Spatial Distribution 0f Unmet Need for Family Planning among Married Women Aged Between 15-49 Years: Evidence from Ethiopia Demographic and Health Survey 2016

Abstract

Introduction: Worldwide, 12% of married women with an age range of 15-49 years have an unmet need for contraception. In Ethiopia unmet need for family planning was high when compared to a developed country (24.5% vs 10% respectively). This high unmet need for family planning show gaps between women reproductive desire to avoid pregnancy and contraceptive behavior. This study shows spatial distribution of this unmet need for family planning among zone of Ethiopia. Objective: The aim of the study was to assess the spatial distribution of unmet need for family planning among married women aged b/w 15 to 49 year in Ethiopia. Methods: Cross-sectional study design was applied using Ethiopia demographic and health survey 2016 data. The sample size was 10,223 married women aged between 15-49 years. Spatial analysis was done using spatial autocorrelation Moran’s I and spatial scan statics was applied to local significant clusters based on Bernoulli model. Results: In Ethiopia, prevalence of unmet need for family planning was 22.3% (95% CI: 21.5%, 23.1%). The highest unmet need for family planning was spatially clustered in Jimma, Arsi, West Arsi, Southwest Shewa, Borena, Guji, West and East Hararge, Agnewak whereas the lowest in Fik, Gode, Afder, Liben Argoba, Afoder, and Sheka zones. Spatial scan statistics identified primary clusters (LLR=55.74, P<0.001) in Arsi, West Arsi, Bale, West Harrarge zone and secondary clusters (LLR=20.26, P<0.001) in Jimma, Southwest Shewa, Gurage, Silti, Hadiya, Yem and Wolayita zone.Conclusions: The study finding shows that insured patients perceived with a higher level of quality of care and satisfaction score. However, non-insured patients received high proportion score on objective quality of care measurements. Therefore, to improve patient experiences at health centers and achieve financial risk protection through CBHI, program managers and health care providers should ensure quality of services to the standards at the health facility to insured and noninsured community members. Conclusions: The prevalence of unmet need in Ethiopia is high. Statistical significant primary and secondary clusters were detected. Unmet need for family planning is important to prioritize family planning strategy, which enables to know about the distribution of unmet need across zone of the nation Therefore, exerting much effort on this area is supreme important as it has significant public health contributions.