Knowledge, attitude, and practice towards unsafe abortions among undergraduate students in selected universities of the Southern Highlands of Tanzania

Abstract

Background: Unsafe abortion remains a significant public health concern, particularly among young women in Sub-Saharan Africa. This study aimed to assess knowledge, attitudes, and practices (KAP) related to unsafe abortion among undergraduate students in Mbeya, Tanzania. Methods: A cross-sectional study was conducted among 227 undergraduate students selected from four higher learning institutions in Mbeya. Data were collected using a structured self-administered questionnaire. Descriptive statistics summarized participant characteristics and KAP levels. Multivariable linear regression was used to identify factors associated with knowledge and attitude scores. Results: The majority of participants were female (58.6%), aged 20–25 years (72.7%), and single (81.1%). Most (69.6%) had heard of unsafe abortion, but only 41% knew of safe abortion providers. Knowledge scores ranged from 0 to 15, with a mean of 8.3 (SD ± 3.1). Female students and those in their fourth year had higher knowledge scores. Importantly, students from UDSM-MCHAS (a medical college) had significantly higher knowledge scores than those from non-medical colleges such as Mzumbe (β = 1.08; 95% CI: 0.11–2.05; p = 0.029), reflecting curriculum-related differences. Knowledge scores were positively associated with practice scores (β = 0.34; 95% CI: 0.12–0.56; p = 0.003). Attitudes were generally positive (mean score = 5.2 ± 1.4), but male students had significantly lower attitude scores than females (β =-0.48; 95% CI:-0.83 to-0.12; p = 0.009). Third-and fourth-year students had significantly more positive attitudes than first-year students. Conclusion: While awareness of unsafe abortion is relatively high among undergraduate students in Mbeya, significant knowledge gaps and risky practices persist. Medical students demonstrated better knowledge, highlighting the importance of curriculum content. Peer-led, gender-sensitive educational interventions are recommended to improve knowledge, reduce stigma, and promote safe reproductive health practices.