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埃塞俄比亚少女和年轻女性中与现代避孕方法使用相关的个体和社区层面因素:对2016年埃塞俄比亚人口与健康调查的多层次分析

Individual and community-level factors associated with modern contraceptive use among adolescent girls and young women in Ethiopia: a multilevel analysis of 2016 Ethiopia demographic and health survey.

作者信息

Hailegebreal Samuel, Seboka Binyam Tariku, Ahmed Mohammedjud Hassen, Teferi Gizaw Hailiye, Regasa Zegaye, Tekabe Beemnet, Sako Sewunet, Gilano Girma

机构信息

Department of Health Informatics, College of Medicine and Health Science, School of Public Health, Arba Minch University, Arba Minch, Ethiopia.

Department of Health Informatics, College of Medicine, and Health Science, Dilla University, Dilla, Ethiopia.

出版信息

Arch Public Health. 2021 Nov 22;79(1):204. doi: 10.1186/s13690-021-00736-8.

Abstract

BACKGROUND

The importance of contraception use is immense for young girls of age 15-24 years. In literatures, there were significant attempts made to study factors associated with adolescent and young women contraception use in Africa. Despite the resulting interventions followed those studies, the contraception uses among youth population in Africa remained below average. Thus, this study is aimed to assess individual and community-level factors associated with contraceptive use in Ethiopian context to support further interventions.

METHODS

Our analysis was based on the secondary data from Ethiopia Demography and Health Survey (EDHS) 2016. Adolescent girls and young women (AGYW) aged 15-24 years were the target population. Means, standard deviations, and proportions were used to describe the study population. To control for the variations due to the differences between clusters, a series of multilevel logistic regression modeling steps were followed and determinants of contraceptive use were outplayed. All variables with bivariate p-value < 0.25 were included in the models and p-value < 0.05 was used to declare associations.

RESULTS

The prevalence of modern contraceptive use among AGYW in Ethiopia was 34.89% [95% CI, 0.32, 0.36]. Married adolescents were 2.01 times [AOR = 2.01, 95% CI = 1.39,3.16], having work was 1.36 times [AOR = 1.36, 95% CI = 1.06,1.71], living in urban areas was 1.61 times [AOR = 1.61, 95% CI = 1.16,2.45], being in middle wealth status was 1.9 times [AOR = 1.90, 95% CI = 1.32,2.65], being in rich wealth quintile was 1.99 time [AOR = 1.99, 95% CI = 1.35,2.68], and having TV exposure was 1.61 times [AOR = 1.6, 95% CI = 1.17,2.20] more likely associated with modern contraceptive uses.

CONCLUSION

The use of modern contraception among AGYW in the country remained appealing and factors like region, residence, marital status, wealth index, religion, working status, parity, husband desire children, ever aborted AGYW, and the television exposures were attributed for the poor improvements. Therefore, the enhancements that consult those factors remained remarkable in improving contraception use, while further increasing in educational engagement, access to health services, and economic empowerment of the AGYW might be the good advantages for the improvements.

摘要

背景

避孕措施对于15至24岁的年轻女孩极为重要。在文献中,人们进行了大量研究以探讨非洲青少年和年轻女性避孕措施使用的相关因素。尽管基于这些研究采取了相应干预措施,但非洲青年人群的避孕措施使用率仍低于平均水平。因此,本研究旨在评估埃塞俄比亚背景下与避孕措施使用相关的个人和社区层面因素,以支持进一步的干预措施。

方法

我们的分析基于2016年埃塞俄比亚人口与健康调查(EDHS)的二手数据。15至24岁的少女和年轻女性为目标人群。使用均值、标准差和比例来描述研究人群。为控制因聚类差异导致的变异,我们采用了一系列多水平逻辑回归建模步骤,并找出了避孕措施使用的决定因素。所有双变量p值<0.25的变量都纳入模型,p值<0.05用于判定关联性。

结果

埃塞俄比亚15至24岁少女和年轻女性中现代避孕措施的使用率为34.89%[95%置信区间,0.32,0.36]。已婚青少年使用现代避孕措施的可能性是未婚青少年的2.01倍[AOR = 2.01,95%置信区间 = 1.39,3.16],有工作的人群是无工作人群的1.36倍[AOR = 1.36,95%置信区间 = 1.06,1.71],居住在城市地区的人群是居住在农村地区人群的1.61倍[AOR = 1.61,95%置信区间 = 1.16,2.45],处于中等财富状况的人群是低财富状况人群的1.9倍[AOR = 1.90,95%置信区间 = 1.32,2.65],处于富裕财富五分位数的人群是低财富状况人群的1.99倍[AOR =  1.99,95%置信区间 = 1.35,2.68],接触电视的人群是未接触电视人群的1.61倍[AOR = 1.6,95%置信区间 = 1.17,2.20]。

结论

该国15至24岁少女和年轻女性中现代避孕措施的使用情况仍有待改善,地区、居住状况、婚姻状况、财富指数、宗教、工作状况、生育次数、丈夫生育意愿、有过流产经历的少女和年轻女性以及电视接触等因素导致改善效果不佳。因此,考虑这些因素的改进措施对于提高避孕措施使用率具有重要意义,同时进一步加强教育参与度、改善医疗服务可及性以及增强少女和年轻女性的经济权能可能有助于改善这一状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f56d/8607592/70087af9ddc0/13690_2021_736_Fig1_HTML.jpg

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