Spousal age difference and its effect on contraceptive use among sexually active couples in Ethiopia: evidence from the 2016 Ethiopia demographic and health survey

Abstract

Background Age difference among spouses can be considered as an indicator of the nature of the marital bond, and influences the couple’s fertility expectations. The age difference is one of the features of the traditional African marriage system. However, the likelihood that women use of contraceptives and spousal age differences is not well studied. Thus, this study was to examine the spousal age difference on contraceptive use. Objective This study was aimed to examine spousal age differences and its effect on contraceptive use among sexually active couples in Ethiopia. Methods The related variables for this study were extracted from Ethiopian Demographic and Health Survey 2016 data. IBM SPSS statistics version 20 software was used for analysis. Logistic regression was conducted to see the association between spousal age difference and contraceptive use. All analyses were adjusted for sample weights. Results Out of the 7268 selected women for contraceptive usage questions, one fourth (25.3%) of them were between ages 25 and 29 and in almost all 7061 (98.4%) of them there was spousal age differences, 1555 (21.4%) of them were from poor socioeconomic group. Nearly all 7184 (98.8%) of them knew contraceptive method. However, among those sexually active in the last 4 weeks only two in five (41.2%) were using a contraceptive method. Spousal age difference was found to be significant factor and women older than their spouses were (AOR: 1.771, 95%CI: 1.276, 2.459) more likely and women having spouse’s age difference greater than 10 years were 1.2% (AOR: .988, 95%CI: .848, 1.150) less likely to use contraception compared to those age difference is ten or less than years respectively. Also, women who were living in urban areas (AOR: 1.482, 95%CI: 1.161 to 1.890), current working status (AOR: 1.170; 95%CI: 1.033 to 1.325), from richest economic category (AOR: 2.560; 95%CI: 2.000 to 3.278) husband’s education, couples’ fertility preference (AOR: 1.233; 95%CI: 1.070 to 1.420) were contraception use predictors. Similarly, being Muslim by religion (AOR: .579 95%CI: 0.496 to 0.675) and husband based decision for their health care use were (AOR: .847, CI: .729 to .985) less likely to use contraception. Conclusion and recommendation This study found association between spousal age differences and contraceptive use. Similarly, women’s age, age difference, place of residence, religion, current working status, socioeconomic, husband’s education, living children and current pregnancy, the couples’ fertility preference and who decides on health care use were found to be predictors of contraceptive use. Strengthening strategies for improving women’s educational status, socio-economic and demographic that will help to limit the age differences and improve contraceptive use. Further study, including qualitative is recommended to dig out the why components and better understand this finding.

Socioeconomic inequalities and family planning utilization among female adolescents in urban slums in Nigeria

“…This might also be an indication of the little relevance of relative household wealth on reproductive health in communities where the rich among the poor are also poor because of the collective orientation they share. Though this specific finding contrasts with a glut of earlier studies in Nigeria and elsewhere that have established the increased use of modern contraceptives among the wealthier and least deprived groups ( 33 – 36 ), it, however, compares with a few other studies that have found higher contraceptive prevalence among women residing in resource-poor communities ( 37 , 38 ) indicating the importance of zeroing in on specific vulnerable groups to understand their specific needs.…”

“…In the south, however, higher wealth status predicts lower use of contraceptives. This finding may be due to a likelihood of low levels of empowerment among young girls in Northern Nigeria, in which case, they are married to older partners and they do not usually possess the agency to participate, either solely or partially, in the decision to utilize modern contraceptives, irrespective of the relative level of wealth in their household ( 33 ). This might also be an indication of the little relevance of relative household wealth on reproductive health in communities where the rich among the poor are also poor because of the collective orientation they share.…”

Contraceptive Use among Gender Based Violence Survivors: The Case of Matabeleland South, Zimbabwe

“…Age difference with a partner was found to have a negative association with the use of contraceptives amongst female GBV survivors. Similar findings were obtained by researchers such as Ibisomi ( 2014) in Nigeria and Kitila (2020) in Ethiopia. In this study, a one year increase in age difference with partner decreased the odds of using contraceptives by 16 %.…”

“…A study done in Ethiopia by Kitila et al (2020) revealed that spousal age difference affects contraceptive use negatively. Women with spouses who were 10 years older were less likely to use contraceptives.…”

Married women’s decision-making autonomy on contraceptive use and its associated factors in Ethiopia: A multilevel analysis of 2016 demographic and health survey

“…“Couple age difference” was obtained by subtracting woman’s age from her husband’s age (age of husband − age of a woman) and further categorized as “negative” (age of a woman is greater than that of husband), “equal” (age of woman and husband is equal), “less than 10 years” (husband is less than 10 years older than women), and “equal or greater than 10 years” (husband’s age exceeds women’s age by 10 years and above). 46 …”