Trend and Inequalities in the Current Family PlanningUse Among Currently Married Reproductive Aged Women and the Family Planning Service Readiness in Addis Ababa Ethiopia.
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Date
2023-11
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Addis Ababa University
Abstract
Background: Family planning use among reproductive aged women in Addis Ababa is declining from
56.9% to 49.9% according to Ethiopian Demographic and Health Survey (EDHS) data during 2005 and
2019. Urban health facilities had lesser availability of family planning services compared to rural facilities
(87% Vs. 95%) according to Service Readiness Assessment 2016. Evidence on the trend, inequalities and
service readiness in family planning services in Ethiopia is scarce and yet such evidence is important to
contribute to the effort towards increasing family planning use.
Objective: The objectives of this study is to assess the trend, and inequality in terms of age group,
religion, parity, women empowerment, education of women and husband, employment and media exposure
in family planning use among re productive aged women and health facilities that give family planning
services in Addis Ababa, and, to assess the family planning service readiness of health facilities in Addis
Ababa.
Methods: The four Demographic and Health Surveys, the 8 Performance Monitoring for Action (PMA)
was used to assess the trend and inequality among married women in Addis Ababa and Service Availability
and Readiness Assessment (SARA) data set to assess the health facilities family planning service readiness.
we used STATA software for the analysis. We used descriptive analysis to show socio demographic statuses
and service readiness. We used logistic regression to show the trend. Concentration index was used for the
ordinal equity stratifiers, regression based predictive probability and odds ratio was used for others such as
age, religion, employment and parity. And finally, regression-based decomposition analysis was used to
identify contribution of socio-economic and demographic factors to inequality in FP use.
Result: The overall trend of FP use is slightly increasing from 45% in 2000 (EDHS) to 60% in
2021(PMA). Primary and higher educational level of women and husband, 20-24 age group, having more
than 1 child, being Christian and being employed were found to be significantly associated with high FP use.
The largest contributors to education-based inequality are secondary and higher educational level of women
(-0.63) in PMA 2019 and having 1 child (2.13) in PMA 2021. Among assessed health facilities, 2.1% provide
13 of the tracer items in 2016 and 1.3% provide all the 14 items in 2018.
Conclusion: Trend in FP use showed a slight increase and was not uniform among the selected equity
stratifiers. Furthermore, estimates of absolute and relative inequalities show significant inequalities. FP
service readiness of health facilities in Addis Ababa were low. It is recommended to maintain improvements
in FP services and scaling up the interventions that directly act on leading determinants of FP inequality by
targeting the disadvantaged group.
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Keywords
Reproductive age, Contraceptive users, Family Planning