埃塞俄比亚无生育意愿女性不使用避孕措施的个体和社区层面决定因素:一项多层次混合效应分析
Individual and community-level determinants of non-use of contraceptive among women with no fertility desire in Ethiopia: a multilevel mixed-effect analysis.
作者信息
Mare Kusse Urmale, Aychiluhm Setognal Birara, Tadesse Abay Woday, Mohammed Osman Ahmed
机构信息
Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
出版信息
Emerg Themes Epidemiol. 2022 Apr 2;19(1):2. doi: 10.1186/s12982-022-00112-z.
BACKGROUND
In Ethiopia, about two-third of women in the reproductive-age do not use any method of contraception. Moreover, evidence on non-use of contraceptives among women who do not have future fertility desires are limited. Therefore, this study intended to identify both individual and community-level determinants of non-use of contraceptives among this group in Ethiopia using a multilevel mixed effect analysis.
METHODS
Data retrieved from the demographic and health survey program official database website ( http://dhsprogram.com ) were used in this study. The suvey was conducting using a multistage cluster sampling technique and a weighted sample of 4398 reproductive-age women with no fertility desire was used in this study. Four models were fitted using a multilevel multivariable logistic regression to identify determinants of non-use of contraceptives and model with the lowest Akaike's Information Criterion was selected as a best fitted model. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables.
RESULTS
Overall, 65.3% [95% CI (63.9%, 66.7%)] of women with no fertility desire were not using any contraceptive method. Living in large central [AOR (95% CI) 0.45 (0.31, 0.67)] and metropolitan regions [AOR (95% CI) 0.39 (0.22, 0.68)] and being from household with middle [AOR (95% CI) 0.65 (0.42, 0.93)] and rich wealth index [AOR (95% CI) 0.67 (0.44, 0.98)] were negatively associated with non-use of contraceptives. Besides, being from a community with high women illiteracy [AOR (95% CI) 1.38 (1.15, 1.67)], being Muslim [AOR (95% CI) 1.86 (1.22, 2.85)], having history of pregnancy termination [AOR (95% CI) 1.59 (1.10, 2.31)], having a husband who desire to have more children [AOR (95% CI) 1.46 (1.02, 2.09)] were the positive determinants of non-utilization of contraceptives.
CONCLUSION
Nearly two-third of reproductive-age women with no fertility desire in Ethiopia do not use any contraceptive method. Awareness creation interventions on the benefits of contraceptives targeting Muslim religion followers and improving women education and their economic empowerment at household level may decrease the proportion of non-use of contraceptives at a national level.
背景
在埃塞俄比亚,约三分之二的育龄妇女未采用任何避孕方法。此外,关于无生育意愿的妇女不使用避孕药具的证据有限。因此,本研究旨在采用多水平混合效应分析确定埃塞俄比亚该群体中不使用避孕药具的个体和社区层面的决定因素。
方法
本研究使用从人口与健康调查项目官方数据库网站(http://dhsprogram.com)检索的数据。该调查采用多阶段整群抽样技术,本研究使用了4398名无生育意愿的育龄妇女的加权样本。使用多水平多变量逻辑回归拟合四个模型以确定不使用避孕药具的决定因素,并选择具有最低赤池信息准则的模型作为最佳拟合模型。使用调整后的优势比及其相应的95%置信区间来声明自变量的统计学显著性。
结果
总体而言,65.3%[95%置信区间(63.9%,66.7%)]无生育意愿的妇女未使用任何避孕方法。居住在大的中心地区[AOR(95%置信区间)0.45(0.31,0.67)]和大都市地区[AOR(95%置信区间)0.39(0.22,0.68)]以及来自中等[AOR(95%置信区间)0.65(0.42,0.93)]和富裕财富指数家庭[AOR(95%置信区间)0.67(0.44,0.98)]与不使用避孕药具呈负相关。此外,来自女性文盲率高的社区[AOR(95%置信区间)1.38(1.15,1.67)]、是穆斯林[AOR(95%置信区间)1.86(1.22,2.85)]、有终止妊娠史[AOR(95%置信区间)1.59(1.10,2.31)]、丈夫希望生育更多孩子[AOR(95%置信区间)1.46(1.02,2.09)]是不使用避孕药具的正向决定因素。
结论
在埃塞俄比亚,近三分之二无生育意愿的育龄妇女未使用任何避孕方法。针对穆斯林宗教信徒开展关于避孕药具益处的宣传干预措施,以及在家庭层面提高妇女教育水平和增强其经济权能,可能会降低全国不使用避孕药具的比例。
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