Internet use, spatial variation and its determinants among reproductive age women in Ethiopia.

BACKGROUND

The Internet is the preferred source of health information for retrieving relevant information. In Ethiopia, the Internet penetration rate is improving year to year, but it is still at a low level compared to the rest of the world and neighboring African countries. Due to a lack of adequate information, it is important to assess Internet use, spatial variation, and determinants of Internet use among reproductive-age group women in Ethiopia.

METHOD

Secondary data from EDHS 2016 were used to analyze 15,683 women aged 15-49 years. Spatial analysis was performed using ArcGIS 10.7. The Bernoulli model was used by applying Kuldorff's methods using SaTScan 10.1.2 software to analyze the purely spatial clusters of Internet use. A multilevel mixed-effect logistic regression was applied to estimate community variance to identify individual- and community-level factors associated with Internet use. All models were fitted in STATA version 17.0, and finally, the adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was reported.

RESULT

The magnitude of Internet use was 4.97% ± 95% CI (4.63-5.32). The overall average age of women was 24.21 ± 8.06 years, with the age range 15-24 years constituting the larger group (39.2%). Women with secondary and above education [AOR = 6.47; 95% CI (5.04, 8.31)], unmarried [AOR = 2.60; 95% CI (1.89, 3.56)], rich [AOR = 1.95; 95% CI (1.00, 3.80)], own a mobile phone [AOR = 3.74; 95% CI (2.75, 5.09)], media exposure [AOR = 2.63; 95% CI (2.03, 3.42)], and urban [AOR = 1.80; 95% CI (1.08, 3.01)] had higher odds of Internet use. The spatial variation in Internet use was found to be nonrandom (global Moran's I = 0.58, p value < 0.001). Fifty-seven primary clusters were identified that were located in Addis Ababa city with a relative likelihood of 10.24 and a log-likelihood ratio of 425.16.

CONCLUSIONS

Internet use among reproductive-age women in Ethiopia is 4.97 and has significant spatial variation across the country. Both community- and individual-level factors affect Internet use in Ethiopia. Therefore, educating women, improving access to media, encouraging women to use family planning, and supporting household wealth could improve women's Internet use.