# Geospatial variation and associated factors of unintended pregnancy among women of reproductive age in Ethiopia: Geographically Weighted Regression Analysis

## TL;DR

This study maps unintended pregnancies in Ethiopia and finds clusters in urban and rural areas, linked to factors like age and access to health facilities.

## Contribution

The study is the first to use geographically weighted regression to analyze unintended pregnancy in Ethiopia's 2016 demographic data.

## Key findings

- Unintended pregnancy clusters were identified in Addis Ababa, Oromia, and SNNPR with a risk ratio of 1.86.
- Factors like maternal age (35–49), primary education, high socioeconomic status, and poor access to health facilities were significant.
- Hotspots of unintended pregnancy were found in Amhara, Addis Ababa, Oromia, and SNNPR.

## Abstract

Unintended pregnancies are a serious public health concern that has several effects on the health of mothers and children. However, no studies have been conducted on unintended pregnancy using geographically weighted regression in the 2016 Ethiopian demographic and health survey. Therefore, this study assessed the geospatial and associated factors of unintended pregnancy in Ethiopia using a 2016 demographic and health survey.

A cross-sectional study used data from the 2016 demographic and health survey and included 7589 women of the reproductive age. Spatial analysis and mapping were conducted using ArcGIS version 10.8. Spatial clusters were identified using the Bernoulli model in SaTScan 10.1. Geographically weighted regression was used to assess associated factors, with significance at p < 0.05.

Unintended pregnancy showed a clustered spatial pattern. SaTScan found 171 primary significant clusters (risk ratio = 1.86, p < 0.001) in Addis Ababa, Oromia, and SNNPR. A geographically weighted regression revealed that maternal age (35–49 years), maternal primary education, high socio economic status, and distance to a health facility (a big problem) were significant factors contributing to unintended pregnancy.

Hotspot analysis identified statistically significant hotspot areas of unintended pregnancy in Amhara, Addis Ababa, Oromia, and SNNPR. Statistically significant coldspot areas of unintended pregnancy were observed in Afar, Dire Dawa, and Somali. Maternal age (35–49 years), maternal primary education, high socio economic status, and distance to health facility (big problem) were statistically significant factors of unintended pregnancy. These results show that the capital city and some key rural and ethnic areas had higher rates of unintended pregnancies, especially among relatively older women with high socioeconomic status and basic education, which indicates that sexual and reproductive health education needs to be strengthened and carried out at all levels, including among high socioeconomic groups.