Abstract
BackgroundContraceptive use is the best and most cost-effective strategy to reduce feto-maternal adverse effects of short birth intervals. More than two-thirds of women in developing countries who do not want to conceive are not using contraception methods. Although there were various primary studies in different parts of the country, there is no nationally representative evidence on postpartum modern contraception utilization and its determinants in Ethiopia.ObjectiveThis review was aimed to determine the best available pieces of evidence to pool the magnitude of postpartum modern contraception utilization and find out its determinants.MethodsPublished studies were extensively searched by using electronic databases and unpublished studies were identified from the digital library. All observational studies conducted on the magnitude of postpartum modern contraception utilization and its determinants in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled magnitude of postpartum modern contraception utilization with a 95% confidence interval (CI). Inverse variance (I2) was used to identify the presence of heterogeneity and forest plot was used to estimate the pooled magnitude of postpartum contraception utilization. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Sub-group analysis was computed to minimize underlying heterogeneity.FindingsIn this review, 19 primary studies were included. The pooled magnitude of postpartum modern contraception utilization in Ethiopia was 45.79% (95%CI 36.45%, 55.13%). The review found that having more than four Antenatal care visits(ANC), having postnatal care visit (PNC), having a formal education, history of family planning use, history of counseling on family planning, and having greater than four alive children as significant determinants of postpartum modern contraception utilization.ConclusionThe magnitude of postpartum modern contraception utilization in Ethiopia was low. ANC visit, PNC visit, maternal educational status, history of previous family planning use, counseling on family planning, and number of alive children were found to be significant determinants of postpartum modern contraception utilization. Therefore, strengthening focused ANC and PNC services to encourage women in utilizing modern contraception during the postnatal period is needed.
Highlights
Planning refers to a conscious effort by a couple to limit or space the number of children they have through the use of contraceptive methods [1]
This review analyzed data from 11,932 postpartum women to estimate the pooled magnitude of postpartum modern contraception utilization
A total of 19(18 published and one unpublished) articles were included in this review yielding the pooled magnitude of postpartum modern contraception utilization in Ethiopia 45.79% with the lowest, 12.05% in Somali regional state [15] and the highest 80.32% in Addis Ababa [14] (Fig 2)
Summary
Planning refers to a conscious effort by a couple to limit or space the number of children they have through the use of contraceptive methods [1]. Postpartum women are among those with a greater unmet need for family planning [4]. In Ethiopia in the year 2016, about 22% of postpartum women have an unmet need for family planning [5]. The unique family planning needs of postpartum women might be because of breastfeeding practice of postpartum women that determines the duration of amenorrhea they had experienced. There were various primary studies in different parts of the country, there is no nationally representative evidence on postpartum modern contraception utilization and its determinants in Ethiopia.
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