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Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data.
Reprod Health. 2021 Jun 10; 18(1):122.RH

Abstract

BACKGROUND

High fertility rates and unintended pregnancies are public health concerns of lower and middle income countries such as Ethiopia. Long acting contraceptives (LACs) take the lion's share in reducing unintended pregnancies and high fertility rates. Despite their numerous advantages, the utilization of LACs remains low in Ethiopia. This study is aimed to explore the geographic variation and associated factors of long acting contraceptive use among reproductive-age women in Ethiopia.

METHODS

This is a secondary data analysis of 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of weighted sample sizes of 10,439 reproductive-age women were included in the final analysis. To clean and analyze the none-spatial data Stata 14 was used while ArcGIS 10.6 and SaTScanTM version 9.6 software were used for spatial analysis. Multilevel Mixed-effect Logistic regression model was used to identify associated factors of LACs utilization. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to identify significant variables.

RESULTS

Long acting contraceptive utilization was non-random (Moran's I: 0.30, p-value < 0.01). Statistically, clusters with significant low utilization of LACs were found in Somali, Afar, Gambela, northern Amhara, eastern Oromia and western part of Southern Nations Nationalities and Peoples (SNNP) regions. Adjusting for other factors such as being married (AOR = 2.51, 95% CI: 1.29-4.87), having one to two (AOR = 2.14, 95% CI: 1.43-3.22), and three to four children (AOR = 1.68, 95% CI: 1.02-2.76), urban (AOR = 1.59, 95% CI: 1.16-2.19), want no more children (AOR = 1.40, 95% CI: 1.08-1.83), working status of women (AOR = 1.33, 95% CI: 1.07-1.65) increased the odds of LACs utilization. While previous history of abortion (AOR = 0.56, 95% CI: 0.39-0.80), and living in the pastoralist community (AOR = 0.22, 95% CI: 0.14-0.35) reduced the odds of LACs utilization in Ethiopia CONCLUSIONS: Significant geographic variation of LACs utilization was observed in Ethiopia. Spots with Low LACs utilization were found in the eastern, north eastern and western part of the country. Socio-demographic and pregnancy related factors were significant determinants of LACs utilization. Designing intervention programs targeting the identified hot spot clusters, and variables that can hinder the utilization of LACs is very important to increase the utilization.

Authors+Show Affiliations

Department of Public Health, College of Health Sciences, Samara University, Samara, Ethiopia.Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia. goshuatalay12@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34112194

Citation

Ebrahim, Oumer Abdulkadir, et al. "Geographic Variation and Associated Factors of Long-acting Contraceptive Use Among Reproductive-age Women in Ethiopia: a Multi-level and Spatial Analysis of Ethiopian Demographic and Health Survey 2016 Data." Reproductive Health, vol. 18, no. 1, 2021, p. 122.
Ebrahim OA, Zeleke EG, Muluneh AG. Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data. Reprod Health. 2021;18(1):122.
Ebrahim, O. A., Zeleke, E. G., & Muluneh, A. G. (2021). Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data. Reproductive Health, 18(1), 122. https://doi.org/10.1186/s12978-021-01171-2
Ebrahim OA, Zeleke EG, Muluneh AG. Geographic Variation and Associated Factors of Long-acting Contraceptive Use Among Reproductive-age Women in Ethiopia: a Multi-level and Spatial Analysis of Ethiopian Demographic and Health Survey 2016 Data. Reprod Health. 2021 Jun 10;18(1):122. PubMed PMID: 34112194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data. AU - Ebrahim,Oumer Abdulkadir, AU - Zeleke,Ejigu Gebeye, AU - Muluneh,Atalay Goshu, Y1 - 2021/06/10/ PY - 2019/12/12/received PY - 2021/06/06/accepted PY - 2021/6/11/entrez PY - 2021/6/12/pubmed PY - 2021/6/22/medline KW - Ethiopia KW - Geographic variation KW - Long-acting contraceptive SP - 122 EP - 122 JF - Reproductive health JO - Reprod Health VL - 18 IS - 1 N2 - BACKGROUND: High fertility rates and unintended pregnancies are public health concerns of lower and middle income countries such as Ethiopia. Long acting contraceptives (LACs) take the lion's share in reducing unintended pregnancies and high fertility rates. Despite their numerous advantages, the utilization of LACs remains low in Ethiopia. This study is aimed to explore the geographic variation and associated factors of long acting contraceptive use among reproductive-age women in Ethiopia. METHODS: This is a secondary data analysis of 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of weighted sample sizes of 10,439 reproductive-age women were included in the final analysis. To clean and analyze the none-spatial data Stata 14 was used while ArcGIS 10.6 and SaTScanTM version 9.6 software were used for spatial analysis. Multilevel Mixed-effect Logistic regression model was used to identify associated factors of LACs utilization. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to identify significant variables. RESULTS: Long acting contraceptive utilization was non-random (Moran's I: 0.30, p-value < 0.01). Statistically, clusters with significant low utilization of LACs were found in Somali, Afar, Gambela, northern Amhara, eastern Oromia and western part of Southern Nations Nationalities and Peoples (SNNP) regions. Adjusting for other factors such as being married (AOR = 2.51, 95% CI: 1.29-4.87), having one to two (AOR = 2.14, 95% CI: 1.43-3.22), and three to four children (AOR = 1.68, 95% CI: 1.02-2.76), urban (AOR = 1.59, 95% CI: 1.16-2.19), want no more children (AOR = 1.40, 95% CI: 1.08-1.83), working status of women (AOR = 1.33, 95% CI: 1.07-1.65) increased the odds of LACs utilization. While previous history of abortion (AOR = 0.56, 95% CI: 0.39-0.80), and living in the pastoralist community (AOR = 0.22, 95% CI: 0.14-0.35) reduced the odds of LACs utilization in Ethiopia CONCLUSIONS: Significant geographic variation of LACs utilization was observed in Ethiopia. Spots with Low LACs utilization were found in the eastern, north eastern and western part of the country. Socio-demographic and pregnancy related factors were significant determinants of LACs utilization. Designing intervention programs targeting the identified hot spot clusters, and variables that can hinder the utilization of LACs is very important to increase the utilization. SN - 1742-4755 UR - https://www.unboundmedicine.com/medline/citation/34112194/Geographic_variation_and_associated_factors_of_long_acting_contraceptive_use_among_reproductive_age_women_in_Ethiopia:_a_multi_level_and_spatial_analysis_of_Ethiopian_Demographic_and_Health_Survey_2016_data_ DB - PRIME DP - Unbound Medicine ER -