Muchie Bisrategebriel Tesfaye, Woya Ashenafi Abate, Tegegne Awoke Seyoum, Kassie Maru Zewdu, Alene Assfaw Muluhabt, Zewdia Wondaya Fenta
Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Statistics, Assosa University, Assosa, Ethiopia.
Front Glob Womens Health. 2025 Apr 23;6:1505789. doi: 10.3389/fgwh.2025.1505789. eCollection 2025.
Contraception aims to prevent unintended pregnancies, significantly impacting maternal and infant mortality in sub-Saharan Africa, especially in Ethiopia. This study investigates factors influencing modern contraceptive use among reproductive-age women in Ethiopia.
We analyzed the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) dataset, which includes 8,196 weighted samples of women and girls aged 15-49. Data management utilized STATA version 17, R version 4.2.2, and Arc GIS 10.8 for mapping. We employed multilevel and spatial analyses to identify determinants.
Only 26% of the women used modern contraceptives, with notable spatial clustering (Global Moran's Index = 0.237776, < 0.001). Hotspots were identified in Benishangul-Gumuz; Gambela; Southern Nations, Nationalities, and Peoples' Region (SNNPR); and eastern Oromia. Being in the 25-34 age group [adjusted hazard ratio (AHR) = 1.346, 95% CI: 1.143, 1.585]; having a higher [adjusted odds ratio (AOR) = 1.919, 95% CI: 1.380, 2.669], secondary (AOR = 1.554, 95% CI: 1.261, 1.914), or primary education level (AOR: 1.3514, 95% CI: 1.1624, 1.5712); being married (AOR = 25.953, 95% CI: 20.397, 32.942); and higher community wealth (AOR = 1.497, 95% CI: 1.114, 2.011) were positively associated with contraceptive usage, whereas being aged 35-49 (AOR = 0.538, 95% CI: 0.446, 0.649), having three or more children (AOR = 0.634, 95% CI: 0.460, 0.872), and living in the Somali region (AOR = 0.114, 95% CI: 0.045, 0.2882) were negatively associated with contraceptive usage. The best-fitting model included individual, community, and spatial variables, with an intra-class correlation coefficient indicating that 15.57% of the variability in contraceptive use was due to cluster differences.
Modern contraceptive use among Ethiopian women is low and varies by cluster. Factors positively associated include age of 25-34, education, marital status, and community wealth. Conversely, women aged 35-49, those with three or more children, and those in the Somali region showed lower usage. Community-level interventions are necessary to improve modern contraceptive adoption.
避孕旨在防止意外怀孕，这对撒哈拉以南非洲地区，尤其是埃塞俄比亚的母婴死亡率有重大影响。本研究调查了影响埃塞俄比亚育龄妇女使用现代避孕方法的因素。
我们分析了2019年埃塞俄比亚微型人口与健康调查（EMDHS）数据集，其中包括8196个15至49岁妇女和女孩的加权样本。数据管理使用STATA 17版、R 4.2.2版和Arc GIS 10.8进行绘图。我们采用多层次和空间分析来确定决定因素。
只有26%的妇女使用现代避孕方法，存在明显的空间聚集现象（全局莫兰指数=0.237776，P<0.001）。在本尚古勒-古穆兹、甘贝拉、南方各族州（SNNPR）和奥罗米亚东部发现了热点地区。年龄在25至34岁之间（调整后风险比[AHR]=1.346，95%置信区间：1.143，1.585）；接受过高等教育（调整后优势比[AOR]=1.919，95%置信区间：1.380，2.669）、中等教育（AOR=1.554，95%置信区间：1.261，1.914）或初等教育水平（AOR：1.3514，95%置信区间：1.1624，1.5712）；已婚（AOR=25.953，95%置信区间：20.397，32.942）；以及社区财富水平较高（AOR=1.497，95%置信区间：1.114，2.011）与避孕使用呈正相关，而年龄在35至49岁之间（AOR=0.538，95%置信区间：0.446，0.649）、有三个或更多孩子（AOR=0.634，95%置信区间：0.460，0.872）以及居住在索马里地区（AOR=0.114，95%置信区间：0.045，0.2882）与避孕使用呈负相关。最佳拟合模型包括个体、社区和空间变量，组内相关系数表明避孕使用中15.57%的变异性是由于聚类差异。
埃塞俄比亚妇女中现代避孕方法的使用比例较低，且因聚类而异。呈正相关的因素包括25至34岁的年龄、教育程度、婚姻状况和社区财富。相反，3
