Spatial Variations in Utilization of Modern Contraceptives in Ethiopia

Abstract

Background: Even though modern contraceptives are known to be important for fertility control, utilization of these services varies across different geographical areas. A geographically linked data analysis using population and health facility data is important to investigate and map the use of family planning services. Thus, this study aimed to assess the spatial patterns of modern contraceptive use and to identify its associated factors among married women in Ethiopia. Method: A secondary data analysis of the 2016 Ethiopia Demographic and Health Survey and the 2014 Ethiopian Service Provision Assessment was conducted. A multilevel analysis was conducted to identify the potential factors associated with the use of modern contraceptives among married women in Ethiopia using the SAS GLIMMIX procedure. Furthermore, a spatial analysis was done to identify the potential hot spot areas of modern contraceptive prevalence rates using ArcGIS. Results: Being exposed to family planning messages, having a higher number of living children, husbands'/partners' education level, and wealth were strongly associated with increased use of modern contraceptives. More importantly, a one unit increase in the mean score of health facilities' readiness to provide short-term modern contraceptives in a typical region was associated with a 20 fold increase in the odds of modern contraceptive use. 24.47% of the variation in the use of modern contraception was accounted for by location. Moreover, the spatial analysis found that Addis Ababa and the Amhara region had high clusters of modern contraceptive use rates as compared to clusters of low contraceptive use rates in the Afar and Somali regions. Conclusion: There were significant variations in the use of modern contraceptives across the different regions of Ethiopia. Therefore, regions with low contraceptive rates and high fertility rates should be targeted for scaling up and tailoring of services to the lifestyles of the population of those regions. Funding: Not applicable. Declaration of Interest: The authors declared that they have no competing interests. Ethical Approval: Ethical approval was obtained from the Human Research Ethics Committee, The University of Newcastle. We also got the Ethiopian Public Health Institute (EPHI) and the Measure DHS program approval to access the datasets.