Wondie Kindu Yinges, Badi Marta Berta, Tamiru Animut Tagele
Department of Clinical Midwifery, School of Midwifery, University of Gondar, Gondar, Amhara Regional State, Ethiopia.
Department of Women's and Family Health, School of Midwifery, University of Gondar, Gondar, Amhara Regional State, Ethiopia.
Open Access J Contracept. 2020 Aug 5;11:77-89. doi: 10.2147/OAJC.S255551. eCollection 2020.
The sharp fertility drop-off in the Amhara region between 2000 and 2011 was due to an increase in modern contraceptive utilization of rural women. However, long-acting contraceptive method utilization was higher among urban than rural women. Therefore, this study aimed to assess rural-urban differentials of long-acting contraceptive method utilization and the contributing factors among reproductive-age women in the Amhara region: analysis of the 2016 EDHS.
The 2016 EDHS data were used. A weighted sample of 2188 (1675 rural and 513 urban) fecund reproductive-age women was used, and a mixed-effects logistic regression model was fitted. Multivariable logistic regression analysis at a -value <0.05 and adjusted odds ratio with a 95% confidence interval were used to declare significant associations.
The overall long-acting contraceptive method use was 13.3% (95% CI=11.6-15.8), and it was 14.8% (95% CI=12.4-17.2) among rural and 8.3% (95% CI=4.5-12.4) among urban women. Among urban women, the odds of long-acting contraceptive method use was higher for women living with a partner (AOR=6.83; 95% CI=1.23-37.84), married women (AOR=5.21; 95% CI=1.95-13.89), women living in a male-headed household (AOR=5.29; 95% CI=1.26-22.38), and women whose partner wanted fewer children (AOR=11; 95% CI=3.46-16.2). Among rural women, the odds of long-acting contraceptive use was higher for women in the richest wealth index (AOR=6.69; 95% CI=3.02-14.83), married women (AOR=30.26; 95% CI=8.81-42.9), women with good knowledge of LACMs (AOR=1.75; 95% CI=1.25-2.46), and women who had no correct knowledge of their ovulatory cycle (AOR=1.93; 95% CI=1.16-3.19).
Long-acting contraceptive method use was lower than the national target. LACM use was 8.3% (95% CI=4.5-12.4) among urban and 14.8% (95% CI=12.4-17.2) among rural women. Overall, marital status, educational level, the total number of children, knowledge of LACMs, and correct knowledge of the ovulatory cycle were significantly associated with LACM use.
2000年至2011年期间，阿姆哈拉地区生育率急剧下降，原因是农村妇女现代避孕方法的使用有所增加。然而，长效避孕方法在城市妇女中的使用率高于农村妇女。因此，本研究旨在评估阿姆哈拉地区育龄妇女长效避孕方法使用的城乡差异及其影响因素：对2016年埃塞俄比亚人口与健康调查的分析。
使用2016年埃塞俄比亚人口与健康调查的数据。采用了2188名（1675名农村妇女和513名城市妇女）具有生育能力的育龄妇女的加权样本，并拟合了混合效应逻辑回归模型。采用p值<0.05的多变量逻辑回归分析和95%置信区间的调整优势比来确定显著关联。
长效避孕方法的总体使用率为13.3%（95%CI=11.6-15.8），农村妇女为14.8%（95%CI=12.4-17.2），城市妇女为8.3%（95%CI=4.5-12.4）。在城市妇女中，与伴侣同住的妇女（优势比=6.83；95%CI=1.23-37.84）、已婚妇女（优势比=5.21；95%CI=1.95-13.89）、生活在男性户主家庭的妇女（优势比=5.29；95%CI=1.26-22.38）以及伴侣希望少生孩子的妇女（优势比=11；95%CI=3.46-16.2）使用长效避孕方法的几率更高。在农村妇女中，最富裕财富指数组的妇女（优势比=6.69；95%CI=3.02-14.83）、已婚妇女（优势比=30.26；95%CI=8.81-42.9）、对长效避孕方法有充分了解的妇女（优势比=1.75；95%CI=1.25-2.46）以及对排卵周期没有正确认识（优势比=1.93；95%CI=！16-3.19）的妇女使用长效避孕方法的几率更高。
长效避孕方法的使用率低于国家目标。城市妇女中长效避孕方法的使用率为8.3%（95%CI=4.5-12.4），农村妇女为14.8%（95%CI=12.4-17.2）。总体而言，婚姻状况、教育水平、子女总数、对长效避孕方法的了解以及对排卵周期的正确认识与长效避孕方法的使用显著相关。
