Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2024 Aug 20;24(1):2252. doi: 10.1186/s12889-024-19715-z.
Contraceptive usage in Ethiopia is significantly influenced by the decision-maker at the household level. Joint decision-making involving both women and their husbands/partners is considered ideal for improving contraceptive uptake among women and for managing health outcomes related to contraceptive side effects. However, there is a lack of substantial evidence regarding the prevalence and impact of joint decision-making on contraceptive use in Ethiopia. Therefore, the current study aimed to assess the magnitude of joint decision-making on contraceptive use and its determinant factors among married, contraceptive-using, reproductive-age women in Ethiopia.
This study was conducted based on the Ethiopian Demographic and Health Survey (EDHS) 2016 data. A total weighted sample of 3,669 married, contraceptive-using, reproductive-age women were included in the study. Multilevel logistic regression was employed due to the hierarchical nature of the data. Variables with a p-value of ≤ 0.2 in the bivariate multilevel analysis were included in the multivariable multilevel analysis. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to determine the direction and strength of associations. Variables with a p-value of < 0.05 in the multivariable multilevel analysis were considered statistically significant for joint decision-making on contraceptive use.
The prevalence of joint decision-making on contraceptive use in Ethiopia was 78.81% [95% CI: 71.35-74.23%]. Several factors were found to be statistically significant in relation to joint decision-making on contraceptive use: Women educational level primary, secondary, and higher (Adjusted odds' ratio (AOR = 1.5; CI 1.2-1.9), (AOR = 1.9; CI 1.3-2.9), and (AOR = 2.1; CI 1.2-3.5) respectively, protestant in religion (AOR = 1.7; CI 1.7-2.5), wealth status rich (AOR = 1.4; CI 1.1-1.9), media exposure (AOR = 1.4; CI 1.1-1.9), and community poverty high (AOR = 0.6; CI 0.6-0.9).
In Ethiopia, the majority of contraceptive users are married, reproductive-age women, and their decision to use contraceptives is typically made jointly with their husbands or partners. Factors positively associated with joint decision-making on contraceptive use include women's educational level (primary, secondary, and higher), being Protestant, having a higher wealth status, and media exposure. Conversely, women living in communities with high poverty levels are less likely to make joint decisions about contraceptive use. Health care providers, health care programmers and policy makers should be focused on these determinant factors to enhance joint decision-making in women's contraceptive use in Ethiopia.
在埃塞俄比亚，避孕措施的使用在很大程度上受到家庭中决策者的影响。妇女及其丈夫/伴侣共同做出决策被认为是提高妇女避孕率和管理与避孕副作用相关的健康结果的理想选择。然而，关于共同决策对埃塞俄比亚避孕使用的普遍性和影响的实质性证据不足。因此，本研究旨在评估已婚、使用避孕药具、处于生育年龄的埃塞俄比亚妇女中共同决策对避孕药具使用的重要性及其决定因素。
本研究基于埃塞俄比亚人口与健康调查（EDHS）2016 年数据进行。共有 3669 名已婚、使用避孕药具、处于生育年龄的妇女被纳入研究。由于数据具有层次结构，因此采用多水平逻辑回归。在双变量多水平分析中 p 值≤0.2 的变量被纳入多变量多水平分析。使用调整后的优势比（AOR）和 95%置信区间（CI）来确定关联的方向和强度。在多变量多水平分析中 p 值<0.05 的变量被认为对共同决策避孕使用有统计学意义。
埃塞俄比亚共同决策避孕使用的流行率为 78.81%[95%置信区间：71.35-74.23%]。有几个因素与共同决策避孕使用有统计学意义：妇女的教育程度为小学、中学和高等（调整后的优势比（AOR）=1.5；CI 1.2-1.9），（AOR=1.9；CI 1.3-2.9）和（AOR=2.1；CI 1.2-3.5），宗教为新教（AOR=1.7；CI 1.7-2.5），财富状况为富裕（AOR=1.4；CI 1.1-1.9），媒体接触（AOR=1.4；CI 1.1-1.9），社区贫困程度高（AOR=0.6；CI 0.6-0.9）。
在埃塞俄比亚，大多数使用避孕药具的人是已婚、处于生育年龄的妇女，她们通常与丈夫或伴侣共同决定使用避孕药具。与共同决策避孕使用呈正相关的因素包括妇女的教育程度（小学、中学和高等）、新教信仰、较高的财富地位和媒体接触。相反，生活在贫困程度较高社区的妇女不太可能共同做出避孕使用的决策。卫生保健提供者、卫生保健规划人员和政策制定者应关注这些决定因素，以加强埃塞俄比亚妇女避孕使用方面的共同决策。
