Contraceptive Method Utilization and Determinant Factors among Young Women (15-24) in Ethiopia: A Mixed-Effects Multilevel Logistic Regression Analysis of the Performance Monitoring for Action 2018 Household Survey

Abstract

Despite highly effective modern contraceptive methods (both short and long acting) are made widely available and accessible globally, their utilization remains low among young women in low- and middle-income countries, including Ethiopia. Hence, this study is aimed at determining its status and identifying the determinant factors by using nationally representative data. A multilevel analysis of the nationwide Performance Monitoring for Action 2018 of Ethiopia round 6 data, collected from June to July, 2018, was conducted. A total of 982 both married and unmarried young women (15-24) were included in the analysis. Descriptive statistics was used to describe the status of contraceptive method utilization and unmet need across regions. A mixed-effects multilevel logistic regression model was used to identify the determinants of the contraceptive method utilization. Adjusted odds ratios with corresponding 95% confidence intervals were used to show the significance of the associations at p < 0.05 . The status of contraceptive method utilization was 54.8% (95% CI: 51.7%, 57.9%), and 18.6% (95% CI: 16.3%, 21.2%) had unmet need. Afar (12.3%), Harari (12.5%), and Ethiopian Somali (20.0%) regions had the lowest contraceptive method utilization. Wealth quintiles and religion were the higher level variables affecting contraceptive method utilization among the young women. Age, marital status, parity, future birth intention, and knowledge of contraceptive methods were the individual level factors identified as determinants of contraceptive method use among the young women. In conclusion, the status of contraceptive method utilization among the young women in Ethiopia is promising as compared to the national target of 55% for 2020; however, still high unmet need exists. The factors also exist both at the contextual and at individual levels. Hence, multilevel interventions need to be in place giving special emphasis to the low performing regions. Besides, region-specific behavioral interventions and family planning services that will be able to reach the young women need to be designed.

Prevalence and factors associated with inconsistent condom use among female sex workers in Ethiopia: findings from the national biobehavioral survey, 2020

“…Evidence from previous similar studies conducted in Ethiopia, Zambia, South Africa, and Pakistan has also shown that FSWs who were ever used alcohol had a lower likelihood of consistent condom use than women who never used alcohol [ 16 , 29 , 30 ]. Similarly, in our analysis sexual violence compromises FSWs’ negotiation ability and decision-making capacity about condom use with their sexual partners, and this finding is consistent with reports from previous studies in Laos and Pakistan emphasizing that FSWs were likely to be physically abused and forced to have sex without condoms [ 16 , 28 , 31 ].…”

Women’s Employment and Intimate Partner Violence: Understanding the Role of Individual and Community Structural Drivers in Low- and Middle-Income Countries

“…Mixed-effects logistic regression models were used to account for the hierarchical (i.e., nested) nature of the data. Due to multistage cluster sampling, women from the same PSU were expected to be more like one another than women from different PSUs, violating the assumption of independence that is foundational to ordinary logistic regression (Debelew & Habte, 2021). Mixed-effects logistic regression also allows for partitioning the total variance into within-group and between-group effects to understand the relative contribution of individual and community variables to the outcome.…”

Social Demographic Dimensions of Contraceptive Use in the Land of Papua: A Cross-Sectional Approach

“…The results supported a previous study that found that contraceptive use was affected by the socio-demographics of women. In addition, the age of users, marital status, education, 9 and users' knowledge of contraceptive methods are several factors associated with the low prevalence of contraceptive use. Thus, the population is influenced by the determinants of contraceptive use in the community.…”

“…They also influence the use of contraception knowledge, information given by family planning field officers, and the husband's support. 8,9 According to the family program performance and accountability survey in 2019, Papua was one of the provinces with the lowest contraceptive use. While the national-level prevalence of contraceptive use was 58.71%, the prevalence of modern contraceptive use in Papua was even lower with only around 13.72% of contraceptive users in 2019.…”