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Kinfe B, Mankelkl G. Factors associated with modern contraceptive utilization among reproductive age women in Cambodia; evidenced by the recent Cambodia demographic and health survey. Contracept Reprod Med 2024; 9:50. [PMID: 39415275 PMCID: PMC11481420 DOI: 10.1186/s40834-024-00315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Accepted: 10/08/2024] [Indexed: 10/18/2024] Open
Abstract
INTRODUCTION Cambodia is a low-income country with limited access to family planning (FP) in terms of modern contraceptive utilization. Despite several FP programs designed to make contraceptives accessible, adoption of contraceptives has been difficult in Cambodia, which has high rates of fertility and maternal mortality. This gap in essential care can put women and adolescent girls at greater risk of adverse outcomes such as stillbirth, spontaneous abortion, unwanted pregnancy, or even maternal death. One of the goals set by the government to decrease both maternal and child mortality and morbidity was increasing the modern contraceptives utilization. So, the main objective of this study was to evaluate spatial variations in modern contraceptives utilization and its contributing factors among women. METHODS Data from the Cambodia 2021-22 Demographic and Health Survey datasets were used for secondary data analysis. A total of 19,496 women of reproductive age participated in the study. A spatial and multilevel mixed effects analysis was done on the factors affecting modern contraceptives utilization among Cambodian women. Finally, the percentage, odd ratio, together with their 95% confidence intervals and the results of the spatial analysis were provided. RESULT The prevalence of modern contraceptive use was 31.2% in Cambodia. Living in an urban area [AOR = 1.224; 95% CI = (1.126.1.330); P = 0.0001]; being married [AOR = 34.131; 95% CI= (12.673, 91.921); P = 0.0001]; and having a history of terminated pregnancy [AOR = 1.137; 95% CI= (1.055, 1.225); P = 0.0001] were found to be positively associated with modern contraceptive utilization. In contrast to this, being between the age range of 46-49 [AOR = 0.421; 95% CI = (0.364, 0.487); P = 0.0001]; being a female-headed household [AOR = 0.784; 95% CI = (0.723, 0.850); P = 0.0001]; and current breast feeding [AOR = 0.84; 95% CI = (0.75, 0.93); P = 0.010] were found to be negatively associated with modern contraceptive utilization. Additionally, the spatial analysis of modern contraceptive utilization showed that a higher proportion was utilized in the southern and southwest regions of Cambodia. CONCLUSION In this study, living in urban area, being married and having history of terminated pregnancy were found positively associated with modern contraceptive utilization. In contrast to this, being old age, being female headed household and being currently breast-feeding women were found negatively associated with modern contraceptive utilization. In addition to this, there were geographic (spatial) variations in modern contraceptive utilization among Cambodian's women across the country.
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Affiliation(s)
- Beletu Kinfe
- Department of Biomedical, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Gosa Mankelkl
- Department of Occupational Health and Safety, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Baritwa MS, Joho AA. Intimate partner violence influences modern family planning use among married women in Tanzania: cross-sectional study. BMC Public Health 2024; 24:421. [PMID: 38336740 PMCID: PMC10858459 DOI: 10.1186/s12889-024-17666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Married women who experience intimate partner violence (IPV) are less likely to negotiate with their partners on modern family planning (FP) use. This study aimed to determine the influence of intimate partner violence and sociodemographics on modern family planning use. METHODS A community-based cross-sectional study was conducted in the Mara region, Tanzania from April to July 2020. A total of 366 married women were interviewed. Data were collected using a structured interviewer-administered questionnaire. Analysis was done using SPSS version 25, and a binary logistic regression model was used to determine the predictors of modern FP use. The significance level was set at a p-value less than 0.05. RESULTS The overall prevalence of IPV was 73% with 54.1% physical, 36.3% psychological, and 25.4%, sexual violence. The prevalence of modern FP use was 62%, and the most (49.1%) common method practiced by married women was injection (Depo Provera). Physical violence (AOR = 0.32, p = 0.0056), and psychological violence (AOR = 0.22, p = 0.0022) had significantly reduced odds of modern FP use. Religion (AOR = 4.6, p = 0.0085), and availability of preferred modern FP methods (AOR = 9.27, p < 0.0001) had significantly increased odds of modern FP use. CONCLUSION In this study, there is a positive association between the use of modern FP methods and IPV. To prevent IPV and its negative health consequences, it is crucial to involve community leaders and primary healthcare workers. They can help in identifying the best strategies to prevent IPV and promote the use of modern FP methods. It is equally important to involve male partners in reproductive health decisions, including the use of modern FP methods. This approach will help reduce reproductive coercion.
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Affiliation(s)
- Mrimi S Baritwa
- Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Angelina A Joho
- Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania.
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Hailegebreal S, Dileba Kale T, Gilano G, Haile Y, Endale Simegn A. Modern contraceptive use and associated factors among reproductive-age women in Ethiopia: multilevel analysis evidence from 2019 Ethiopia mini demographic and health survey. J Matern Fetal Neonatal Med 2023; 36:2234067. [PMID: 37433665 DOI: 10.1080/14767058.2023.2234067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/26/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Despite the high fertility and population growth rates, the use of modern contraceptives remains low in low- and middle-income countries. Different pocket-sized studies on the use of modern contraceptive methods conducted in various parts of Ethiopia have been extremely varied and ambiguous. Therefore, this study aimed to assess modern contraceptive use and its associated factors in women of reproductive age in Ethiopia. METHODS Cross-sectional data from the Ethiopia Interim Demographic Health Survey (EMDHS) 2019 in a stratified, two-stage, and cluster sampling study. Multilevel binary logistic regression analysis was used to fit the associated factors. The interclass correlation (ICC), median odds ratio (MOR), proportional change variance (PVC), and deviance were used for model comparison and fitness. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the significant factors of modern contraceptive use. RESULT The multilevel analysis demonstrated that Orthodox religion [AOR = 1.7; 95%CI: 1.4-2.10] protestant religion [AOR = 1.2; 95%CI: 0.93-1.62], married [AOR = 4.2; 95%CI: 1.93-9.07], primary education [AOR = 1.5; 95%CI: 1.26-1.76], secondary education [AOR = 1.36; 95%CI: 1.04-1.77 [AOR = 1.89; 95%CI: 1.37-2.61], middle [AOR = 1.4; 95%CI: 1.14-1.73], rich [AOR = 1.3; 95%CI: 1.06-2.68] were positively associated with modern contraceptive utilization, while the age group of 40-49 [AOR = 0.45, 95% CI: 0.34-0.58], and high community poverty [AOR = 0.62; 95%CI: 0.46-0.83] were negatively associated with modern contraceptive utilization. CONCLUSION The prevalence of modern contraception in Ethiopia remains low. Maternal age, religion, maternal education, marital status, wealth index, region, and community poverty were significant predictors of modern contraceptive utilization in Ethiopia. Governments and non-governmental organizations should expand their public health programs to poorer communities to increase the use of modern contraception in the country.
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Affiliation(s)
- Samuel Hailegebreal
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Temesgen Dileba Kale
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Gilano
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Yosef Haile
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Chekol YM, Jemberie SB, Goshe BT, Tesema GA, Tessema ZT, Gebrehewet LG. Geographic weighted regression analysis of hot spots of modern contraceptive utilization and its associated factors in Ethiopia. PLoS One 2023; 18:e0288710. [PMID: 38032986 PMCID: PMC10688731 DOI: 10.1371/journal.pone.0288710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/04/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Utilization of modern contraceptives is a common healthcare challenge in Ethiopia. Prevalence of modern contraception utilization is varying across different regions. Therefore, this study aimed to investigate Geographic weighted regression analysis of hotspots of modern contraceptive utilization and its associated factors in Ethiopia, using Ethiopian Demographic and Health Survey 2016 data. METHODS Based on the 2016 Ethiopian Demographic Health Survey data, a total weighted sample of 8,673 women was included in this study. For the Geographic Weighted Regression analysis, Arc-GIS version 10.7 and SaTScan version 9.6, statistical software was used. Spatial regression was done to identify factors associated with the hotspots of modern contraceptive utilization and model comparison was carried out using adjusted R2 and AICc. Variables with a p-value < 0.25 in the bi-variable analysis were considered for the multivariable analysis. Multilevel robust Poisson regression analysis was fitted for associated factors since the prevalence of modern contraceptive was >10%. In the multilevel robust Poisson regression analysis, the adjusted prevalence ratio with the 95% confidence interval was reported to declare the statistical significance and strength of association. RESULT The prevalence of modern contraceptive utilization in Ethiopia was 37.25% (95% CI: 36.23%, 38.27%). Most of the hotspot areas were located in Oromia and Amhara regions, followed by the SNNPR region and Addis Ababa City administration. Single Women, poor Women, and more fertility preference were significant predictors of hotspots areas of modern contraceptive utilization. In the multivariable multilevel robust Poisson regression analysis, Women aged 25-34 years (APR = 0.88, 95% CI: 0.79, 0.98), 35-49 years (APR = 0.71, 95% CI: 0.61, 0.83), married marital status (APR = 2.59, 95% CI: 2.18, 3.08), Others religions (APR = 0.76, 95% CI: 0.65, 0.89), number of children 1-4 (APR = 1.18, 95% CI: 1.02, 1.37), no more fertility preference (APR = 1.21, 95% CI: 1.11, 1.32), Afar, Somali, Harari, and Dire Dawa: (APR = 0.42, 95% CI: 0.27, 0.67), (APR = 0.06, 95% CI: 0.03, 0.12), (APR = 0.78, 95% CI: 0.62, 0.98), and (APR = 0.75, 95% CI: 0.58, 0.98), respectively. Amhara region (APR = 1.34, 95% CI: 1.13, 1.57), rural residence (APR = 0.80, 95% CI: 0.67, 0.95) High community wealth index (APR = 0.78, 95% CI: 0.67, 0.91) were significantly associated with modern contraceptive utilization. CONCLUSION AND RECOMMENDATION There were significant spatial variations of factors affecting modern contraceptive use across regions in Ethiopia. Therefore, public health interventions targeting areas with low modern contraceptive utilization will help to increase modern contraception use considering significant factors at individual and community levels.The detailed map of modern contraceptive use cold spots among reproductive age group and its predictors could assist program planners and decision-makers to design targeted public health interventions.Government of Ethiopia must develop more geographic targeted strategies for improving socioeconomic status of women and availability & accessibility of health facilities in rural areas of the countries.
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Affiliation(s)
- Yazachew Moges Chekol
- Department of Health Information Technician, Mizan Aman College of Health Science, Mizan Aman, Ethiopia
| | | | - Bazezew Takel Goshe
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lewi Goytom Gebrehewet
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bizuneh FK, Bizuneh TK, Masresha SA, Yayeh BM. Individual and community level factors for modern contraceptives utilization among reproductive aged women in Amhara region, Mixed effect multi-level modeling, Data from Mini-EDHS, 2019. Contracept Reprod Med 2023; 8:56. [PMID: 38012780 PMCID: PMC10683182 DOI: 10.1186/s40834-023-00256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Modern contraceptive has been identified as a key strategy to control unintended pregnancy, protect the health of the mother and child, and promote women wellbeing. Despite this and increasingly wider availability of modern contraceptives, however, there are still high levels of unmet need for birth interspacing and contraceptive use in Amhara regions. This study aimed to identify factors associated with the enhancing of modern contraceptives utilization among reproductive aged women in Amhara region, using a mixed effects multilevel modeling data from mini-EDHS 2019. METHODS A community-based cross-sectional study was conducted among 711(wt = 100%) samples of reproductive-aged women. The data were interviewed by trained data collectors using a semi-structured questionnaire for the final mini-EDHS 2019 data set. A multilevel binary logistic regression model was fitted to identify the enhancing factors for modern contraceptive utilization Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was used to identify factors associated with utilization. RESULT The median age of the participants was 31 with (IQR ± 13) years. The overall modern contraceptive utilization was 42.3% (95%CI: 38.7; 46.1). Individual and community factors accounted for 21.4% of the variation in modern contraceptive utilization at the cluster level. Being age 25 years (AOR = 12.99; 95%CI: 4.5-37.2), 26-35 years (AOR = 8.8, 95%CI: 3.25- 24), 36-45 years (AOR = 5.6, 95%CI: 2.2-16.2), being married (AOR = 4.2, 95%CI: 2.21-6.97), educated women (AOR = 11.6, 95%CI: 3.22-40.4), and being middle-economic class (AOR = 3.03; 95%CI: 1.87-4.91) were identified as individual enhancing factors. Whereas, being urban resident (AOR = 5.19; 95%CI: 5.19: 41.7) and having media exposure (AOR = 1.5; 95%CI: 1.58-3.7) were community-level enhancing factors for modern contraceptive utilization. CONCLUSION Compared to earlier studies, in Amhara region, a lower prevalence rate of modern contraceptive utilization was reported. The variation in utilization at the cluster level, 21.4%, was attributed to individual and community-level factors. Healthcare providers should prioritize raising awareness about contraceptive side effects to encourage new users and decrease the number of individuals who discontinue contraceptive methods.
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Affiliation(s)
- Fassikaw Kebede Bizuneh
- School of public health, College of health science, Woldia University, North East, Ethiopia.
| | - Tsehay Kebede Bizuneh
- Department of Geography, Faculty of social science, Bahir Dare University, Bahir Dar, Ethiopia
| | | | - Berihun Mulu Yayeh
- School of public health, College of health science, Woldia University, North East, Ethiopia
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Nimani TD, Tadese ZB, Tadese EE, Butta FW. Trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women, based on the 2000, 2005, 2011, and 2016 Ethiopian demographic and health survey. BMC Womens Health 2023; 23:629. [PMID: 38012691 PMCID: PMC10683082 DOI: 10.1186/s12905-023-02789-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The most common family planning method is modern contraception. It is a cost-effective way to reduce maternal and neonatal morbidity and mortality and enable women to make informed choices about their reproductive and sexual health. The trend of modern contraceptive utilization has shown drastic change in Ethiopia, and identifying the major factors contributing to such a drastic change is vital to improving plans and strategies for family planning programs. Therefore, this study analyzed the trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women in Ethiopia. METHOD This study used secondary data from the EDHS 2000-2016, collected from a population-based cross-sectional study by the Central Statistical Agency, focusing on married reproductive-age women aged 15-49. The study analyzed the modern contraceptive use trends through descriptive analyses conducted in three phases: 2000-2005, 2005-2011, and 2011-2016. The study utilized bivariable and multivariable logistic regression analyses to identify determinant factors, with significant variables declared using a P-value of 0.05 and an adjusted OR with 95% confidence interval. Analysis was conducted using STATA.14 and R. Spatial analysis was done using ArcGIS version 10.8 and SatScan™ version 9.6. RESULT A weighted total of 33,478 women are included in the study, with a mean age of 31.4 years (8.6 SD). There was a significant increase in the trend of modern contraceptive use among married women over the study period, from 2000 to 2016, from 7.2% to 2000 to 15.7% in 2005, to 30% in 2011, and to 39.5% in 2016. The maximum increase was seen in the second phase (2005-2011), with a 14.3% increase. Factors like age of respondents, educational status, religion, residence, region, wealth index, number of living children, husbands' desire to have more children, and media exposure were found to be predictors for modern contraceptive utilization. CONCLUSION The prevalence of modern contraceptive use is below 50%, and there is also evidence of wide geographical variation in modern contraceptive use in Ethiopia. Thus, policymakers, high institutions, and other stakeholders must work collaboratively with the government in order to improve awareness about modern contraceptive use.
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Affiliation(s)
- Teshome Demis Nimani
- Department of epidemiology and biostatistics, School of Public Health College of medicine and Health Science, Haramaya University, Harar, Ethiopia.
| | - Zinabu Bekele Tadese
- Department of Health Informatics, School of Public Health, College of Medicine and Health Science, Samara University, Samara, Ethiopia
| | - Eyob Eshete Tadese
- Department of nursing, College of medicine and Health Science, Mettu University, Mettu, Ethiopia
| | - Fikadu Wake Butta
- Department of Health Informatics, School of Public Health College of medicine and Health Science, Mettu University, Mettu, Ethiopia
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Tiruneh MG, Kebede Bizuneh F. Determinates of anemia among Human Immune Deficiency Virus positive children on Anti-retro Viral Therapy in selected health facilities, Northwest Ethiopia: A Case-Control Study. J Nutr Sci 2023; 12:e95. [PMID: 37706072 PMCID: PMC10495818 DOI: 10.1017/jns.2023.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/09/2023] [Accepted: 07/27/2023] [Indexed: 09/15/2023] Open
Abstract
Even though antiretroviral therapy (ART) access for human immunodeficiency virus (HIV)-infected children increased dramatically, anaemia has continued as a challenge regardless of a cluster of differentiation (CD4) count and viral load. Hence, the present study aimed to assess the determinants of iron deficiency anaemia among children living with HIV after the initiation of ART. An institution-based unmatched case-control study was conducted among consecutively selected 712 children on HIV care from 1 September to 30 October 2022 in the Metekel zone. A pre-tested and structured data extraction checklist was used to collect the data. Data were analysed using STATA version 16 software. Binary logistic regression was used to find the association between independent variables and anaemia. The level of statistical significance was declared at a value of P < 0⋅05. A total of 712 HIV-positive children (178 cases and 534 controls) were included in this study, with a completeness rate of 98⋅8 %. In multivariable analysis, variables that have a statistically significant association with anaemia were as follows: CD4 count <350 (Adjusted Odds Ratio [AOR] 2⋅76; 95 % CI 1⋅76, 4⋅34), World Health Organization (WHO) clinical stage III (AOR 7⋅9; 95 % CI 3⋅5, 17⋅91) and stage IV (AOR 7⋅8; 95 % CI 3⋅37, 18⋅1), cotrimoxazole prophylaxis therapy (AOR 0⋅5; 95 % CI 0⋅31, 0⋅8) and mid-upper arm circumference (MUAC) ≤11⋅5 mm (AOR 2⋅1; 95 % CI 1⋅34, 3⋅28). The present study found that CD4 count, WHO clinical stage, cotrimoxazole prophylaxis therapy and MUAC were significantly associated with anaemia in children on ART. Therefore, continuous screening of anaemia and nutritional treatment is essential in these patients.
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Affiliation(s)
- Misganaw Guadie Tiruneh
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Fassikaw Kebede Bizuneh
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Mankelkl G, Kinfe B. Spatial variations and multilevel mixed effect analysis on determinants factors of modern contraceptive utilization among reproductive age women in Ethiopia; proven by Ethiopian mini demographic health survey 2019. BMC Womens Health 2023; 23:77. [PMID: 36814235 PMCID: PMC9948416 DOI: 10.1186/s12905-022-02030-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/26/2022] [Indexed: 02/24/2023] Open
Abstract
INTRODUCTION Globally, in 2019, there are 1.9 billion women of reproductive age (15-49), of which 1.1 billion have a need for family planning. Of these, 842 million use contraceptives, and 270 million still have an unmet need for contraception. Ethiopia is a low-income country with inadequate access to family planning (FP), especially in the developing regions. The Ethiopian government was striving to increase the number of health facility in order to provide quality maternal care and services. Increasing the modern contraceptive prevalence rate is one of the goals of the government to reduce maternal and child mortality and morbidity. METHODS Secondary data analysis was conducted using data from mini-EDHS of 2019 demographic and health Survey datasets. The study comprised a total of 8885 reproductive-age women. Spatial variations and multilevel mixed effect analysis on determinants factors of modern contraceptive use among reproductive age women in Ethiopia; evidenced by mini-EDHS 2019. Finally, the percentage and odd ratio, its 95% confidence intervals, and the result of spatial analysis were reported. RESULT This study includes a total weighted sample of 8885 reproductive-age women from the 2019 mini-Ethiopian demographic and health survey. The prevalence of modern contraceptive use was 25.5% in Ethiopia. living in urban area [AOR = 2.13; 95% CI = (1.75, 2.61); P = 0.000], being married [AOR = 1.42; 95% CI = (1.19, 1.70); P = 0.000] were found positively associated with contraceptive use. In contrast to this, attending primary education [AOR = 0.91; 95% CI = (0.74, 1.12); P = 0.000]., being Muslim [AOR = 0.25; 95% CI = (0.22, 0.29); P = 0.000], being poorest [AOR = 0.54; 95% CI = (0.45, 0.66); P = 0.000] were found negatively associated with contraceptive use. CONCLUSION In this study Individual and community level factors were associated with modern contraceptive use and also there were spatial variations in modern contraceptive use across the region among reproductive-age women. Empowering women to have better educational status, improving the wealth index, promoting marriage, creating awareness among rural residences women and promoting education about modern contraceptives through religiously acceptable persons, and promoting modern contraceptive use in developing regions were the key factors to improve modern contraceptive use among reproductive age women in Ethiopia.
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Affiliation(s)
- Gosa Mankelkl
- College of Medicine and Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia.
| | - Beletu Kinfe
- College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Belachew TB, Negash WD, Bitew DA, Asmamaw DB. Modern contraceptive utilisation and its associated factors among reproductive age women in high fertility regions of Ethiopia: a multilevel analysis of Ethiopia Demographic and Health Survey. BMJ Open 2023; 13:e066432. [PMID: 36787981 PMCID: PMC9930559 DOI: 10.1136/bmjopen-2022-066432] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE This study is aimed to assess the magnitude of modern contraceptives utilisation and associated factors among reproductive age women in high fertility regions of Ethiopia. DESIGN Cross-sectional study. SETTING High fertility regions of Ethiopian. PARTICIPANTS A total weighted sample of 3822 married reproductive age women. METHODS In this study, data were obtained from the recent Ethiopian Demographic and Health Surveys. A total weighted sample of 3822 women of reproductive age was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of modern contraceptive utilisation. Statistical significance was determined using adjusted OR (AOR) with 95% CI. RESULTS The overall modern contraceptive utilisation was 29.75% (95% CI 28.2% to 31.2%). Among the factors associated with utilisation were women's age 25-34 years (AOR 1.3; 95% CI 1.01 to 1.66) and ≥35 (AOR 1.71; 95% CI 1.37 to 2.70), husband's occupation (AOR 1.49; 95% CI 1.03 to 1.99), number of alive children: 1-4 (AOR 2.20; 95% CI 1.47 to 3.30), 5-8 (AOR 1.74; 95% CI 1.09 to 2.77), husband's desired number of children (AOR 0.77; 95% CI 0.61 to 0 .96), residency (AOR 2.37; 95% CI 1.20 to 4.67), community media exposure (AOR 1.77; 95% CI 1.01 to 3.08), region (AOR 0.13; 95% CI 0.03 to 0.52) and religion (AOR 0.49; 95% CI 0.36 to 0.66) were significantly associated with modern contraceptive utilisation. CONCLUSION Modern contraceptives utilisation in high fertility regions of Ethiopia was low. Women age, husband occupation, number of living children, husband's desired number of children, residency, community media exposure, region and religion were significantly associated with modern contraceptive utilisation. Therefore, to improve the utilisation of modern contraceptives, public health policy makers should consider creating awareness through mass media, male involvement in family planning, as well as family planning programmes, should be encouraged in rural areas.
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Affiliation(s)
| | | | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Idris H, Sari IP, Heru H. Long-Term Contraceptive Method Use among Married Women of Reproductive Age: Cross Sectional Study in South Sumatra. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The population of growth rate in Indonesia is still high, including South Sumatra. The use of modern contraceptives tends to stagnate at the moment.
AIM: This study aims to analyze the determinant of long-term contraceptive method use among married women of reproductive age in South Sumatra.
METHODS: This study is a quantitative study with a cross-sectional design. We used secondary data, Indonesia Health and Demographics Survey 2017. The unit of analysis in this study is reproductive age women (15–49 years) in South Sumatra who successfully became respondents to the 2017 IDHS and married status. The number of respondents was 686. We analyzed the predictor of long-term contraceptive method use using logistic regression.
RESULTS: The proportion of users of long-term contraceptive method was 18.2%. Factors related to the use of these contraceptives include received visits from health workers, number of living children, and mother’s employment (p < 0.05). Respondent who received visits from health workers within the last 6 months was 2.7 times more likely to use long-term contraceptive method than respondent who did not receive a health worker visit.
CONCLUSION: Married women who get visits by health workers are more likely to use long-term contraceptive methods. This study result could be used as a reference for making policies that focus on increasing visit by health workers to married women and give counseling the benefit of long-term contraceptive method use.
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Abebe M, Mersha A, Degefa N, Gebremeskel F, Kefelew E, Molla W. Determinants of induced abortion among women received maternal health care services in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case-control study. BMC Womens Health 2022; 22:107. [PMID: 35397584 PMCID: PMC8994190 DOI: 10.1186/s12905-022-01695-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background About 210 million women become pregnant per year, with one out of every ten pregnancies terminating unsafely worldwide. In developing countries, unsafe induced abortion is a leading cause of maternal mortality and morbidity. In addition, the burden of public health is also greatest in developing regions. In Ethiopia, abortion was responsible for 8.6% of maternal deaths. Despite the problem's significance, little is known about the factors that lead to women terminating their pregnancies. Therefore, this study aims to identify the factors associated with having induced abortion in public hospitals of Arba Minch and Wolayita Sodo town, Southern Ethiopia. Methods An institutional-based unmatched case–control study was conducted among 413 women from 15th April to 15th June 2021 in selected public hospitals of Arba Minch and Wolayita Sodo town, Southern Ethiopia. Cases were women who received induced abortion care services or who received post-abortion care services after being presented to the selected public hospital with an attempt of induced abortion whereas controls were women who came for maternal health care (antenatal or postnatal care) services in selected public hospitals and never had history of induced abortion. The data were collected by pretested and structured questionnaires with face-to-face interviews via Kobo Collect v3.1 mobile tools and analyzed by STATA version14. Logistic regression model was used to identify factors associated with induced abortion. In this study P-value less than 0.05 with 95% CI was declared a result as statistically significant. Results In this study, 103 cases and 309 controls were participated. Urban residence (AOR = 2.33, 95%CI:1.26, 4.32), encountered first sex at age of 20–24 years (AOR = 0.51, 95%CI:0.27,0.97), multiple sexual partner (AOR = 5.47, 95%CI: 2.98,10.03), women who had one child (AOR = 0.32, 95%CI: 0.10, 0.99), and good knowledge of contraceptives (AOR = 0.12, 95%CI: 0.03, 0.46) were identified as determinants of induced abortion. Conclusions Interventions focusing on those identified factors could probably reduce the burden and consequences of induced abortion. Sexual and reproductive health education and family planning programs would target urban dwellers, women who start sexual intercourse between the ages of 15 and 19, women with more than one sexual partner, women with a desire to limit childbearing, and women with poor contraceptive knowledge in order to reduce induced abortion. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01695-0.
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Affiliation(s)
- Mesfin Abebe
- Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Abera Mersha
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Nega Degefa
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Feleke Gebremeskel
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Etenesh Kefelew
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Wondwosen Molla
- Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
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12
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Mare KU, Aychiluhm SB, Tadesse AW, Mohammed OA. Individual and community-level determinants of non-use of contraceptive among women with no fertility desire in Ethiopia: a multilevel mixed-effect analysis. Emerg Themes Epidemiol 2022; 19:2. [PMID: 35366932 PMCID: PMC8976977 DOI: 10.1186/s12982-022-00112-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In Ethiopia, about two-third of women in the reproductive-age do not use any method of contraception. Moreover, evidence on non-use of contraceptives among women who do not have future fertility desires are limited. Therefore, this study intended to identify both individual and community-level determinants of non-use of contraceptives among this group in Ethiopia using a multilevel mixed effect analysis. METHODS Data retrieved from the demographic and health survey program official database website ( http://dhsprogram.com ) were used in this study. The suvey was conducting using a multistage cluster sampling technique and a weighted sample of 4398 reproductive-age women with no fertility desire was used in this study. Four models were fitted using a multilevel multivariable logistic regression to identify determinants of non-use of contraceptives and model with the lowest Akaike's Information Criterion was selected as a best fitted model. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. RESULTS Overall, 65.3% [95% CI (63.9%, 66.7%)] of women with no fertility desire were not using any contraceptive method. Living in large central [AOR (95% CI) 0.45 (0.31, 0.67)] and metropolitan regions [AOR (95% CI) 0.39 (0.22, 0.68)] and being from household with middle [AOR (95% CI) 0.65 (0.42, 0.93)] and rich wealth index [AOR (95% CI) 0.67 (0.44, 0.98)] were negatively associated with non-use of contraceptives. Besides, being from a community with high women illiteracy [AOR (95% CI) 1.38 (1.15, 1.67)], being Muslim [AOR (95% CI) 1.86 (1.22, 2.85)], having history of pregnancy termination [AOR (95% CI) 1.59 (1.10, 2.31)], having a husband who desire to have more children [AOR (95% CI) 1.46 (1.02, 2.09)] were the positive determinants of non-utilization of contraceptives. CONCLUSION Nearly two-third of reproductive-age women with no fertility desire in Ethiopia do not use any contraceptive method. Awareness creation interventions on the benefits of contraceptives targeting Muslim religion followers and improving women education and their economic empowerment at household level may decrease the proportion of non-use of contraceptives at a national level.
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Affiliation(s)
- Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
| | - Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Osman Ahmed Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Tsegaw M, Mulat B, Shitu K. Modern Contraceptive Utilization and Associated Factors Among Married Women in Liberia: Evidence from the 2019 Liberia Demographic and Health Survey. Open Access J Contracept 2022; 13:17-28. [PMID: 35210875 PMCID: PMC8857995 DOI: 10.2147/oajc.s350117] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/26/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Contraceptive methods help individuals control the number, interval, and timing of pregnancies and prevent unwanted pregnancies. OBJECTIVE This study aimed to assess the prevalence of modern contraceptive utilization and associated factors among married reproductive-age women in Liberia. METHODS This study was based on a large community-based cross-sectional survey, conducted from October 16, 2019, to February 12, 2020, in Liberia. The survey employed a multistage cluster sampling technique to recruit study participants. Binary logistic regression was used to identify associated factors of contraceptive utilization. A p-value of <0.05 and a 95% confidence interval were used to declare statistical significance. RESULTS The overall modern contraceptive utilization among reproductive-age women in Liberia was 23.87% (95% CI: 27.3, 29.9). Women with the age group of 20 and 24 years [AOR = 2.08 (95% CI:1.37, 3.14)], 25-29 years [AOR = 1.73 (95% CI: 1.13, 2.65)], 45-49 years [AOR = 0.46, 95% CI: 0.27, 0.76], being Muslim [AOR = 0.52, 95% CI: 0.399, 0.67], residing in South Eastern Regions (B) [AOR = 1.40, 95% CI: 1.11, 1.79], south central [AOR=0.48 95% CI:0.37, 0.61] and North Central region [AOR = 0.48, 95% CI: 0.37, 0.61], being employed [AOR = 1.26, 95% CI:1.06, 1.51], having 1-2 child/children [AOR = 2.81, 95% CI:1.80, 4.39] 3-4 children [AOR = 3.87, 95% CI:3.87, 6.24] and 5 and above [AOR = 7.06, 95% CI: 4.27, 11.69], completed primary [AOR = 1.52, 95% CI: 1.22, 1.88] and higher education [AOR = 1.72, 95% CI: 1.01, 2.94], having educated husband [AOR = 1.35, 95% CI: 1.12, 1.63], being from richer households [AOR = 1.41, 95% CI:1.09, 1.82], and had declared infecund [AOR = 0.13, 95% CI: 0.046, 0.36] were independently associated with modern contraceptive utilization among married women in Liberia. CONCLUSION The prevalence of modern contraceptive utilization among reproductive-age women in Liberia was low. Contraceptive utilization was affected by partners' education and participants' socio-demographic and obstetric attributes. Thus, public health interventions are urgently required to enhance use of contraceptives among this group of population.
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Affiliation(s)
- Menen Tsegaw
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Bezawit Mulat
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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14
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Tsehay CT. Factors associated with modern contraceptive demands satisfied among currently married/in-union women of reproductive age in Ethiopia: a multilevel analysis of the 2016 Demographic and Health Survey. BMJ Open 2022; 12:e049341. [PMID: 35110305 PMCID: PMC8811575 DOI: 10.1136/bmjopen-2021-049341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Regardless of the local and international initiatives, excluding exempting services, demand satisfied for contraceptives remains low in Ethiopia. This circumstance is supposed to be attributed to different level factors; however, most were not well addressed in the previous studies. Therefore, this study aimed at assessing the magnitude and individual, household and community-level factors associated with demand satisfied for modern contraceptive (DSFMC) methods among married/in-union women of reproductive age. DESIGN Cross-sectional study. SETTING A community-based study across the country. PARTICIPANTS Randomly selected 9126 married/in-union women had participated using a structured questionnaire. OUTCOME DSFMC methods among married/in-union women of reproductive age. RESULTS DSFMC methods in Ethiopia was 39.5% (95% CI 38.5% to 40.5%). Women aged 35-49 years (adjusted OR (AOR): 0.43, 95% CI 0.32 to 0.58), Muslim religion (AOR: 0.58, 95% CI0.43 to 0.78), husband lived elsewhere (AOR: 0.42, 95% CI 0.29 to 0.60), joint decision making to use (AOR: 1.30, 95% CI 1.04 to 1.62), good knowledge (AOR: 1.57, 95% CI 1.32 to 1.86) and wealth status of poorer (AOR: 1.56, 95% CI 1.17 to 2.06), middle (AOR: 1.77, 95% CI 1.33 to 2.35), richer (AOR: 1.96, 95% CI 1.49 to 2.59), and richest (AOR: 1.49, 95% CI 1.05 to 2.08), pastoralist regions (AOR: 0.28, 95% CI 0.18 to 0.42), and agrarian regions (AOR: 1.72, 95% CI 1.21 to 2.44) and rural residency (AOR: 0.56, 95% CI 0.37 to 0.82) were factors significantly associated. CONCLUSIONS Women's age, religion, the current living place of husbands and women's knowledge were individual-level factors. Household wealth status and mutual decision making to use were household-level factors. Region and residency were households and community-level factors associated with DSFMCs. Increasing the accessibility of modern contraceptive methods to women in rural areas and pastoralist regions, those living separately, engaging religious leaders and men in the programme, would increase their satisfying demand.
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Affiliation(s)
- Chalie Tadie Tsehay
- Department of Health Systems and Policy, University of Gondar, Gondar, Ethiopia
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15
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Shagaro SS, Gebabo TF, Mulugeta BT. Four out of ten married women utilized modern contraceptive method in Ethiopia: A Multilevel analysis of the 2019 Ethiopia mini demographic and health survey. PLoS One 2022; 17:e0262431. [PMID: 35030213 PMCID: PMC8759669 DOI: 10.1371/journal.pone.0262431] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 12/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background
Modern contraceptive method is a product or medical procedure that interferes with reproduction from acts of sexual intercourse. Globally in 2019, 44% of women of reproductive age were using a modern method of contraception but it was 29% in sub-Saharan Africa. Therefore, the main aim of this analysis was to assess the prevalence of modern contraceptive utilization and associated factors among married women in Ethiopia.
Method
The current study used the 2019 Ethiopia mini demographic and health survey dataset. Both descriptive and multilevel mixed-effect logistic regression analysis were done using STATA version 14. A p-value of less than 0.05 and an adjusted odds ratio with a 95% confidence interval were used to report statistically significant factors with modern contraceptive utilization.
Result
The overall modern contraceptive utilization among married women in Ethiopia was 38.7% (95% CI: 37.3% to 40.0%). Among the modern contraceptive methods, injectables were the most widely utilized modern contraceptive method (22.82%) followed by implants (9.65%) and pills (2.71%). Maternal age, educational level, wealth index, number of living children, number of births in the last three years, number of under 5 children in the household, religion, and geographic region were independent predictors of modern contraceptive utilization.
Conclusion
In the current study only four out of ten married non-pregnant women of reproductive age utilized modern contraceptive methods. Furthermore, the study has identified both individual and community-level factors that can affect the utilization of modern contraceptive methods by married women in the country. Therefore, concerned bodies need to improve access to reproductive health services, empower women through community-based approaches, and minimize region wise discrepancy to optimize the utilization.
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Affiliation(s)
- Sewunet Sako Shagaro
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- * E-mail:
| | - Teshale Fikadu Gebabo
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Be’emnet Tekabe Mulugeta
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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