Negash Habtu Kifle, Lakew Ayenew Molla, Molla Gebretsadik Endeshaw, Baraki Adhanom Gebreegziabher, Mariye Yitbarek Fantahun, Tesfaye Winta, Bekele Bezawit Habtamu, Eticha Biruk Lelisa
Department of Anatomy, 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.
PLoS One. 2025 Mar 12;20(3):e0319003. doi: 10.1371/journal.pone.0319003. eCollection 2025.
Comprehensive family planning is essential for reproductive health, allowing individuals to make informed choices about family size and enhancing maternal and child health. Long-acting contraceptives (LACs) are known for their high efficacy and consistent use. This study examines the prevalence and determinants of LAC utilization among women of reproductive-age in 11 East African countries.
Secondary data from Demographic and Health Surveys (2015-2022) across 11 East African nations were pooled and analyzed. The study sample included 144,414 women aged 15-49. Bivariate and multivariate regression analyses were conducted using Stata 17 to explore factors associated with LAC utilization. Results are presented as adjusted odds ratios (AOR), with statistical significance at p < 0.05.
The prevalence of LAC utilization among reproductive-age women in East Africa is 14.87%. Women from middle-income households are 13% more likely to utilize LACs compared to those from poor households (AOR = 1.13, 95% CI: 1.08-1.18), while those from wealthy households are 15% more likely (AOR = 1.15, 95% CI: 1.11-1.20). Married women and those living with a partner are 42% more likely to utilize LACs than unmarried women (AOR = 1.42, 95% CI: 1.33-1.52). Educational attainment significantly impacts LAC utilization: women with primary education are 52% more likely (AOR = 1.52, 95% CI: 1.44-1.60), those with secondary education are 63% more likely (AOR = 1.63, 95% CI: 1.53-1.73), and women with higher education are twice as likely to utilize LACs (AOR = 2.00, 95% CI: 1.84-2.17).
LAC utilization remains relatively low in the studied East African countries. Factors positively associated with higher LAC utilization include being married, higher income, educational attainment, employment, and media exposure. Additionally, women with more than three children and those from countries with lower illiteracy and poverty rates also have higher LAC utilization. Conversely, a history of abortion, fewer health fieldworker visits, and later initiation of sexual activity and childbirth are associated with lower LAC utilization. These findings emphasize the need for targeted interventions to overcome barriers and promote LAC access and utilization.
全面的计划生育对生殖健康至关重要，它能让个人对家庭规模做出明智选择，并改善母婴健康。长效避孕药（LACs）以其高效性和持续使用性而闻名。本研究调查了11个东非国家育龄妇女中长效避孕药的使用情况及其决定因素。
汇总并分析了11个东非国家人口与健康调查（2015 - 2022年）的二手数据。研究样本包括144,414名年龄在15 - 49岁的女性。使用Stata 17进行双变量和多变量回归分析，以探索与长效避孕药使用相关的因素。结果以调整后的优势比（AOR）呈现，p < 0.05具有统计学意义。
东非育龄妇女中长效避孕药的使用率为14.87%。与贫困家庭的妇女相比，中等收入家庭的妇女使用长效避孕药的可能性高13%（AOR = 1.13，95%置信区间：1.08 - 1.18），而富裕家庭的妇女可能性高15%（AOR = 1.15，95%置信区间：1.11 - 1.20）。已婚妇女和与伴侣同居的妇女使用长效避孕药的可能性比未婚妇女高42%（AOR = 1.42，95%置信区间：1.33 - 1.52）。教育程度对长效避孕药的使用有显著影响：小学学历的妇女可能性高52%（AOR = 1.52，95%置信区间：1.44 - 1.60），初中学历的妇女可能性高63%（AOR = 1.63，95%置信区间：1.53 - 1.73），高中学历的妇女使用长效避孕药的可能性是两倍（AOR = 2.00，95%置信区间：1.84 - 2.17）。
在所研究的东非国家，长效避孕药的使用率仍然相对较低。与长效避孕药较高使用率呈正相关的因素包括已婚、收入较高、教育程度、就业和媒体曝光。此外，有三个以上孩子的妇女以及来自文盲率和贫困率较低国家的妇女长效避孕药使用率也较高。相反，有堕胎史、较少接受卫生工作者家访以及较晚开始性行为和生育与长效避孕药较低使用率相关。这些发现强调了需要有针对性的干预措施来克服障碍并促进长效避孕药的获取和使用。
