guided by a cross-sectional research design and underpinned by quantitative methodology. A self-administered questionnaires was used to collect data from female students selected using a multi-stage sampling method. Data was analysed using SPSS version 24, and bivariate and multivariable logistic regression was performed to determine the association of dependent and independent variables. Results: Data was collected from 1266 female students with the response rate of more than 100%. The study found that 866 (68.5%) of the students had good knowledge about safe abortion. Having ever heard about safe abortion (AOR = 4.37, 95% CI: 1.89, 10.84), older age (AOR = 2.79, 95% CI: 1.17, 7.29), family education (AOR = 3.19, 95% CI: 1.33, 7.07), and urban habitation (AOR = 2.43, 95% CI: 1.27, 4.36) were predictors of students’ knowledge of safe abortion. Findings show that 722 (57%) of students had favourable attitude towards safe abortion. Staying in an urban area (AOR = 1.52, 95% CI: 1.10, 2.22), and age (AOR = 6.59, 95% CI: 2.72, 11.22) were found to be significant predictors of students’ attitude towards safe abortion. Conclusion: The study revealed that half of the students had good knowledge and attitude towards safe abortion while a significant proportion had poor knowledge and unfavourable attitude. Findings show that having ever heard about abortion, residence, age of students, and family education were predictors of knowledge on safe abortion. In addition, age and residents were predictors of students’ attitude towards abortion. There is need for health communication and education programmes to address the subject of safe abortion among students. Health communication and education programmes should target students from rural areas and employ age-specific programmes. Government should provide youth-friendly reproductive services to the rural areas of South Africa.