Spatial variations and multi-level determinants of modern contraceptive utilization among young women (15–24 years) in Ethiopia: spatial and multi-level analysis of mini-EDHS 2019

Abstract

Introduction There is tremendous regional inequalities and low uptake of modern contraceptives particularly among young women (15–24 years), characterized by high fertility but high unmet need for contraceptives in Ethiopia. Hence, the present study aimed at exploring the spatial distribution and the multi-level determinants of modern contraceptive use among young women in Ethiopia. Methods This study was conducted using the 2019 Ethiopian demographic and health survey data on a weighted sample of 3,379 young women. STATA version 14 for the multi-level, and ArcGIS 10.7 and Sat Scan 9.6 for the spatial analysis were used. Spatial analysis was done to identify the hotspot areas of modern contraceptive use in Ethiopia. Multi-variable multi-level logistic regression was used for identifying determinants of modern contraceptive use and variables with a p-value < 0.05 were considered to be significant determinants. Result The overall prevalence of modern contraceptive use among young women in Ethiopia was 17.23% (95% CI: 10.98, 23.47). The hotspots areas for modern contraceptive use were detected in the central and south-western Amhara, western and central Oromia, and western SNNPR regions. Whereas the Somali region, Dire dawa, and Harari cities were cold spot areas for modern contraceptive use. Being married (AOR = 18.5; 95% CI: 12.66, 27.27), parity (AOR = 4.82; 95% CI: 1.27, 18.32), having television (AOR = 2.39; 95%CI: 1.43, 3.99), having radio (AOR = 1.43; 95%CI: 1.05, 1.94) had higher odds of using modern contraceptives compared to their counterparts. Besides, family size of above five (AOR = 0.46; 95% CI: 0.34, 0.62) and living in Somali region (AOR = 0.05; 95% CI: 0.01, 0.32) were associated with decreased odds of using modern contraceptives among young women in Ethiopia. Conclusion The modern contraceptive use was low among young women and considerably varied across regions in Ethiopia. A remarkably low rate of modern contraceptive use (cold spot) area was detected in Somali region-Ethiopia. Taking in to account a geographic perspective and key factors identified in this study would be vital for efficient resource allocation, targeted interventions, and informed decision-making to enhance contraceptive uptake in Ethiopia.

Modern contraceptive utilization and associated factors among younger and older married youth women in Ethiopia: Evidence from Ethiopia Mini Demographic and Health Survey 2019

“…Other reasons might also be religious beliefs, cultural practices, misconceptions, health concerns, and infrequent sex [ 68 , 70 , 71 ]. However, previously study showed that this finding has disagreement with studies conducted in Ethiopia [ 72 ] and Indonesia [ 46 ].…”

“…Women who had one to two under five children in their household were more likely to use modern contraceptive utilization in women aged 25–34 years when compared to women who had no under five children in their household. Study done in another part of Ethiopia supported this evidence [ 72 ] and Liberia [ 73 ]. The reason might be that women who have a desired number of children are more likely to use contraceptives.…”

Modern Contraceptive Use Behavior among Young Married Women in Urban Settings of Ethiopia: A Multilevel Analysis

“…This could be due to higher listenership of SRH-related messages among young married women residing in urban cities. The 2019 Ethiopian Mini Demographic and Health Survey data indicated that the prevalence of modern contraceptive use among young married women aged 15 to 24 was only 17% on average (7). Another study conducted in Malawi indicated that 31% of young women used contraceptive (13).…”

“…In Ethiopia, young married women's (age 15 to 24 years) use of modern contraceptives increased from 6% in 2000 to 16% in 2005 and to 36% in 2011 based on the three EDHS (6). However, it has since seemed to have declined as the 2019 EDHS data showed the prevalence of modern contraceptive use among young women at only 17% on average (7). Among young preparatory school students aged 15 to 22 years, the proportion of individuals who had undergone induced abortion at some point in their lifetime was high, 13.6% based on a study conducted in Southern Region of Ethiopia (8).…”