BackgroundAfrica is one of the regions impacted by high rates of unsafe abortions due to the inaccessibility of comprehensive abortion care due to healthcare workers’ behaviours and attitudes.AimThe study aims to explore underlying factors influencing Tanzanian and Ethiopian healthcare workers’ attitudes and behaviours towards abortion care between 2015 to 2020.MethodologyThe study inductively compared Ethiopian and Tanzanian healthcare workers behaviours using a qualitative comparative case study method and secondary data was collected from previous research and newspaper articles on healthcare workers’ behaviours and attitudes towards abortion. The Ethiopian and Tanzanian cases compared take different approaches towards the governance of abortion care. While Ethiopia is persistently and gradually legalizing, Tanzania presents a typical restrictive case.ResultsThe results of the study demonstrated that there are fundamental differences in the management of abortion care between the two cases. The way abortion is managed in each case influences how healthcare workers behave towards abortion and these behaviours are influenced by personal, institutional, political, and legal factors.ConclusionsThe study concluded that there exists a vacuum between abortion governance and accessibility whose degree of latitude invites the intervention of attitudes and other workplace factors to influence behaviours of healthcare workers in real-time. The study also demonstrated that attitudes – behavior relationship is inconsistent to predict real-time actions and decisions because of non-subjective workplace factors.