Abstract
BackgroundEthiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate. This study aimed to assess individual and community-level predictors of modern contraceptive use among sexually active rural women in Ethiopia.Data and methodsA sample of 9450 sexual active rural women aged 15-49 was extracted from the 15, 683 nationally representative samples of 2016 Ethiopian Demographic and Health Survey (EDHS). Multi-level logistic regression model was considered to identify determinant factors of modern contraceptive use among sexually active rural women in Ethiopia.ResultThe prevalence of modern contraceptive use among respondents was 20% in rural Ethiopia. Injection (66.35%) was the most common type of modern contraceptive use. In the last full model of the multilevel analysis, individual and community-level factors accounted for 86.69% of the variation in the use of modern contraceptive methods. Secondary and above-educated women (AOR = 1.39, 95%CI: 1.06, 2.81), having 1-4 living children (AOR = 2.70, 95%CI: 2.07, 3.53), rich wealth status (AOR = 2.26, 95%CI: 1.96, 2.60), married women (AOR = 17.31, 95%CI: 10.72, 27.94), having primary educated husband (AOR = 1.45, 95%CI: 1.27, 1.67) and being working husband (AOR = 2.26, 95%CI: 1.96, 2.60) were significantly positively associated with individual-level factors of the use of modern contraceptive methods. Besides, modern contraceptive use was negatively associated with Muslim women (AOR = 0.29, 95%CI: 0.25, 0.33). Compared to the Tigray region, women living in the Afar, Somali, Harari, and Dire Dawa regions had lower use of modern contraceptive methods. Women who had access to mass media (AOR = 1.35, 95%CI: 1.16, 1.57) were more likely to use contraceptives than their counterparts.ConclusionThe prevalence of modern contraceptive use among rural women has very low. Both individual and community-level factors were significant predictors of modern contraceptive use. Consequently, the government and other stakeholders need to address educational opportunities; creating awareness about modern contraception and valuable counseling would increase modern contraceptive methods utilization.
Highlights
Ethiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate
The result of this study showed that 20.9% of the respondent used a modern contraceptive method which is lower than that reported from 2016 Ethiopian Demographic and Health Survey (EDHS) 35% [7]
This study revealed that an increasing educational level of respondents; whose husbands were more likely to use a modern contraceptive method
Summary
Ethiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate. The result of the high fertility rate is poor health conditions in general, and inadequate availability of medical care, the risks of pregnancy are higher in Africa than anywhere else [1, 2]. With a current population of 112 million with a fertility rate of 4.6 children born per woman, Ethiopia leads sub-Saharan Africa; one of the highest populations in Africa [1,2,3,4,5,6,7]. High fertility carries the highest risk of child mortality, as it is generally difficult for Ethiopian families to provide adequate food and health care for all their children. The problem of overpopulation has been compounded by poverty, war, drought, inadequate infrastructure, and poor agricultural and industrial production [8, 9]
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