Abstract
BackgroundEthiopia is the second most populous country in Africa, known for its high fertility and low contraceptive use. The magnitude of contraceptive use in the emerging regions of the country is below the national average. However, there is a paucity of evidence regarding the reasons for low contraceptive use in these regions. Therefore, this study aimed to assess contraceptive use and associated factors in the emerging regions of Ethiopia.MethodsFor the quantitative part, a community based cross-sectional study was conducted among 2891 reproductive age women who were selected by multistage sampling technique. Data were collected face to face using an open data kit software, and STATA version 14 was used for data analysis. Frequencies, percentages, summary measures and tables were used to summarize and present the data. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with contraceptive use, by computing odds ratio with 95% confidence interval. Level of significance was considered at p-value < 0.05. For the qualitative part, phenomenological study was conducted among 252 health care workers and community members who were selected purposely. The data were collected by focused group discussions, in-depth interviews and key informant interviews. The data were audio-recorded in the local languages, and then translated to English verbatim. NVivo version 11 was used to analyze the data through a thematic analysis method.ResultsThe overall contraceptive prevalence rate was 22.2%; with 11.7, 38.6, 25.5 and 8.8% for Afar, Benshangul Gumuz, Gambela and Somali Regions, respectively. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. Additionally, the qualitative study identified three themes as barriers to contraceptive use: individual, health care system and sociocultural factors.ConclusionsContraceptive prevalence rate was low in this study compared to the national average. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. From the qualitative aspect, individual, health care system and sociocultural factors were identified as barriers to contraceptive use. Therefore, the emerging regions of Ethiopia need special focus in increasing contraceptive use through behavioral influence/change.
Highlights
Ethiopia is a low income country with poor health service coverage, including family planning (FP), in the emerging regions [1]
There was no participant from Afar Region with a monthly household income greater than the median (1000 Ethiopian Birr (ETB)), but participants from Benishangul Gumuz (BG) (55.5%), Gambela (48.8%) and Somali (67.6%) Regions reported monthly income greater than the median (1000 Ethiopian birr (ETB))
With the objective to assess the magnitude of current contraceptive use and associated factors, this study revealed that the overall contraceptive prevalence rate (CPR) was 22.2%; high variation was observed in CPR among regions (11.7% in Afar, 38.6% in BG, 25.5% in Gambela and 8.8% in Somali)
Summary
Ethiopia is a low income country with poor health service coverage, including family planning (FP), in the emerging regions [1]. There was a significant regional variation in CPR among the emerging regions, with 3% in Somali Region and 38.5% in Benishangul Gumuz (BG) Region. Different factors such as age, education, family size, spousal communication on FP, number of live children, spousal approval on FP, ideal number of desired children, residence, religion, knowledge, and attitudes influence the uptake in contraceptive use [4,5,6,7]. Ethiopia has set an ambitious plan to improve primary health care services.
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