Spatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysis
Abstract Background The unmet need for family planning (FP) occurs when women want to limit or delay childbearing but lack access to contraception, leading to unintended pregnancies and increased maternal and child mortality, especially in developing countries. This study uses the 2021 PMA-Ethiopia...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12889-025-21917-y |
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| author | Abiyu Abadi Tareke Eyob Ketema Bogale Tadele Fentabel Anagaw Misganaw Guadie Tiruneh Eneyew Talie Fenta Destaw Endeshaw Habitu Birhan Eshetu Amare Mebrat Delie Ousman Adal Tegegne |
| author_facet | Abiyu Abadi Tareke Eyob Ketema Bogale Tadele Fentabel Anagaw Misganaw Guadie Tiruneh Eneyew Talie Fenta Destaw Endeshaw Habitu Birhan Eshetu Amare Mebrat Delie Ousman Adal Tegegne |
| author_sort | Abiyu Abadi Tareke |
| collection | DOAJ |
| description | Abstract Background The unmet need for family planning (FP) occurs when women want to limit or delay childbearing but lack access to contraception, leading to unintended pregnancies and increased maternal and child mortality, especially in developing countries. This study uses the 2021 PMA-Ethiopia survey to assess unmet need for family planning (FP) among reproductive age women, addressing limitations in previous research that relied on outdated and non-representative data. The findings offer valuable insights to help policymakers address local challenges and improve reproductive health outcomes in Ethiopia. Methods This study utilized secondary data from the Performance Monitoring for Action Ethiopia survey conducted in 2021. A total of 5,203 reproductive-aged women were included in this study. STATA version 16 was used to cross-tabulate and fit the models. To account for the hierarchical structure of the data, we employed multilevel logistic regression. We estimated four statistical models: a null model (Model 0) to assess between-community variations, Model I incorporating individual-level predictors, Model II adding community-level factors, and Model III including both. To select the best-fitting model, we conducted model comparison using BIC, AIC, deviance, and log-likelihood ratio (LLR) to assess model performance. We calculated adjusted odds ratios along with their corresponding 95% confidence intervals (CIs). Furthermore, a significance level of p < 0.05 was considered as strong evidence of statistical significance. Results The prevalence of unmet need for family planning among reproductive-age women was 23.60% [95% CI: 22.46%, 24.78%]. Model comparison indicated that Model III exhibited the best fit, with the lowest AIC (5306) and DIC (5300) values, along with an improved log-likelihood (-2650). Factors positively associated with unmet need included women aged 45–49 [AOR = 4.7, 95% CI: (2.97, 7.43)], 40–44 [AOR = 3.21, 95% CI: (2.23, 4.61)], 35–39 [AOR = 2.47, 95% CI: (1.78, 3.44)], and 30–34 years [AOR = 2.42, 95% CI: (1.76, 3.33)] compared to those aged 15–19 years. Conversely, having 1–2 children [AOR = 0.47, 95% CI: 0.39, 0.56], having 3–4 children [AOR = 0.50, 95% CI: 0.39, 0.63], and having five or more children [AOR = 0.51, 95% CI: 0.39, 0.66] were factors negatively associated with unmet need compared to women who are para 0. Furthermore, the spatial pattern of unmet need for family planning exhibited clustering (Moran’s index = 0.25, p-value = 0.0039). The primary cluster is located in the central part of Oromia, northern SNNP, northwest of Sidama, and northeastern part of Southwest Ethiopia. Conclusion This study affirms the ongoing high prevalence of unmet need for family planning in Ethiopia. It identified women’s age and parity as crucial factors correlated with unmet need for FP. Additionally, there exists an unequal distribution of the burden of unmet need for FP across the country. To address the varying reproductive health needs at different life stages and parity levels, the interventional plan needs to be based on women’s age and the number of children they have. Moreover, location-tailored interventional plans should be employed to optimize family planning related service inequalities. |
| format | Article |
| id | doaj-art-c36e58bf8fde4b32923fa0d54675f279 |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj-art-c36e58bf8fde4b32923fa0d54675f2792025-08-20T03:13:15ZengBMCBMC Public Health1471-24582025-02-0125111310.1186/s12889-025-21917-ySpatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysisAbiyu Abadi Tareke0Eyob Ketema Bogale1Tadele Fentabel Anagaw2Misganaw Guadie Tiruneh3Eneyew Talie Fenta4Destaw Endeshaw5Habitu Birhan Eshetu6Amare Mebrat Delie7Ousman Adal Tegegne8Amref Health in Africa, COVID-19 Vaccine/EPI Technical Assistant at West Gondar Zonal Health DepartmentHealth Promotion and Behavioral Science Department, College of Medicine and Health ScienceDepartment of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar UniversityDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Public Health College of Medicine and Health Science, Injibara UniversityDepartment of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar UniversityCurtin School of Population Health, Curtin UniversityDepartment of Public Health, College of Medicine and Health Science, Injibara UniversityDepartment of emergency, Bahir Dar University, College of Medicine and Health SciencesAbstract Background The unmet need for family planning (FP) occurs when women want to limit or delay childbearing but lack access to contraception, leading to unintended pregnancies and increased maternal and child mortality, especially in developing countries. This study uses the 2021 PMA-Ethiopia survey to assess unmet need for family planning (FP) among reproductive age women, addressing limitations in previous research that relied on outdated and non-representative data. The findings offer valuable insights to help policymakers address local challenges and improve reproductive health outcomes in Ethiopia. Methods This study utilized secondary data from the Performance Monitoring for Action Ethiopia survey conducted in 2021. A total of 5,203 reproductive-aged women were included in this study. STATA version 16 was used to cross-tabulate and fit the models. To account for the hierarchical structure of the data, we employed multilevel logistic regression. We estimated four statistical models: a null model (Model 0) to assess between-community variations, Model I incorporating individual-level predictors, Model II adding community-level factors, and Model III including both. To select the best-fitting model, we conducted model comparison using BIC, AIC, deviance, and log-likelihood ratio (LLR) to assess model performance. We calculated adjusted odds ratios along with their corresponding 95% confidence intervals (CIs). Furthermore, a significance level of p < 0.05 was considered as strong evidence of statistical significance. Results The prevalence of unmet need for family planning among reproductive-age women was 23.60% [95% CI: 22.46%, 24.78%]. Model comparison indicated that Model III exhibited the best fit, with the lowest AIC (5306) and DIC (5300) values, along with an improved log-likelihood (-2650). Factors positively associated with unmet need included women aged 45–49 [AOR = 4.7, 95% CI: (2.97, 7.43)], 40–44 [AOR = 3.21, 95% CI: (2.23, 4.61)], 35–39 [AOR = 2.47, 95% CI: (1.78, 3.44)], and 30–34 years [AOR = 2.42, 95% CI: (1.76, 3.33)] compared to those aged 15–19 years. Conversely, having 1–2 children [AOR = 0.47, 95% CI: 0.39, 0.56], having 3–4 children [AOR = 0.50, 95% CI: 0.39, 0.63], and having five or more children [AOR = 0.51, 95% CI: 0.39, 0.66] were factors negatively associated with unmet need compared to women who are para 0. Furthermore, the spatial pattern of unmet need for family planning exhibited clustering (Moran’s index = 0.25, p-value = 0.0039). The primary cluster is located in the central part of Oromia, northern SNNP, northwest of Sidama, and northeastern part of Southwest Ethiopia. Conclusion This study affirms the ongoing high prevalence of unmet need for family planning in Ethiopia. It identified women’s age and parity as crucial factors correlated with unmet need for FP. Additionally, there exists an unequal distribution of the burden of unmet need for FP across the country. To address the varying reproductive health needs at different life stages and parity levels, the interventional plan needs to be based on women’s age and the number of children they have. Moreover, location-tailored interventional plans should be employed to optimize family planning related service inequalities.https://doi.org/10.1186/s12889-025-21917-yPrevalenceFactors associatedUnmet needFamily planningSpatial analysisPMA |
| spellingShingle | Abiyu Abadi Tareke Eyob Ketema Bogale Tadele Fentabel Anagaw Misganaw Guadie Tiruneh Eneyew Talie Fenta Destaw Endeshaw Habitu Birhan Eshetu Amare Mebrat Delie Ousman Adal Tegegne Spatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysis BMC Public Health Prevalence Factors associated Unmet need Family planning Spatial analysis PMA |
| title | Spatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysis |
| title_full | Spatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysis |
| title_fullStr | Spatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysis |
| title_full_unstemmed | Spatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysis |
| title_short | Spatial variation and associated factors of unmet need for family planning among reproductive age women in Ethiopia, insights from 2021 PMA-Ethiopia data: multilevel logistic regression analysis |
| title_sort | spatial variation and associated factors of unmet need for family planning among reproductive age women in ethiopia insights from 2021 pma ethiopia data multilevel logistic regression analysis |
| topic | Prevalence Factors associated Unmet need Family planning Spatial analysis PMA |
| url | https://doi.org/10.1186/s12889-025-21917-y |
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