Unmet need for contraception among married adolescent girls and young women in Haramaya Health and demographic surveillance system, Eastern Ethiopia

Abstract

BackgroundThe prevalence of unmet need for contraception is the highest in low- and middle-income countries (LMIC). Contraceptive use among young married or unmarried women is lower than that among older women in developing countries. Previous studies generalized the findings to all women of reproductive age and have not investigated psychosocial factors that influence contraceptive use. This study aimed to identify factors associated with unmet need for contraception among young married women in the Haramaya Health and Demographic Surveillance System (HDSS), eastern Ethiopia.MethodologyA cross-sectional, community-based study of young married women aged 15–24 years was conducted. A simple random sampling method was used to select 550 young married women. Data were collected using a pretested structured questionnaire. Using adjusted odds ratio (AOR) with a 95% confidence interval (CI), factors associated with unmet need for contraception were identified using multivariable logistic regression analysis.ResultsThe overall prevalence of unmet need for contraception was 154 (30.3%). Adolescents (15–19) (AOR = 2.05, 95% CI: 1.16–3.62), husbands' negative attitude toward contraception (AOR = 2.1, 95% CI: 1.05–4.46), and no previous use of contraception (AOR = 3.9, 95% CI: 2.29–6.71) were significantly and positively associated with unmet need for contraception. On the contrary, young women with secondary education or higher (AOR = 0.55, 95% CI: 0.28–1.084) were negatively and significantly associated with unmet need for contraception.ConclusionThe prevalence of unmet need for contraception among young women in Haramaya was high. Unmet need was affected by age, husbands' attitude toward contraceptives, the educational status of women, and previous use of contraception. This study underscored the need to improve girls' educational status to empower them in making contraceptive use decisions with their partners. Programs should also engage male partners who are perceived as key decision-makers when it comes to contraceptive use.

Trends and determinants of unmet need for modern contraception among adolescent girls and young women in Tanzania, 2004–2016

“…This can be explained by the opposition that these AGYW are likely to face from their partners regarding modern contraceptive use. Other studies have demonstrated that married AGYW unsupported by their partners on modern contraceptive use, are likely to have higher unmet need [ 38 ]. Further, we also observed that sexually active AGYW (in the past 4 weeks) have a higher unmet need compared to their counterparts, possible explanation for this finding is that sexually active AGYW are likely to be married and even though they are willing to use modern contraception methods, they are likely to be hindered by their partners’ preferences or negative attitude toward contraceptive use.…”

Sexual and reproductive health experiences, access to services, and sources of information among university students in Ethiopia

“…Research among young people in Ethiopia has found significant unmet SRH needs. Unmet need for family planning was estimated at 16% among all women ages 15-49 in 2019, and studies have found this number may be higher for adolescents and young women (18,19). In 2016, the median age at first intercourse was 16 years old, with more than half of young people having intercourse before the age of 18 (20).…”