Determinants of long-acting family planning utilization among reproductive-age women in Ethiopia: further analysis of recent demographic and health survey data

TL;DR

This study identifies factors influencing the low use of long-acting family planning methods among women in Ethiopia, using national health survey data.

Contribution

The study provides national-level evidence on determinants of long-acting family planning utilization in Ethiopia, which was previously lacking.

Findings

The utilization rate of long-acting family planning methods was 8.6% among reproductive-age women in Ethiopia.

Key determinants included age, rural residence, female-headed households, large family size, and having many young children.

The study recommends targeted interventions to improve access and uptake of these methods in specific populations.

Abstract

Despite advancements in modern contraceptive use in Ethiopia, the uptake of long-acting family planning services remains low due to various factors. To our knowledge, there is currently no national evidence regarding the prevalence of long-acting family planning methods. Therefore, this study aimed to identify the determinants of long-acting family planning utilization among women of reproductive age in Ethiopia.

A secondary data analysis was conducted using the 2019 Ethiopian Demographic and Health Survey data. The data were extracted from the child record file using STATA version 15. A total of 4,782 reproductive-age women were selected for the study. After applying appropriate weighting, generalized estimating equation modeling was performed using the xtgee command in STATA. Model selection was based on the quasi-likelihood criteria, and model fitting was carried out using two proposed working correlation structures: exchangeable and independent. The generalized estimating equations modeling of the study parameters was assessed accordingly.

The magnitude of long-acting family planning utilization in this study was 8.6 [95% confidence interval (CI): 7.8–9.4]. Determinants of long-acting family planning utilization were age of women 40–49 years [odds ratio (OR) = 1.87, 95% CI: 1.7–4.7], rural residence (OR = 0.47, 95% CI: 0.19–0.89], female head of household (OR = 1.67, 95% CI: 1.5–2.2), family size ≥13 (OR = 0.04, 95 CI: 0.003–0.68), and number of children aged under 5 years ≥4 (OR = 0.26, 95% CI: 0.09–0.68).

The utilization of long-acting family planning methods among women in Ethiopia is relatively low compared to the Ethiopian government's plan. Key factors influencing this utilization include age, place of residence, head of household, family size, and number of children aged under 5 years. These findings suggest that the country should enhance the use of long-acting family planning by focusing on improving access for young and adolescent women, empowering women, and addressing the needs of households with larger family sizes. Reproductive health interventions, including family planning services, should specifically target rural, male-headed households with young women who have more than four children aged under 5 years to increase the uptake of long-acting family planning methods.