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

IF 3.6 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Emerging Themes in Epidemiology Pub Date : 2022-04-02 DOI:10.1186/s12982-022-00112-z

Kusse Urmale Mare, Setognal Birara Aychiluhm, Abay Woday Tadesse, Osman Ahmed Mohammed

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引用次数: 2

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.

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埃塞俄比亚无生育意愿妇女不使用避孕药具的个人和社区层面决定因素:多层次混合效应分析

背景：在埃塞俄比亚，大约三分之二的育龄妇女不使用任何避孕方法。此外，关于未来没有生育意愿的妇女不使用避孕药具的证据有限。因此，本研究旨在通过多水平混合效应分析，确定埃塞俄比亚这一群体中不使用避孕药具的个人和社区决定因素。方法：从人口与健康调查项目官方数据库网站（http://dhsprogram.com）用于本研究。调查采用多阶段整群抽样技术进行，本研究使用了4398名无生育意愿的育龄妇女的加权样本。使用多水平多变量逻辑回归对四个模型进行拟合，以确定不使用避孕药的决定因素，并选择Akaike信息标准最低的模型作为最佳拟合模型。调整后的比值比及其相应的95%置信区间用于声明自变量的统计显著性。结果：总体而言，65.3%[95%CI（63.9%，66.7%）]没有生育意愿的女性没有使用任何避孕方法。居住在大中心[AOR（95%CI） 0.45（0.31，0.67）]和大都市地区[AOR（95%CI） 0.39（0.22，0.68）]和来自中等[AOR（95%CI）的家庭 0.65（0.42，0.93）]和富人财富指数[AOR（95%CI） 0.67（0.44，0.98）]与不使用避孕药具呈负相关。此外，来自妇女文盲率高的社区[AOR（95%CI） 1.38（1.15，1.67）]，是穆斯林[AOR（95%CI） 1.86（1.22，2.85）]，有终止妊娠史[AOR（95%CI） 1.59（1.10，2.31）]，有一个想要更多孩子的丈夫[AOR（95%CI） 1.46（1.02，2.09）]是未使用避孕药具的积极决定因素。结论：埃塞俄比亚近三分之二没有生育意愿的育龄妇女没有使用任何避孕方法。针对穆斯林宗教信徒的关于避孕药具益处的提高认识干预措施，以及在家庭一级改善妇女教育和增强她们的经济权能，可能会降低国家一级不使用避孕药具的比例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Emerging Themes in Epidemiology Medicine-Epidemiology

CiteScore

4.40

自引率

4.30%

发文量

审稿时长

28 weeks

期刊介绍： Emerging Themes in Epidemiology is an open access, peer-reviewed, online journal that aims to promote debate and discussion on practical and theoretical aspects of epidemiology. Combining statistical approaches with an understanding of the biology of disease, epidemiologists seek to elucidate the social, environmental and host factors related to adverse health outcomes. Although research findings from epidemiologic studies abound in traditional public health journals, little publication space is devoted to discussion of the practical and theoretical concepts that underpin them. Because of its immediate impact on public health, an openly accessible forum is needed in the field of epidemiology to foster such discussion.