Abstract
Background Studies conducted to date in Ethiopia did not explore the spatial distribution, individual-level, and community-level factors affecting women's nonautonomy on decision to use contraceptives. Hence, this study aimed to assess the spatial distribution of women's nonautonomy on decision regarding contraceptive utilization and its determinants in Ethiopia. Methods Data were accessed from the Demographic Health Survey program official database website (https://dhsprogram.com). A weighted sample of 3,668 married reproductive-age women currently using contraceptives was included in this analysis. Bayesian multilevel logistic regression models were fitted to identify the determinants of women's nonautonomy on contraceptive utilization. Adjusted odds ratio with 95% credible interval was used to select variables that have a significant effect on nonautonomy on contraceptive utilization. Results A high proportion of women with nonautonomy on decision regarding contraceptive utilization was found in northern parts of Southern Nations, Nationalities, and People's Region, Southern parts of Oromia, and Benishangul-Gumuz regions of the country. Overall, 2876 (78.40% (95% CI: 77.0%, 79.7%)) women were nonautonomous on decision regarding contraceptive utilization. In the final model, age from 35–49 (AOR (95% CI) = 0.63 (0.54, 0.72)), living in the richer households (AOR (95% CI) = 0.12 (0.03, 0.26)), being married at 18 years or above (AOR (95% CI) = 0.33 (0.19, 0.57)), and residing in an rural areas (AOR (95% CI) = 1.34 (1.01, 1.71)) and metropolitan regions (AOR (95% CI) = 0.71(0.54, 0.91)) were associated with women's nonautonomy on decision regarding contraceptive utilization. Conclusions In Ethiopia, the spatial distribution of women's nonautonomy on decision about contraceptive utilization was nonrandom. More than three-fourths of married reproductive-age women in Ethiopia are nonautonomous on decision regarding contraceptive utilization. Region, residence, current age, age at marriage, and wealth index were statistically associated with women's nonautonomy on decision regarding contraceptive utilization.
Highlights
Studies conducted to date in Ethiopia did not explore the spatial distribution, individual-level, and community-level factors affecting women’s nonautonomy on decision to use contraceptives
Nonautonomous women on decision regarding contraceptive utilization were higher in Tigray, Amhara, eastern part of Afar, Eastern and Northern Somali, Benishangul-Gumuz, northern parts of SNNPR, Gambela, and Oromia regions
Our analysis revealed that the likelihood of being nonautonomous on decision regarding contraceptive utilization was 82% lower for women in rich households compared to those from poor households (AOR 0.12 (0.03, 0.26))
Summary
Studies conducted to date in Ethiopia did not explore the spatial distribution, individual-level, and community-level factors affecting women’s nonautonomy on decision to use contraceptives. This study aimed to assess the spatial distribution of women’s nonautonomy on decision regarding contraceptive utilization and its determinants in Ethiopia. More than three-fourths of married reproductive-age women in Ethiopia are nonautonomous on decision regarding contraceptive utilization. Several studies conducted across the world have identified different community- and individual-level factors affecting women’s nonautonomy on decision regarding contraceptive utilization [15,16,17,18,19,20,21,22,23,24]. Nearly 76% of women are nonautonomous on decision regarding contraceptive utilization in Ethiopia [21]
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