Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis
BackgroundContraception 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.MethodsWe analyzed the 20...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Global Women's Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fgwh.2025.1505789/full |
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| author | Bisrategebriel Tesfaye Muchie Ashenafi Abate Woya Awoke Seyoum Tegegne Maru Zewdu Kassie Muluhabt Alene Assfaw Wondaya Fenta Zewdia |
| author_facet | Bisrategebriel Tesfaye Muchie Ashenafi Abate Woya Awoke Seyoum Tegegne Maru Zewdu Kassie Muluhabt Alene Assfaw Wondaya Fenta Zewdia |
| author_sort | Bisrategebriel Tesfaye Muchie |
| collection | DOAJ |
| description | BackgroundContraception 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.MethodsWe 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.ResultsOnly 26% of the women used modern contraceptives, with notable spatial clustering (Global Moran's Index = 0.237776, p < 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.ConclusionsModern 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. |
| format | Article |
| id | doaj-art-ce731121ca454952a78bcf81d176f7d1 |
| institution | OA Journals |
| issn | 2673-5059 |
| language | English |
| publishDate | 2025-04-01 |
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| series | Frontiers in Global Women's Health |
| spelling | doaj-art-ce731121ca454952a78bcf81d176f7d12025-08-20T02:24:59ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592025-04-01610.3389/fgwh.2025.15057891505789Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysisBisrategebriel Tesfaye Muchie0Ashenafi Abate Woya1Awoke Seyoum Tegegne2Maru Zewdu Kassie3Muluhabt Alene Assfaw4Wondaya Fenta Zewdia5Department of Statistics, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Statistics, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Statistics, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Statistics, Assosa University, Assosa, EthiopiaDepartment of Statistics, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Statistics, Bahir Dar University, Bahir Dar, EthiopiaBackgroundContraception 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.MethodsWe 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.ResultsOnly 26% of the women used modern contraceptives, with notable spatial clustering (Global Moran's Index = 0.237776, p < 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.ConclusionsModern 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.https://www.frontiersin.org/articles/10.3389/fgwh.2025.1505789/fullmodern contraceptive usewomenmultilevel analysisspatial analysisEthiopia |
| spellingShingle | Bisrategebriel Tesfaye Muchie Ashenafi Abate Woya Awoke Seyoum Tegegne Maru Zewdu Kassie Muluhabt Alene Assfaw Wondaya Fenta Zewdia Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis Frontiers in Global Women's Health modern contraceptive use women multilevel analysis spatial analysis Ethiopia |
| title | Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis |
| title_full | Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis |
| title_fullStr | Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis |
| title_full_unstemmed | Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis |
| title_short | Spatial disparities and determinants of modern contraceptive use among reproductive age women in Ethiopia: application of multilevel spatial analysis |
| title_sort | spatial disparities and determinants of modern contraceptive use among reproductive age women in ethiopia application of multilevel spatial analysis |
| topic | modern contraceptive use women multilevel analysis spatial analysis Ethiopia |
| url | https://www.frontiersin.org/articles/10.3389/fgwh.2025.1505789/full |
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