Postpartum Contraceptive Use and Its Determinants in Ethiopia: A Systematic Review and Meta-analysis

Abstract

Background. Postpartum contraceptive use is defined as the avoidance of short spaced pregnancies and unintended pregnancy through the first 12 months after delivery. In Ethiopia, different studies have been conducted to assess the prevalence of postpartum contraceptive use and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of postpartum contraceptive use and determinants in Ethiopia using the accessible studies. Methods. The articles were identified through electronic search of reputable databases (MEDLINE through PubMed, EMBASE, HINARI, Science Direct, and Cochrane Library) and the hand search of reference listed in previous prevalence studies to retrieve more. 18 articles are included based on a comprehensive list of inclusion and exclusion criteria. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity between the studies. A random effects model was calculated to estimate the pooled prevalence of postpartum contraceptive use. Moreover, the determinants for family planning use were reviewed. Results. The pooled prevalence of family planning use among mothers during the postpartum period in Ethiopia was 48.11% (95% CI: 36.96, 59.27). Besides, subgroup analysis revealed that the highest family planning use prevalence among postpartum mothers was observed in Addis Ababa, 65.41 (95% CI: 48.71, 82.11). Resumed sexual activity: 7.91 (95% CI: 4.62, 13.55), antenatal care: 4.98 (95% CI: 2.34, 10.21), secondary school and above level of maternal education: 3.53 (95% CI: 1.67, 7.45), postnatal care: 3.16 (95% CI: 1.7, 5.88), menses resumption: 3.12 (95% CI: 1.52, 6.39), and ≥6 months of postpartum period: 2.78 (95% CI: 1.97, 3.93) have shown a positive association with the use of family planning among mothers in the postpartum epoch. Conclusions. In this study, family planning use among mothers of the postpartum period in Ethiopia was significantly low compared to the existing global commendation on postpartum contraceptive use. Resumed sexual activity, antenatal care, secondary and above level of maternal education, postnatal care, menses resumption, and postpartum period≥6 months were found to be significantly associated with postpartum contraceptive use.

Postpartum modern contraception utilization and its determinants in Ethiopia: A systematic review and meta-analysis

“…The discrepancy may be due to cultural influences and the relatively high unmet need for family planning in Ethiopia [ 5 ]. The present finding is comparable to a study finding from Ethiopia(48.11%) [ 17 ] and Rwanda (51.1%) [ 43 ].…”

“…The magnitude of postpartum modern contraception utilization in Ethiopia ranges from 12.05% to 80.32% [14,15]. Different studies found antenatal care, postnatal care, resumed sexual activity, partner approval for contraceptive use, menses return, and counseling on family planning use as determinants of postpartum modern contraception use [15][16][17][18][19][20].…”

Barriers and determinants of postpartum family planning uptake among postpartum women in Western Ethiopia: a facility-based cross-sectional study

“…The single population proportion formula was used to calculate the sample size with the following assumption. The proportion of postpartum women who utilized postpartum family planning which was 48.11% was taken [ 10 ]. The marginal error of 4%, design effect 1.5, and 95% confidence level.…”

“…Data were collected by 25 data collectors who know Afan Oromo and Amharic. The quantitative data were collected through interviewer-administered interviews using adopted questionnaires from reviewed literature on postpartum family planning [ 3 , 10 – 25 ]. Inorder to minimize potential bias, the authors used precise tools and well trained female BSC nurses,who were not working in the same facility/study area, for data collection.…”

The impact of having a dedicated obstetrics and gynecology resident to provide contraceptive counseling on immediate postpartum family planning uptake: a “pre–post” study

“…A recent systematic review and meta-analysis found that postpartum family planning uptake in Ethiopia is low compared to the existing global recommendations on postpartum contraceptive use. Resumption of sexual activity, having received antenatal care, maternal education above or equal to secondary school, postnatal care with family planning counselling, resumption of menses, and being ≥ 6 months postpartum were found to be significantly associated with postpartum contraceptive use [ 12 ].…”