Geographical variation and factors influencing modern contraceptive use among married women in Ethiopia: evidence from a national population based survey

TLDR

Modern contraceptive use remains low across Africa, and Ethiopia still lags despite recent gains. The study examined factors linked to modern contraceptive use and its geographic variation among married women aged 15–49 in Ethiopia using secondary analysis of 10,204 DHS respondents. Researchers employed a nationally representative two‑stage stratified DHS sample and conducted bivariate and multivariate logistic regressions to assess prevalence and determinants of contraceptive use. Wealth, education, employment, higher parity, monogamy, community conversations, and home health‑worker visits were positively associated with use, while rural residence, older age, polygamous unions, and child death were negatively linked; spatial analysis revealed higher prevalence in central and southwestern regions, underscoring significant socioeconomic, urban‑rural, and regional disparities and highlighting community conversation and female education as priority interventions.

Abstract

Modern contraceptive use persists to be low in most African countries where fertility, population growth, and unmet need for family planning are high. Though there is an evidence of increased overall contraceptive prevalence, a substantial effort remains behind in Ethiopia. This study aimed to identify factors associated with modern contraceptive use and to examine its geographical variations among 15-49 married women in Ethiopia.We conducted secondary analysis of 10,204 reproductive age women included in the 2011 Ethiopia Demographic and Health Survey (DHS). The survey sample was designed to provide national, urban/rural, and regional representative estimates for key health and demographic indicators. The sample was selected using a two-stage stratified sampling process. Bivariate and multivariate logistic regressions were applied to determine the prevalence of modern contraceptive use and associated factors in Ethiopia.Being wealthy, more educated, being employed, higher number of living children, being in a monogamous relationship, attending community conversation, being visited by health worker at home strongly predicted use of modern contraception. While living in rural areas, older age, being in polygamous relationship, and witnessing one's own child's death were found negatively influence modern contraceptive use. The spatial analysis of contraceptive use revealed that the central and southwestern parts of the country had higher prevalence of modern contraceptive use than that of the eastern and western parts.The findings indicate significant socio-economic, urban-rural and regional variation in modern contraceptive use among reproductive age women in Ethiopia. Strengthening community conversation programs and female education should be given top priority.