Meselu Wudalew, Habtamu Ashenafi, Woyraw Wubetu, Birlew Tsegaye Tesfa
Wudalew Meselu Tesfaye, Associate, Health Financing Program, Clinton Health Access Initiative, Addis Ababa, Ethiopia.
Ashenafi Habtamu, Health Services Management, Economics and Health Policy, College of Health Sciences, Arsi University, Assela, Ethiopia.
Public Health Pract (Oxf). 2022 Mar 13;3:100243. doi: 10.1016/j.puhip.2022.100243. eCollection 2022 Jun.
Accessing family planning is a key investment in reducing the broader costs of health care and can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is still low but it is steadily increasing. Identifying the contributing factors to the changes in contraceptive use among women helps to improve women's contraceptive use and helps to plan strategies for family planning programs. Thus, the current study aimed to analyze the trends and predictors of changes in modern contraceptive use over time among married women in Ethiopia.
Secondary data analysis of the national representative data of 2000-2016 Ethiopian Demography and Health Survey was employed.
This secondary data analysis was considered using 2000 through 2016 Ethiopian Demographic and Health Surveys. The study used data from the four DHSs conducted in Ethiopia (2000-2016). The data from all EDHS was collated so as to follow the trends throughout the period considered for the survey. Married women aged 15-49 years with sample sizes of 36,721 (9,203 in 2000, 8,438 in 2005, 9,478 in 2011, and 9,602 in 2016) were included. The analysis involved three levels, including trend analysis (to see changes from 2000 to 2005, 2005-2011, 2011-2016 and 2000-2016). Bivariate and multivariate analysis were also considered to identify predictors of modern contraceptive use. Data was extracted from the EDHS datasets for which authorization was obtained from the DHS Program/ICF International using a data extraction tool. SPSS 24 was employed for data management and analysis.
Among married women of reproductive age, modern contraceptive prevalence increased from 6.2% in 2000 to 35.2% in 2016. This 5-fold increment in modern contraceptive use was due to being in the age group of 25-29 years (AOR = 1.4; 95%CI (1.1, 1.7)), having two children (AOR = 1.3; 95%CI (1.1, 1.6)), the richest wealth category (AOR = 3.0; 95% CI (2.5, 3.5)), currently working (AOR = 1.3; 95%CI (1.2, 1.5)) and attending secondary and above education (AOR = 1.2; 95%CI (1.1, 1.6)) were found to be predictors.
Over the past 15 years, an annual average of a 1.9% point increment has been observed in modern contraceptive use, but the country lags behind the SDGs's 2030 target of achieving zero unmet needs for contraception. Program interventions, and continued education of women, are mandatory, as education is one of the major factors contributing to increasing contraceptive use.
获得计划生育服务是一项关键投资，有助于降低更广泛的医疗保健成本，并可大幅减少孕产妇、婴儿和儿童死亡人数。在埃塞俄比亚，现代避孕方法的使用率仍然较低，但呈稳步上升趋势。确定影响女性避孕方法使用变化的因素有助于提高女性的避孕使用率，并有助于制定计划生育项目的策略。因此，本研究旨在分析埃塞俄比亚已婚女性现代避孕方法使用随时间的变化趋势及预测因素。
采用2000 - 2016年埃塞俄比亚人口与健康调查的全国代表性数据进行二次数据分析。
本二次数据分析使用了2000年至2016年的埃塞俄比亚人口与健康调查数据。该研究采用了在埃塞俄比亚进行的四次人口与健康调查（2000 - 2016年）的数据。对所有埃塞俄比亚人口与健康调查的数据进行整理，以跟踪调查所涉期间的趋势。纳入了年龄在15 - 49岁的已婚女性，样本量分别为36721人（2000年9203人，2005年8438人，2011年9478人，2016年9602人）。分析包括三个层面，即趋势分析（观察2000年至2005年、2005 - 2011年、2011 - 2016年以及2000 - 2016年的变化）。还进行了双变量和多变量分析以确定现代避孕方法使用的预测因素。数据从埃塞俄比亚人口与健康调查数据集提取，已获得人口与健康调查项目/国际家庭保健组织（ICF国际）的授权，使用数据提取工具进行提取。采用SPSS 24进行数据管理和分析。
在育龄已婚女性中，现代避孕普及率从2000年的6.2%增至2016年的35.2%。现代避孕方法使用率增长了5倍，原因在于年龄在25 - 29岁（调整后比值比[AOR]=1.4；95%置信区间[CI](1.1, 1.7)）、育有两个孩子（AOR = 1.3；95%CI(1.1, 1.6)）、最富裕财富类别（AOR = 3.0；95%CI(2.5, 3.5)）、目前有工作（AOR = 1.3；95%CI(1.2, 1.5)）以及接受过中等及以上教育（AOR = 1.2；95%CI(1.1, 1.6)）被发现是预测因素。
在过去15年中，现代避孕方法使用率平均每年增长1.9个百分点，但该国仍落后于可持续发展目标中2030年实现避孕需求零未满足的目标。由于教育是促进避孕方法使用增加的主要因素之一，因此必须进行项目干预并持续对女性进行教育。
