Determinants of Modern Contraceptive Utilization among Married Women in Ethiopia: A Multilevel Mixed Effect Analysis.
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Date
2021-09
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Addis Abeba University
Abstract
Background: Despite the progress, the prevalence of modern contraceptive use remains low in
Ethiopia. There are numerous predictors to use modern contraceptive methods. Attention has
been given to individual-level factors on modern contraception while contextual characteristics
are equally relevant to increase the utilization. The study implied figuring out barriers related to
end-users and the community characteristics that are critical for developing appropriate family
planning programs and policies to improve the uptake.
Objective: This study aims to identify individual and community-level factors of modern
contraceptive use, using a multilevel analytic approach.
Method: The study utilized the national data collected by Performance Monitoring and
Accountability 2018, Ethiopia. Multilevel mixed-effect regression analysis of 3706 married
women of reproductive age group nested within 220 clusters was carried out. Results are
presented using odds ratios along with their 95% confidence interval.
Result: Respondents who utilize modern contraceptive methods accounted for 42.9% in
Ethiopia in 2018. Analysis of the random intercept model evidenced that the between
community variance of modern contraception is non-zero. The fixed-effect model showed
significantly lower odds of modern contraceptive utilization among older women, women in a
polygamous marriage (OR 0.67, 95%CI 0.49-0.92), women living in a community with a higher
mean parity (OR 0.67, 95%CI 0.46-0.93), and women living in a community with higher mean
household size(OR 0.65, 95%CI 0.46-0.84), while completing secondary level of education
(OR 1.65, 95%CI 1.24-2.30), visiting a health facility(OR 1.49, 95%CI 1.25-1.79), and being
wealthy(OR 1.76, 95%CI 1.26-3.06) are among the positively predicting variables of modern
contraception. The effect of community variations for education implies that there is a
considerable difference in modern contraceptive use among communities.
Conclusion: This study revealed that both individual and community-level variables were
significant determinants of modern contraceptive use in Ethiopia. The study recommends,
improving women's education, wealth status, and community fertility `norms as measures that
can be implemented to accelerate modern contraceptive adoption in the country.
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Keywords
Modern Contraceptive Use, Community, Multilevel Logistic Regression, Mixed effect model, Ethiopia.