Abstract
Unless evidence based decisions are made based on local contexts, the low prevalence level of contraceptive use and the corresponding higher total fertility rate will make Ethiopia to remain the most populous country in Africa. The purpose of this study was to assess the status of modern contraceptive use among married women in Debre Birhan district, Ethiopia. A community based cross-sectional study was conducted among married women of reproductive age. Systematic random sampling technique was used to choose 851 study subjects. Before data collection, ethical clearance was obtained from the institution, and data was collected by trained diploma nurses using pretested structured questionnaire and analyzed by statistical package for social sciences (SPSS), version 20. Logistic regression analysis was employed to identify the predictors of modern contraceptive use. Modern contraceptive prevalence rate among married women was 46.9%. Injectables were the most frequently used type of modern contraceptive method (62.9%), followed by intrauterine device (16.8%), pills (14%), norplant (4.3%), male condom (1.2%) and female sterilization (0.8%). Multiple logistic regression model revealed that the need to have more children [AOR 95% CI: 9.27 (5.43 to 15.84)], husband approval [AOR 95% CI: 2.82 (1.67 to 4.80)] and husband-wife communication about contraceptives [AOR 7.32, 95% CI (3.60 to 14.86)] were found to be an independent predictors for the use of modern contraceptives. There were no statistical significant differences between modern contraceptive use and other socio-demographic and reproductive health related variables after an adjustment. Modern contraceptive use declined among married women in the district. The culture of publicly discussing the use of contraceptives and breaking the silence among the people demands substantial efforts. Considering users of contraceptives as deviant also requires paradigm shift in thinking. Key words: Debre-Birhan, married women, modern contraceptive, use.
Highlights
EPI INFO was used to calculate the sample size using single population proportion formula based on an assumption that 29% of the modern contraceptive prevalence utilization in Ethiopia, and design effect of 2 (The main reason of using design effect of 2 is to reduce the variability as a result of two stages that we passed from the District level to village and household level)
Of all 851 married women who responded to the questionnaire, the majority of the respondents were
The need for more children was the main reason for the discontinuation of modern contraceptive use that is supported by findings from Dembia district, West
Summary
Despite the introduction of modern contraceptives in Ethiopia in 1966 (Korra, 1997; Assefa et al, 2006). License 4.0 International License contraceptive prevalence rate (29%) remained lowest (Central Statistical Authority, 2011). The country is the second most populous in Africa with a total fertility rate of 4.85 (Population Reference Bureau, 2009). Maternal and child health related problems are rampant in the country. Unwanted pregnancy is among the prominent reproductive health related problems (USAID Health Policy Development, 2010). Imagine how appropriate use of modern contraceptives would save the life of millions of women, but with this current rate of utilization, the country may not be successful in achieving one of the indicators of Millennium Development Goal 4 and 5 unless all stakeholders are able to exert substantial and multidimensional efforts collaboratively
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