Adaptation and validation of the abortion provider stigma scale in Ethiopia

Abstract

Abortion care providers often face stigma from their communities and colleagues, which may compromise the quality of service they provide. This study aimed to adapt and validate the revised Abortion Provider Stigma Scale (APSS) for use in the Ethiopian context. A cross-sectional psychometric study was conducted among 98 providers in reproductive clinics across Ethiopia. The original 35-item APSS was reviewed by experts, culturally adapted and expanded to 44 items across five domains: disclosure management, internalized states, judgement, social isolation, and discrimination. The scale was then translated into Amharic and pilot tested before administration. Internal consistency was high across most domains (Cronbach’s alpha > 0.70), and Confirmatory Factor Analysis supported the five-domain structure, though model fit indices were suboptimal. Nearly half of participants reported stigma, with internalized and disclosure-related stigma being most prevalent. The adapted APSS demonstrated potential for assessing abortion provider stigma and tracking intervention outcomes in Ethiopia.