Spatial variations and associated factors of modern contraceptive use in Ethiopia: a spatial and multilevel analysis

Chojenta, Catherine; Forder, Peta; Getachew, Theodros; Smith, Roger; Loxton, Deborah

doi:10.1136/bmjopen-2020-037532

Cited by 42 publications

(81 citation statements)

References 23 publications

(55 reference statements)

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“…Place of residence (urban, rural) and region (seven administrative divisions, namely Barishal, Chattogram, Dhaka, Khulna, Mymensingh, Rajshahi, Rangpur, Sylhet) were the communitylevel factors. To our knowledge, this is the first study in Bangladesh and other LMICs that considered the health facility-level factors because of their potential role in modern contraception use in SBI (21,27,28). We generated four health service variables: average distance to the nearest family planning facility, family planning service availability, readiness to provide family planning services, and general health facility readiness.…”

Section: Exposure Variablesmentioning

confidence: 99%

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Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey

Islam

Rahman

et al. 2021

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Background: The Sustainable Development Goals target significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth interval (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce these adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. Methods: The Bangladesh Demographic and Health Survey 2017/18 and Bangladesh Health Facility Data 2017 were linked and analysed. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization. We used descriptive statistics to summarise characteristics of respondents and multilevel Poisson regression to assess the predictors of SBI. Results: Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20-34 years (PR, 0.14, 95% CI, 0.11-0.17) and more than or equal to 35 years (PR, 0.03, 95% CI, 0.02-0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61, 95% CI, 0.45-0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women for whom the children born from the second most pregnancies died (PR, 5.23, 95% CI, 4.18-6.55), those who were living in Chattogram (PR, 1.52, 95% CI, 1.12-2.07) or Sylhet (PR, 2.83, 95% CI, 2.08-3.86) divisions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34, 95% CI, 0.22-0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85, 95% CI, 1.33-2.18) for every kilometer increase in the distance of nearby health facilities from homes of women. Conclusion: More than a quarter of live births in Bangladesh occurred in short intervals. This relatively high prevalence is a challenge for Bangladesh in reducing pregnancy-related adverse consequences, including maternal and child mortality. Policies and programmes are needed to increase awareness of SBI and associated adverse health outcomes and expand access to modern contraceptives.

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Section: Exposure Variablesmentioning

confidence: 99%

“…We generated four health service variables: average distance to the nearest family planning facility, family planning service availability, readiness to provide family planning services, and general health facility readiness. The details of this approach can be found elsewhere (28,29).…”

Section: Exposure Variablesmentioning

confidence: 99%

Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey

Islam

Rahman

et al. 2021

Preprint

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“…There was a variation among regions and city administrations regarding contraceptive use. A piece of information from EDHS 2016 showed that the variation observed was region-based (10). However, studies showed a continuous assessment of contraceptive use and their drawbacks, risks, and increasing societal commitment regarding the expansion of them to reduce the risk of unwanted pregnancy is necessary (11).…”

mentioning

confidence: 99%

“…And the status of the achievement of this policy with spatially informing studies is very crucial. Some studies applied multilevel analysis to identify related implementations when considering different clusters (10,23,24). Despite this, most studies in the country were dealing with contraceptive prevalence, side effects, and socio-demographic factors; regarding the distribution of intention at the country level through spatial mapping as there was little information in this area.…”

mentioning

confidence: 99%

Assessment of Intention to Use Contraceptive Methods With Spatial Distributions and Associated Factors Among Women in Ethiopia: Evidence From EDHS 2016

Gilano

Hailegebreal

2021

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Background: Modern contraceptive methods have immense influences on the health of mothers and their children. Using contraceptive methods is seen to control family size and unnecessary pregnancies. And it leads to peaceful and known family status. Considering different factors like resources and various cultural aspects, assessing the intention to use might bring areas with these problems into the light to act on them. Methods: We used multilevel logistic regression and spatial analysis techniques to the data from the 2016 Ethiopian demographic health survey. We downloaded the data from the EDHS website after the approval of the request for the data. We pooled the data to assess the intention to use contraceptive methods among 15-49 age women. After applying bivariate and multilevel binary logistic regression, we presented the information on Community and Individual level using tables, figures, and spatial distribution. We applied a p-value <0.05 and adjusted odds ratios (AOR) with 95% confidence intervals (CI).Result: the intention to use contraceptive methods was 44.11%. Spatially, we found intention to use contraception highly clustered in North and Western Ethiopia. The average number of children (4.5±2.9), age at first cohabitation (16.9±3.99), and the ideal number of children (4.77±2.0). Some other factors associated with intention to use contraceptive methods were age, education, the information was given by health facility, age at first cohabitation, the ideal number of children, Wealth status, and Regions that were significant.Conclusion: We observed various distributions among regions. Education status and various socio-cultural aspects need serious considerations to increase the intention to use contraceptive methods. Besides the efforts done, policy decisions might need to consider this finding and uphill the intervention against associated factors like socio-cultural and demographic variables in those areas.

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“…Increased availability of the geographically referenced health facility and population data creates a window of opportunity to determine the precise effects of health facility-level and population-level factors on LAMC use. However, only a few studies conducted in LMICs [20][21][22][23] have examined these aspects in relation to contraception use in general and LAMC use in particular. Moreover, those studies did not present a stratified analysis of the influence of health facility-level factors on contraception use in rural and urban areas, despite substantial variations in the distribution of health facilities and contraception using patterns in rural and urban areas.…”

Section: Introductionmentioning

confidence: 99%

Availability and readiness of healthcare facilities and their effects on long-acting modern contraception use in Bangladesh: Analysis of linked data

Khan

Islam

Akter

2021

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Aim Evidence on the availability and accessibility of health facilities and their impacts on long-acting modern contraceptives (LAMC) use in low- and middle-Income countries are scarce. This study examined the influence of the availability and readiness of health facilities in determining the use of LAMC in Bangladesh. Methods We linked data of the Bangladesh Demographic and Health Survey and the Health Facility Survey using the administrative-boundary linkage method. Mixed effect multilevel logistic regression was conducted. The sample comprised 10,938 married women of 15-49 years of age, who were fertile but did not desire a child within two years of the date of survey. The outcome variable was the current use of LAMC (yes, no) and the explanatory variables were health facility-, individual-, household- and community-level factors. Results Nearly 34% of participants used LAMC with significant variations across areas in Bangladesh. The average distance between the nearest LAMC-providing health facilities and womens homes was 6.36 km, higher in the Sylhet division (8.34 km) and lower in the Dhaka division (4.34 km). Increased scores for the management (adjusted odds ratio (AOR) 1.59; 95% CI, 1.21-2.42) and infrastructure (AOR, 1.44; 95% CI, 1.01-1.69) of health facilities were positively associated with the overall uptake of LAMC. AORs for women to report using LMAC were 2.16 (95% CI, 1.18-3.21) and 1.74 (95% CI, 1.15-3.20), respectively, for per unit increase in the availability and readiness scores to provide LAMC at the nearest health facilities. Nearly 27% decline in the likelihood of LAMC uptake was observed for every kilometer increase in the average regional-level distance between womens homes and the nearest health facilities. Conclusion The availability of health facilities close to residence and their improved management, infrastructure, and readiness to provide LAMC play a significant role in increasing LAMC uptake among women. Policies and programs should prioritize increasing the availability and accessibility of health facilities that provide LAMC services.

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Spatial variations and associated factors of modern contraceptive use in Ethiopia: a spatial and multilevel analysis

Cited by 42 publications

References 23 publications

Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey

Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey

Assessment of Intention to Use Contraceptive Methods With Spatial Distributions and Associated Factors Among Women in Ethiopia: Evidence From EDHS 2016

Availability and readiness of healthcare facilities and their effects on long-acting modern contraception use in Bangladesh: Analysis of linked data

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