Predictors of modern contraceptive usage among sexually active rural women in Ethiopia: A multi-level analysis

Abstract

Background Ethiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate. This study aimed to assess individual and community-level predictors of modern contraceptive use among sexually active rural women in Ethiopia. Data and methods A sample of 9450 sexual active rural women aged 15-49 was extracted from the 15, 683 nationally representative samples of 2016 Ethiopian Demographic and Health Survey (EDHS). Multi-level logistic regression model was considered to identify determinant factors of modern contraceptive use among sexually active rural women in Ethiopia. Result The prevalence of modern contraceptive use among respondents was 20% in rural Ethiopia. Injection (66.35%) was the most common type of modern contraceptive use. In the last full model of the multilevel analysis, individual and community-level factors accounted for 86.69% of the variation in the use of modern contraceptive methods. Secondary and above-educated women (AOR = 1.39, 95%CI: 1.06, 2.81), having 1-4 living children (AOR = 2.70, 95%CI: 2.07, 3.53), rich wealth status (AOR = 2.26, 95%CI: 1.96, 2.60), married women (AOR = 17.31, 95%CI: 10.72, 27.94), having primary educated husband (AOR = 1.45, 95%CI: 1.27, 1.67) and being working husband (AOR = 2.26, 95%CI: 1.96, 2.60) were significantly positively associated with individual-level factors of the use of modern contraceptive methods. Besides, modern contraceptive use was negatively associated with Muslim women (AOR = 0.29, 95%CI: 0.25, 0.33). Compared to the Tigray region, women living in the Afar, Somali, Harari, and Dire Dawa regions had lower use of modern contraceptive methods. Women who had access to mass media (AOR = 1.35, 95%CI: 1.16, 1.57) were more likely to use contraceptives than their counterparts. Conclusion The prevalence of modern contraceptive use among rural women has very low. Both individual and community-level factors were significant predictors of modern contraceptive use. Consequently, the government and other stakeholders need to address educational opportunities; creating awareness about modern contraception and valuable counseling would increase modern contraceptive methods utilization.

Factors associated with non-use of modern contraceptives among sexually active women in Ethiopia: a multi-level mixed effect analysis of 2016 Ethiopian Demographic and Health Survey

“…Women, who had given birth to a child in the last 5 years were less likely to non-use modern contraceptive than those women who had not given birth. This result is in agreement with other studies [ 20 , 35 , 36 , 51 ]. The odds of not use modern contraceptive method among women delivered at the health facility were lower by 0.84 times as compared to women deliver at home.…”

“…Muslims women were more likely to not use contraception compared Christian women. This finding is consistent with the findings of [ 20 , 36 , 50 ]. This could be due to the Muslim community's strong belief in a holy book that prohibits family planning [ 34 ].…”

“…The findings of this study revealed that 79.49% of sexually active women did not use a modern contraceptive method, which is consistent with findings from studies in Ethiopia (79.5%) [ 20 , 25 ] and Ghana (78.5%) [ 34 ]. Furthermore, as women’s ages increased, their use of FP decreased.…”

“…There is a significant association between women wealth status and non-use of modern contraceptive method. The result of the current study was in line with the studies conducted in Nepal [ 36 ], Ethiopia [ 20 , 35 , 38 ], Rwanda [ 46 ], Burkina Faso [ 47 ], and Nigeria [ 48 ].This might be due to the fact that women from rich households might be more educated and have occupations, as supported by this study, to extend their business agendas and further. When women’s occupation status increases, they will be more inclined to use contraception because their support gives them more control over reproductive health and the desire to limit family size [ 49 ].…”

“…This finding was consistent with the findings of a Nepal [ 35 , 36 ], and Malawi [ 37 ] study, which discovered that as women’s ages increase, so does their likelihood of using modern contraception. Studies conducted in China [ 34 ], and Ethiopia [ 20 , 35 , 38 ] found results that differed from this one. The low contraceptive prevalence among women aged 15–24 years is most likely due to the fact that the majority of these women engage in unsafe sex, are newly married, and marriage is based on the institution of producing children.…”