Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.
PLoS One. 2024 Sep 5;19(9):e0306068. doi: 10.1371/journal.pone.0306068. eCollection 2024.
BACKGROUND: The notion of unmet need for family planning indicates the gap between women's contraceptive practice and their reproductive intention. Although universal access to sexual and reproductive health services including contraceptive methods is a bedrock for sustainable development goals, the unmet need for contraception is high among young women in low-income countries including Ethiopia. The unmet need for contraception is associated with unintended pregnancy which most of the time end in unsafe abortion. Hence, this study aimed to assess the determinants of unmet need for family planning among young married women in Ethiopia using nationally representative data. METHOD: This study utilized secondary data collected in the 2016 Ethiopia Demographic and Health Survey (EDHS). A two-stage cluster sampling method was used. The analysis included a total of 2444 sexually active married young women (15-24 years). Multilevel logistic regression analysis was conducted to identify individual and community level factors associated with unmet need for contraceptives and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses. RESULTS: In this study, the prevalence of unmet need for contraceptive method among married young women was 18.4% [95% CI: (16.9, 20.0)]. Female head of the household [AOR: 1.62, CI (1.25, 2.11)], primary level of education [AOR: 1.53, CI: (1.16, 2.03)], family size ≥5 [AOR: 1.53, 95%CI: (1.22, 1.93)], undecided to have child [AOR: 2.86, 95%CI: (1.58, 5.20)] and infecund [AOR: 1.54, 95%CI: (1.08, 2.20)] were factors positively associated with unmet need for family planning. Whereas the odds of unmet need for contraceptive method was lower among women-initiated sex between 15-17 years and >17 years [AOR:0.72, 95%CI (0.53, 0.98)] and [AOR: 0.58, 95%CI: (0.40, 0.85)] respectively and community with high proportion of poverty [AOR: 0.68, 95%CI: (0.46, 0.99)]. CONCLUSION: The prevalence of unmet need for contraceptive methods among young married women was relatively high. Being female household head, age at first sexual intercourse, educational status of the woman, family size, desire for more children, and community poverty were significantly associated with unmet need for family planning. Hence, interventions targeting these special populations at the individual and community level would play a paramount role in meeting the unmet need for contraception among young married women in Ethiopia.
背景:计划生育未满足需求的概念表明了妇女避孕实践与生育意愿之间的差距。尽管普及包括避孕方法在内的性健康和生殖健康服务是可持续发展目标的基石,但在包括埃塞俄比亚在内的低收入国家,年轻妇女对避孕的未满足需求仍然很高。避孕未满足需求与意外怀孕有关,而大多数意外怀孕最终都会导致不安全堕胎。因此,本研究旨在利用全国代表性数据评估埃塞俄比亚年轻已婚妇女避孕未满足需求的决定因素。
方法:本研究使用了 2016 年埃塞俄比亚人口与健康调查(EDHS)收集的二手数据。采用两阶段聚类抽样方法。分析共包括 2444 名有性行为的已婚年轻妇女(15-24 岁)。采用多水平逻辑回归分析确定与避孕未满足需求相关的个体和社区层面因素,结果以 95%置信区间(CI)的调整比值比(AOR)表示,所有分析均以 p 值<0.05 表示具有统计学意义。
结果:在这项研究中,已婚年轻妇女避孕未满足需求的流行率为 18.4%[95%CI:(16.9,20.0)]。家庭主妇[AOR:1.62,CI(1.25,2.11)]、小学教育水平[AOR:1.53,CI:(1.16,2.03)]、家庭规模≥5[AOR:1.53,95%CI:(1.22,1.93)]、未决定要孩子[AOR:2.86,95%CI:(1.58,5.20)]和不育[AOR:1.54,95%CI:(1.08,2.20)]是与避孕未满足需求呈正相关的因素。而在 15-17 岁和>17 岁之间的女性发起性行为[AOR:0.72,95%CI(0.53,0.98)]和[AOR:0.58,95%CI:(0.40,0.85)]以及社区中贫困比例较高[AOR:0.68,95%CI:(0.46,0.99)]的妇女,避孕方法的未满足需求的可能性较低。
结论:年轻已婚妇女避孕方法未满足需求的流行率相对较高。作为家庭主妇、初次性行为年龄、妇女教育程度、家庭规模、希望生育更多孩子以及社区贫困是与避孕未满足需求显著相关的因素。因此,针对这些特殊人群的个人和社区层面的干预措施将在满足埃塞俄比亚年轻已婚妇女对避孕的未满足需求方面发挥重要作用。
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