Prevalence and determinants of unintended childbirth in Ethiopia

BACKGROUND: Ethiopia’s population policy specifically aims to reduce TFR from 7.7 to 4.0 and to increase contraceptive use from 4.0% to 44.0% between 1990 and 2015. In 2011, the use of contraceptive methods increased seven-fold from 4.0% to 27%; and the TFR declined by 38% to 4.8. The use of modern contraceptives is, however, much higher in the capital Addis Ababa (56%) and other urban areas but very low in rural areas (23%) far below the national average (27%). In 2011, one in four Ethiopian women had an unmet need for contraception. The main aim of this study was to assess the pattern and examine the socioeconomic and demographic correlates of unintended childbirth among women 15-49 years in Ethiopia. METHODS: Data from the 2011 nationally representative Ethiopia Demographic and Health Survey are used. It covered 16,515 women of which 7,759 had at least one birth and thus included for this study. Multivariate logistic regression is used to see the net effects of each explanatory variable over the outcome variable. RESULTS: The study found that nearly one in three (32%) births was unintended; and about two-thirds of these were mistimed. The regression model shows that the burden of unintended births in Ethiopia falls more heavily on young, unmarried, higher wealth, high parity, and ethnic majority women and those with less than secondary education and with large household size. These variables showed statistical significance with the outcome variable. CONCLUSION: The study found a relatively high prevalence of unintended childbirth in Ethiopia and this implies high levels of unmet need for child spacing and limiting. There is much need for better targeted family planning programs and strategies to strengthen and improve access to contraceptive services, to raise educational levels, and related information and communication particularly for those affected groups including young, unmarried, multipara, and those with less than secondary level of education. Further quantitative and qualitative research on the consequences of unintended pregnancy and childbirth related to prenatal and perinatal outcomes are vital to document process of change in the problem overtime.