Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia.
School of Mathematics, Statistics and Computer Science, College of Agriculture Engineering and Science, University of KwaZulu-Natal, Durban, South Africa.
PLoS One. 2023 Aug 2;18(8):e0282225. doi: 10.1371/journal.pone.0282225. eCollection 2023.
Unintended pregnancy is amajor sexual and reproductive health problem that imposes substantial health, economical and psychosocial costs to individuals and society as well as significant emotional distress to women, families, and society. The main aim of this study was to investigate the spatial distribution and predictors of unintended pregnancy in Ethiopian regions and administrative zones.
This study was conducted based on data from 2016 Ethiopian Demographic and Health Survey. The prevalence of unintended pregnancy across regions and or zones was assessed using spatial analysis, and the effect of different factors on unintended pregnancy in Ethiopia was investigated using a generalized linear mixed model with a multistage clustered sampling strategy. The crude and best linear unbiased predictor estimations of zones were integrated with the shape file data to demonstrate the performance of each zone on maps.
The prevalence of unintended pregnancy for reproductive women in Ethiopia was29.49%. The highest rates of unintended pregnancy were recorded in the North Gondar zone of the Amhara region and the Jima zone in the Oromiya region. The mixed effects model revealed that age [AOR = 0.78, 95% CI, 0.62-0.97], residence [AOR = 2.62, 95%CI, 1.94, 7.27], marital status [AOR = 0.05, 95%CI, 0.01-0.38], women education [AOR = 1.34, 95%CI, 0.75-2.39], smoking cigarettes [AOR = 3.67, 95CI, 1.17-11.56], and poorer wealth index [AOR = 1.89, 95% CI, 1.51-2.31] were significantly associated with unintended pregnancy.
In Ethiopia, unintended pregnancy is a public health issue, and prevention stratagem for unintended pregnancy among reproductive women need to be focused based on the identified predictors. The spatial distribution of unintended pregnancy varied greatly at zonal and regional levels in Ethiopia. Hence, we recommended that, creating awareness of sexual and reproductive health with special priority to the identified hotspot areas (Amhara, Oromiya and SNN regions) to reduce unintended pregnancy. Emphasis on fertility and contraceptive techniques should be given to couples by health professionals.
意外怀孕是一个主要的性健康和生殖健康问题,它给个人和社会带来了巨大的健康、经济和社会心理成本,也给妇女、家庭和社会带来了巨大的情感困扰。本研究的主要目的是调查埃塞俄比亚地区和行政区的意外怀孕的空间分布和预测因素。
本研究基于 2016 年埃塞俄比亚人口与健康调查的数据。使用空间分析评估了各地区和行政区之间意外怀孕的流行率,并使用广义线性混合模型和多阶段聚类抽样策略调查了不同因素对埃塞俄比亚意外怀孕的影响。利用形状文件数据对各区域的原始和最佳线性无偏预测值进行了整合,以展示各区域在地图上的表现。
埃塞俄比亚育龄妇女的意外怀孕率为 29.49%。意外怀孕率最高的地区是阿姆哈拉地区的北贡达尔区和奥罗米亚地区的吉马区。混合效应模型显示,年龄[比值比(AOR)=0.78,95%置信区间(CI),0.62-0.97]、居住地(AOR=2.62,95%CI,1.94-7.27)、婚姻状况(AOR=0.05,95%CI,0.01-0.38)、妇女教育(AOR=1.34,95%CI,0.75-2.39)、吸烟(AOR=3.67,95CI,1.17-11.56)和较贫穷的财富指数(AOR=1.89,95%CI,1.51-2.31)与意外怀孕显著相关。
在埃塞俄比亚,意外怀孕是一个公共卫生问题,需要根据已确定的预测因素,针对育龄妇女制定预防意外怀孕的策略。埃塞俄比亚各地区和行政区之间的意外怀孕空间分布差异很大。因此,我们建议,通过特别关注确定的热点地区(阿姆哈拉、奥罗米亚和 SNN 地区),提高性健康和生殖健康意识,以减少意外怀孕。卫生专业人员应向夫妇强调生育和避孕技术。