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

Abstract

Background Contraceptive use is the best and most cost-effective strategy to reduce feto-maternal adverse effects of short birth intervals. More than two-thirds of women in developing countries who do not want to conceive are not using contraception methods. Although there were various primary studies in different parts of the country, there is no nationally representative evidence on postpartum modern contraception utilization and its determinants in Ethiopia. Objective This review was aimed to determine the best available pieces of evidence to pool the magnitude of postpartum modern contraception utilization and find out its determinants. Methods Published studies were extensively searched by using electronic databases and unpublished studies were identified from the digital library. All observational studies conducted on the magnitude of postpartum modern contraception utilization and its determinants in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled magnitude of postpartum modern contraception utilization with a 95% confidence interval (CI). Inverse variance (I2) was used to identify the presence of heterogeneity and forest plot was used to estimate the pooled magnitude of postpartum contraception utilization. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Sub-group analysis was computed to minimize underlying heterogeneity. Findings In this review, 19 primary studies were included. The pooled magnitude of postpartum modern contraception utilization in Ethiopia was 45.79% (95%CI 36.45%, 55.13%). The review found that having more than four Antenatal care visits(ANC), having postnatal care visit (PNC), having a formal education, history of family planning use, history of counseling on family planning, and having greater than four alive children as significant determinants of postpartum modern contraception utilization. Conclusion The magnitude of postpartum modern contraception utilization in Ethiopia was low. ANC visit, PNC visit, maternal educational status, history of previous family planning use, counseling on family planning, and number of alive children were found to be significant determinants of postpartum modern contraception utilization. Therefore, strengthening focused ANC and PNC services to encourage women in utilizing modern contraception during the postnatal period is needed.

Factors associated with modern contraceptives uptake during the first year after birth in Ethiopia: A systematic review and meta-analysis

“…Women who had formal education were 2.6 times more likely to utilize modern contraceptives during postpartum period compared to women who did not have formal education. This finding is similar with a previously conducted systematic review and meta-analysis study in Ethiopia [ 11 ]. This might be due to the fact that the more educated women have better understanding of benefits of contraceptives during postpartum period and risks of shorter inter-pregnancy interval.…”

“…However, there is huge variability in the findings. Moreover, although there were previous attempts to do a systematic review and meta-analysis, they included few studies and largely focused on one region of Ethiopia, limiting their generalizability to the country as a whole [ 11 , 12 ]. In our review we tried to include primary studies conducted from all major regions in Ethiopia to address this limitation.…”

Timely initiation of postpartum contraceptive utilization in Sebata Hawas district, Ethiopia: A cross-sectional study

“…First, as the level of educational attainment increases postpartum women are likely to have a better understanding of the available health facilities and the benefits of fertility regulation [26]. Second, women who have been educated are more likely to visit a health facility and receive counseling or services on family planning and go on to use contraceptives timely, than those who have not been educated [27,28]. Studies elsewhere have revealed a similar pattern of relationship between educational level and contraceptive use during postpartum [23,29].…”

Factors associated with utilization of modern postpartum family planing methods during the extended postpartum period among mothers who gave birth in the last 12 months at Injibara town, Northwest, Ethiopia: a cross-sectional study

“…In Ethiopia, the utilization of PPFP ranges from 10.3% to 80.3% [ 16 , 17 ]. Reports of two different systematic reviews and meta-analysis studies done in Ethiopia show that the pooled magnitude of the utilization of modern PPFP methods was 45.79% and 48.11% [ 18 , 19 ].…”