Reproductive Health | |
Determinants of low family planning use and high unmet need in Butajira District, South Central Ethiopia | |
Alemayehu Worku1  Wubegzier Mekonnen1  | |
[1] School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia | |
关键词: Ethiopia; rural; Butajira; unmet need; Family planning use; | |
Others : 820993 DOI : 10.1186/1742-4755-8-37 |
|
received in 2011-10-24, accepted in 2011-12-08, 发布年份 2011 | |
【 摘 要 】
Background
The rapid population growth does not match with available resource in Ethiopia. Though household level family planning delivery has been put in place, the impact of such programs in densely populated rural areas was not studied. The study aims at measuring contraception and unmet need and identifying its determinants among married women.
Methods
A total of 5746 married women are interviewed from October to December 2009 in the Butajira Demographic Surveillance Area. Contraceptive prevalence rate and unmet need with their 95% confidence interval is measured among married women in the Butajira district. The association of background characteristics and family planning use is ascertained using crude and adjusted Odds ratio in logistic regression model.
Results
Current contraceptive prevalence rate among married women is 25.4% (95% CI: 24.2, 26.5). Unmet need of contraception is 52.4% of which 74.8% was attributed to spacing and the rest for limiting. Reasons for the high unmet need include commodities' insecurity, religion, and complaints related to providers, methods, diet and work load. Contraception is 2.3 (95% CI: 1.7, 3.2) times higher in urbanites compared to rural highlanders. Married women who attained primary and secondary plus level of education have about 1.3 (95% CI: 1.1, 1.6) and 2 (95% CI: 1.4, 2.9) times more risk to contraception; those with no child death are 1.3 (95% CI: 1.1, 1.5) times more likely to use contraceptives compared to counterparts. Besides, the odds of contraception is 1.3 (95% CI: 1.1, 1.6) and 1.5 (1.1, 2.0) times more likely among women whose partners completed primary and secondary plus level of education. Women discussing about contraception with partners were 2.2 (95% CI: 1.8, 2.7) times more likely to use family planning. Nevertheless, contraception was about 2.6 (95% CI: 2.1, 3.2) more likely among married women whose partners supported the use of family planning.
Conclusions
The local government should focus on increasing educational level. It must also ensure family planning methods security, increase competence of providers, and create awareness on various methods and their side effects to empower women to make an appropriate choice. Emphasis should be given to rural communities.
【 授权许可】
2011 Mekonnen and Worku; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140712062826482.pdf | 237KB | download |
【 参考文献 】
- [1]TGE: The National Population Policy of Ethiopia. Addis Ababa; 1993.
- [2]Seyoum A, Ferede T: The Structure of the Ethiopian Economy - A SAM-based Characterisation. 2004.
- [3]Summary and Statistical Report of the 2007 Population and Housing Census FDRE Census Commission: Addis Ababa; 2008.
- [4]Gurumu E, Goldstein S, Goldstein A: Fertility decline driven by poverty: the case of Addis Ababa. Ethiopia J Biosoc Sci 2008, 40.
- [5]Sibanda A, et al.: The proximate determinants of the decline to below-replacement fertility in Addis Ababa, Ethiopia. Stud Fam Plann 2003, 34(1):1-7.
- [6]Ferdousi SK, et al.: Unmet need of family Planning among rural women in Bangladesh. J Dhaka MedColl 2010, 19(1):11-15.
- [7]Moreland S, Smith E, Sharma S: World population prosepects and unmet need for family planning. Futures Group: Washington, USA; 2010.
- [8]Ashford L: Unmet need for family planning: Recent trends and their implications for programs. Measure Communication Policy Brief, PRB, Editor 2003.
- [9]CSA, ICF M: Ethiopia Demographic and Health Survey 2000, C.S.A.a.O. Macro", Editor. Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2001.
- [10]CSA, ICF M: Ethiopia Demographic and Health Survey 2005, C.S.A.a.O. Macro, Editor. Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2006.
- [11]CSA, ICF M: Ethiopia Demographic and Health Survey 2011 Preliminary Report. Central Statistical Agency, Addis Ababa, Ethiopia; MEASURE DHS, ICF Macro, Calverton, Maryland, USA; 2011.
- [12]Anastasia JG: Sexual activity and Contraceptive Use: The components of the Decisionmaking Process. Studies in family planning 1998, 29(2):154-166.
- [13]Hogan DP, Berhanu B, Hailemariam A: Household Organization, Women's Autonomy, and Contraceptive Behavior in Southern Ethiopia. Studies in family planning 1999, 30(4):302-314.
- [14]Campbell M, Sahin-Hodoglugil NN, Potts M: Barriers to Fertility Regulation: A Review of the Literature. Studies in family planning 2006, 37(2):87-98.
- [15]Babalola S, Fatusi A: Determinants of use of maternal health services in Nigeria - Looking beyond individual and household factors. BMC Pregnancy and Childbirth 2009., 9(43)
- [16]Kaba M: Fertility regulation among women in rural communities around Jimma, Western Ethiopia. Ethiop J Health Dev 2000, 14(2):117-125.
- [17]Blanc AK: The role of conflict in the rapid fertility decline in Eritrea and prospects for the future. STUDIES IN FAMILY PLANNING 2004, 35(4):236-245.
- [18]Creanga AA, et al.: Low use of contraception among poor women in Africa: an equity issue. Bull World Health Organ 2011, 89:258-266.
- [19]Erulkar AS, Muthengi E: Evaluation of Berhane Hewan: A program to delay child marriage in rural Ethiopia. International Perspectives on Sexual and Reproductive Health 2009, 35(1):6-14.
- [20]Sharan M, Valente TW: Spousal Communication and Family Planning Adoption: Effects of a Radio Drama Serial in Nepal. International Family Planning Perspectives 2002, 28(1):16-25.
- [21]Lasee A, Becker S: Huseband-Wife Communication About Family Planning and Contraceptive Use in Kenya. International Family Planning Perspectives 1997, 23(1):15-20+33.
- [22]Banteyerga H: Ethiopia's Health Extension Program: Improving Health through Community Involvement. MEDICC Rev 13(3):46-9.
- [23]Bekele A, Kefale M, Tadesse M: Preliminary Assessment of the Implementation of the Health Services Extension Program: The case of Southern Ethiopia. Ethiop J Health Dev 2008, 22(3):302-305.
- [24]CSA: The Conutry Level Report of the 2007 Ethiopian Census. Central Statistical Agency: Addis Ababa; 2009.
- [25]Audu B, et al.: Social Issues in Reproductive Health: Polygamy and the use of contraceptives. International Journal of Gynecology and Obstetrics 2008, 101(1):88-92.
- [26]Mekonnen W, Worku A: Determinants of fertility in rural Ethiopia: the case of Butajira Demographic Surveillance System (DSS). BMC Public Health 11(1):782.
- [27]Byass P, et al.: Spatio-temporal clustering of mortality in Butajira HDSS, Ethiopia, from 1987 to 2008. Glob Health Action 3
- [28]MOH: National Reproductive Health Strategy 2006 - 2015. Federal Democratic Republic of Ethiopia, Ministry of Health.: Addis Ababa, Ethiopia; 2006.
- [29]Macro I: Ethiopia Demographic and Health Survey 2011: Preliminary report. Central Statistical Agency and ICF Macro: Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2011.
- [30]Shah MA, et al.: Unmet need for contraception in Kuwait: issues for health care providers. Soc Sci Med 2004, 59(8):1573-80.
- [31]Bongaarts J, Bruce J: The causes of unmet need for contraception and the social content of services. Stud Fam Plann 1995, 26(2):57-75.
- [32]Kebede Y: Quality of family planning service in Dembia district, north west Ethiopia. Ethiop Med J 2007, 45(1):29-38.
- [33]Fantahun M, et al.: Young adult and middle age mortality in Butajira demographic surveillance site, Ethiopia: lifestyle, gender and household economy. BMC Public Health 2008, 8:268. BioMed Central Full Text
- [34]Beekle AT, McCabe C: Awareness and determinants of family planning practice in Jimma, Ethiopia. Int Nurs Rev 2006, 53(4):269-76.
- [35]Fantahun M: Comparative study of the characteristics of family planning service users and non-users in northwest Ethiopia. Afr J Reprod Health 2006, 10(1):62-70.
- [36]Fitaw Y, Berhane Y, Worku A: Impact of child mortality and fertility preferences on fertility status in rural Ethiopia. East Afr Med J 2004, 81(6):300-6.
- [37]Emmelin A, et al.: Vulnerability to episodes of extreme weather: Butajira, Ethiopia, 1998-1999. Glob Health Action 2009., 2
- [38]Ali AAA, et al.: Use of Family Planning Methods in Kassala, Eastern Sudan. BMC Research Notes 2011, 4:43. BioMed Central Full Text
- [39]Terefe A, Larson CP: Modern Contraception use in Ethiopia: Does involving husbands make a difference? Am J Public Health 1993, 83:1567-1571.