Unmet need for family planning among reproductive-age women living with HIV in Ethiopia: A systematic review and meta-analysis.

Bereket Kefale,Assefa Andargie,Yitayish Damtie,Bezawit Adane,Melaku Yalew,Mastewal Arefaynie,Elsabeth Addisu,Catherine S. Todd

doi:10.1371/journal.pone.0255566

Abstract

BackgroundClosing the gap of unmet for family planning is crucial to eliminate new pediatric HIV infections likewise to improve maternal and child health among reproductive-age women living with HIV. However, studies conducted on unmet need for family planning among reproductive-age women living with HIV showed inconsistent and non-conclusive findings on the magnitude of the problem. Moreover, there was no meta-analysis conducted in this area. So this systematic review and meta-analysis were conducted to estimate the pooled prevalence unmet need for family planning among reproductive-age women living with HIV in Ethiopia.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review both published and unpublished studies in Ethiopia. All studies in PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health databases were searched. Meta-analysis was performed using STATA 14 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger regression asymmetry test, respectively. Forest plots were used to present the pooled prevalence with a 95% confidence interval (CI).ResultsThis review included 7 studies, and 3333 study participants. The pooled prevalence of unmet need for family planning among reproductive-age women living with HIV in Ethiopia was 25.13% (95%CI: 19.97, 30.29). The pooled prevalence of unmet need for spacing and limiting was 13.91% (95%CI: 10.11, 17.72) and 9.11% (95%CI: 6.43, 11.78), respectively.ConclusionsOne-fourths of reproductive-age women living with HIV had an unmet need for family planning. A variety of programmatic investments are needed to achieve more meaningful progress toward the reduction of unmet need for family planning among reproductive-age women living with HIV.

Highlights

Women of reproductive age are disproportionately affected by the HIV/Acquired Immune Deficiency Syndrome (AIDS) pandemic
This systematic review and meta-analysis were conducted to estimate the pooled prevalence unmet need for family planning among reproductive-age women living with HIV in Ethiopia
The pooled prevalence of unmet need for family planning among reproductive-age women living with HIV in Ethiopia was 25.13% (95%confidence interval (CI): 19.97, 30.29)

Summary

Introduction

Women of reproductive age are disproportionately affected by the HIV/AIDS pandemic. In Sub-Saharan Africa (SSA), the region highly affected by HIV, women and girls continue to be the foremost affected and accounted for 59% of all new HIV infections in the region in 2019 [1]. In Ethiopia, women cover more than 60% and 55% of adults living and newly infected with HIV/AIDS, respectively [2]. In SSA, about 333,000 new infant infections could be averted annually, if all women in the region who did not wish to become pregnant could have access to contraceptive services [8, 9]. Closing the gap of unmet for family planning is crucial to eliminate new pediatric HIV infections likewise to improve maternal and child health among reproductive-age women living with HIV. Studies conducted on unmet need for family planning among reproductive-age women living with HIV showed inconsistent and non-conclusive findings on the magnitude of the problem.

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