Reason and Associated Factors for Nonuse of Contraceptives Among Ethiopian Rural Married Women: A Multilevel Mixed Effect Analysis

Mulugeta, Solomon Sisay; Muluneh, Mitiku Wale; Belay, Alebachew Taye; Yalew, Mequanint Melkam; Agegn, Setegn Bayabile

doi:10.1177/23779608221150599

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…3 ). This findings mirror of a study done in Ethiopia where women in border far states were less likely to use contraceptives [ 53 ]. At the community level, the negative association between frequent visits to health facilities and modern contraceptive use raises important considerations regarding the quality and accessibility of contraceptive services.…”

Section: Discussionsupporting

confidence: 86%

Prevalence, distribution and factors associated with modern contraceptive use among women of reproductive age in Uganda: evidence from UDHS 2016

Towongo,

Kelepile

2024

Contracept Reprod Med

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Background Unintended pregnancies pose significant health risks, particularly in sub-Saharan Africa, where millions of cases are recorded annually, disproportionately affecting adolescent women. Utilization of modern contraceptives is crucial in managing fertility and reducing unintended pregnancies, abortions, and associated health complications. This study aimed to assess the prevalence, distribution and factors associated with modern contraceptives utilization among women aged 15–49 in Uganda. Methods The study used secondary data from the 2016 Uganda Demographic and Health Survey (UDHS). The study sample comprise of 9,235 women aged 15–49 who used any method to prevent pregnancy in the five years preceding 2016 UDHS survey. The outcome variable for this study is utilization of modern contraceptives. Univariate, bivariate, and multilevel binary logistic regression was used to examine the relationship between individual and contextual factors on the modern contraceptive use among women aged 15–49 in Uganda. Choropleth mapping and network analysis in ArcGIS 10.8.2 was used to visualize spatial distribution of modern contraceptive use and measure community access to health facilities respectively. Results The prevalence of modern contraceptive use was 53.19% (n = 4,919) in Uganda, with significant spatial variation by district. Higher prevalence (23.18%) was observed among women aged 20–29 compared to adolescents (4.1%). Only 21.9% of married women reported using modern contraceptives. At the individual-level, the factors that positively influenced use of modern contraceptives included: women’s marital status, wealth index and level of education while sex of the household head, ever terminated a pregnancy and religion negatively affected the use of modern contraceptives. At community-level, community access to health facilities was found to have negative influence on the use of modern contraceptives among women. In communities where women frequently visited health facilities in the 12 months preceding the survey, the use of modern contraceptives reduced by 3.9%. Accessibility analysis revealed challenges, with women in northeastern districts (rural districts) facing travel times exceeding four hours to reach health facilities. Conclusion Utilization of modern contraceptives are essential for promoting women’s health and well-being, particularly concerning maternal healthcare. This study highlights disparities in modern contraceptive use across age groups and the districts, emphasizing the need for targeted interventions. Policymakers and stakeholders must prioritize strategies that promote utilization of modern contraceptives and maternal healthcare services to address these disparities effectively. Such efforts are crucial for improving reproductive health outcomes and reducing the burden of unintended pregnancies and related complications in Uganda.

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Section: Discussionsupporting

confidence: 86%

Prevalence, distribution and factors associated with modern contraceptive use among women of reproductive age in Uganda: evidence from UDHS 2016

Towongo,

Kelepile

2024

Contracept Reprod Med

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Geospatial variations and determinants of contraceptive utilization among married reproductive age women in Ethiopia: spatial and multilevel analysis of Ethiopian Demographic and Health Survey, 2019

Terefe,

Getnet,

Akalu

et al. 2023

Front. Glob. Womens Health

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IntroductionContraception is the most effective method of preventing unwanted pregnancies and their associated disadvantages. It is critical to recognize one's desire to utilize contraceptives before drafting and implementing a good family planning program, especially in developing nations like Ethiopia.ObjectiveThis study aimed to identify the geospatial variations and determinants affecting the utilization of contraceptives among married reproductive age women in Ethiopia.MethodThis study was based on an extensive national survey, the Ethiopian Demographic and Health Survey. A total weighted sample of 5,743 married reproductive-age women was included. Because of the hierarchical nature of the DHS data, a spatial analysis multilevel logistic regression model was used to study individual and community-level factors that may influence contraceptives. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of contraceptive usage. ArcGIS version 10.3 was used to visualize the distribution of contraceptives. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance.ResultThe overall utilization of contraceptives was discovered at 41.25% (39.98, 42.53). Participants age range of 25–34 years [AOR = 0.80, CI: (0.66, 0.96,)] and 35–49 years [AOR = 0.50, CI 95%:(0.66, 0.96)] times less likely to use contraceptives than 15–24 years old respectively. Having primary [AOR = 1.47, CI 95%: (1.25, 1.73)], secondary [AOR = 1.42, CI 95%: (1.09, 1.83)] and higher education level [AOR = 1.92, CI 95%: (1.41, 2.60)], middle wealth [AOR = 1.48, CI 95%: (1.14, 1.90)], richer [AOR = 1.41, CI 95%: (1.07, 1.86)] and richest [AOR = 2.17, CI 95%: (1.52, 3.11)], having 1–4 ANC follow up have [AOR = 1.60, CI 95%: (1.26, 2.03)], gave birth at age of 35–44 [AOR = 0.29, CI 95%: (0.22, 0.37)], having 3–5 children [AOR = 1.26, CI 95%: (1.03, 1.52)], being from community of high level women education [AOR = 1.61, CI 95%: (1.21, 2.15)] were associated positively. Participants from Amhara, Oromia, Benishangul and SNNPR regions have revealed [AOR = 2.40, CI 95%: (1.53, 3.77)], [AOR = 1.64, CI 95%: (1.05, 2.56)], [AOR = 1.62, CI 95%: (1.01, 2.62)] and [AOR = 2.04, CI 95: (1.31, 3.19)], in contrast, Somali and Afar regions have shown [AOR = 011, CI 95%: (0.05, 0.22)] and [AOR = 0.31, CI 95%: (0.18, 0.54)] times less likely to use contraceptive services than Tigray Region respectively. The spatial analysis of contraceptive usage discovered that the northern, central and southern parts of the country had higher utilization of contraceptives than the eastern and northeastern of the country.ConclusionThe study revealed that contraceptive usage among married women is comparatively low, with wide regional variation. Raising awareness among mothers about the importance of antenatal care and assisting mothers who are financially disadvantaged or do not have access to health facilities will aid in providing better family planning services. Improving contraceptive information dissemination at community and regional levels is key to averting potential barriers.

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Reason and Associated Factors for Nonuse of Contraceptives Among Ethiopian Rural Married Women: A Multilevel Mixed Effect Analysis

Cited by 2 publications

References 30 publications

Prevalence, distribution and factors associated with modern contraceptive use among women of reproductive age in Uganda: evidence from UDHS 2016

Prevalence, distribution and factors associated with modern contraceptive use among women of reproductive age in Uganda: evidence from UDHS 2016

Geospatial variations and determinants of contraceptive utilization among married reproductive age women in Ethiopia: spatial and multilevel analysis of Ethiopian Demographic and Health Survey, 2019

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