Individual and community-level determinants of non-use of contraceptive among women with no fertility desire in Ethiopia: a multilevel mixed-effect analysis

Abstract

Background In Ethiopia, about two-third of women in the reproductive-age do not use any method of contraception. Moreover, evidence on non-use of contraceptives among women who do not have future fertility desires are limited. Therefore, this study intended to identify both individual and community-level determinants of non-use of contraceptives among this group in Ethiopia using a multilevel mixed effect analysis. Methods Data retrieved from the demographic and health survey program official database website (http://dhsprogram.com) were used in this study. The suvey was conducting using a multistage cluster sampling technique and a weighted sample of 4398 reproductive-age women with no fertility desire was used in this study. Four models were fitted using a multilevel multivariable logistic regression to identify determinants of non-use of contraceptives and model with the lowest Akaike’s Information Criterion was selected as a best fitted model. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. Results Overall, 65.3% [95% CI (63.9%, 66.7%)] of women with no fertility desire were not using any contraceptive method. Living in large central [AOR (95% CI) 0.45 (0.31, 0.67)] and metropolitan regions [AOR (95% CI) 0.39 (0.22, 0.68)] and being from household with middle [AOR (95% CI) 0.65 (0.42, 0.93)] and rich wealth index [AOR (95% CI) 0.67 (0.44, 0.98)] were negatively associated with non-use of contraceptives. Besides, being from a community with high women illiteracy [AOR (95% CI) 1.38 (1.15, 1.67)], being Muslim [AOR (95% CI) 1.86 (1.22, 2.85)], having history of pregnancy termination [AOR (95% CI) 1.59 (1.10, 2.31)], having a husband who desire to have more children [AOR (95% CI) 1.46 (1.02, 2.09)] were the positive determinants of non-utilization of contraceptives. Conclusion Nearly two-third of reproductive-age women with no fertility desire in Ethiopia do not use any contraceptive method. Awareness creation interventions on the benefits of contraceptives targeting Muslim religion followers and improving women education and their economic empowerment at household level may decrease the proportion of non-use of contraceptives at a national level.

Modern contraceptive method utilization and determinant factors among women in Ethiopia: Multinomial logistic regression mini- EDHS-2019 analysis

“…This is not astonishing because education supports women to be well informed on the benefits of contraceptives and empowers them to have the independence to make decisions on their fertility and in the exercise of their reproductive rights [ 37 ].The findings of the current study indicate that women with a low level of wealth index have better chance of using contraceptive than their counterparts. This finding is consistent with finding of study done in Ethiopia [ 55 ]. On the contrary,this finding is in contrary with the prevous findings of study in Ethiopia [ 56 , 57 ].…”

Spatial distribution and determinants of high-risk fertility behavior among reproductive-age women in Ethiopia

“…Residence, community-level poverty, community level of women's education, and region were included as community-level variables. Regions were classified into three categories; Amhara, Oromia, Tigray, and SNNP regions were categorized as a large central region; Harari, Addis Ababa, and Dire Dawa were categorized as metropolitan regions, and the others (Somali, Gambela, Afar, and Benishangul Gumuz region) were categorized as a small peripheral region [ 37 , 38 ]. Because the data were not normally distributed, community poverty and literacy levels were classified as high or low, using the median value as the classification cutoff point.…”

Fertility status and associated factors among the reproductive age group in Ethiopia: Mini Demographic and Health Survey 2019

“…This could explain by informal literacy constitutes a society-wide problem that cannot be isolated to one strand or tier but must be addressed by everyone. While the government has invested a great deal in resolving the issue, it remains a deep-rooted problem [20,21].…”