Factors associated with non-use of modern contraceptives among sexually active women in Ethiopia: a multi-level mixed effect analysis of 2016 Ethiopian Demographic and Health Survey.

Background: Appropriate contraceptive use prevents unintended pregnancy, protects the health of mother and child, and promotes women's well-being. Use of modern Family planning in Ethiopia was still very low. The purpose of this study was to assess the factors that are associated with non-use of modern family planning services among women of reproductive age.

Method: A nationally representative 2016 EDHS women data were used for analysis. A total of 15,683 women in the reproductive age group were included in this study. Descriptive and multilevel multivariable binary logistic regression models were used to summarize descriptive data and measure statistical association between the dependent and the individual and community level variable, respectively. Adjusted Odds Ratio (AOR) and confidence interval were respectively used to measure association and its statistical significance.

Result: Among women in the reproductive age group 79.49% (95% CI: 78.85%, 80.12%) did not use a modern contraceptive method. Women age between 25-34 years (AOR = 0.54, 95% CI: 0.47-0.61) and age between 34-49 year (AOR = 0.62, 95% CI: 0.55-0.71), having primary educated women (AOR = 0.0.77, 95% CI: 0.68-0.87),secondary and above educational (AOR = 0.88, CI: 0.75-1.03), Secondary and above-educated husband (AOR = 0.84, 95% CI: 0.72-0.96), rich women (AOR = 0.74,95%CI:0.65-0.85), health facility delivery (AOR = 0.84, 95%CI: 0.73-0.0.98), being watching TV (AOR = 0.74, 95% CI: 0.65-0.85), having 1-2 living children (AOR = 0.21, 95% CI: 0.19-0.23) are less likely to not use contraception were identified. Furthermore, Muslim women (AOR = 1.43, 95% CI: 1.23-1.62), women living in rural area (AOR = 3.43; 95% CI: 2.72-4.32), and ANC visit 1.25(1.07-1.47) were more likely to not use contraception. Further, Women in Afar, Somali, Gambela, Harari, and Dire Dawa were less likely to use modern contraception methods than women in Tigray, but Amhara region had a lower rate of non-use.

Conclusion: Family planning interventions should target younger women, women living in rural areas, the poor, and Muslim women. Moreover, initiatives to empower women associated to family planning programs would be beneficial in increasing contraceptive uptake among sexually active women in Ethiopia.