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Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study
OBJECTIVE: The study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia. DESIGN: A community-based cross-sectional study was conducted in September 2018. Data were analysed...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482466/ https://www.ncbi.nlm.nih.gov/pubmed/32907899 http://dx.doi.org/10.1136/bmjopen-2019-036519 |
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author | Alemayehu, Mussie Medhanyie, Araya Abrha Reed, Elizabeth Mulugeta, Afework |
author_facet | Alemayehu, Mussie Medhanyie, Araya Abrha Reed, Elizabeth Mulugeta, Afework |
author_sort | Alemayehu, Mussie |
collection | PubMed |
description | OBJECTIVE: The study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia. DESIGN: A community-based cross-sectional study was conducted in September 2018. Data were analysed using R software. To determine the fixed effect of individual-level and community-level factors of FP use, a two-level mixed-effects logistic regression was used. The result was described using the Adjusted OR (AOR), and the variance partition coefficient. SETTING AND PARTICIPANTS: Afar, Ethiopia (2018; n=891) married women of reproductive age (15–49) years. PRIMARY OUTCOME MEASURES: FP use or non-use. RESULTS: The current use of FP was 18.7% (16.31%–21.43%). Women who need to walk 1 hour and more to the nearest health facility (AOR 0.14, 95% CI 0.05 to 0.3), have ANC visit of 4 and above (AOR 6.02, 95% CI 1.74 to 20.8), had their last birth at a health facility (AOR 2.71 95% CI 1.27 to 5.81), have five and more children (AOR 4.71, 95% CI 1.86 to 11.9), have high knowledge on FP (AOR 2.74, 95% CI 1.11 to 6.74) and had high intentions to use FP (AOR 10.3, 95% CI 3.85 to 27.6) were more likely to report FP use. The magnitude of the effect of for FP use was smaller than that of 9 of the 13 individual factors. Apart from this 19.4% of the total variance in the odds of using FP attributed to between community difference (intraclass correlation coefficient=0.194). Regarding the community-level characteristics, clusters of having higher electronic media possession (AOR 2.84, 95% CI 1.2 to 6.72) and higher women decision making on FP (AOR 8.35, 95% CI 2.7 to 27.1) were significantly associated with increased FP use compared with clusters with lower reports of these aspects. CONCLUSION: FP use among the pastoralist community is influenced by both individual cluster/community-level characteristics or factors. Even though the effect of clustering in FP use was large in comparison with the unexplained between-cluster variation, it was lower than the individual-level factors. TRAIL REGISTRTION NUMBER: NCT03450564 |
format | Online Article Text |
id | pubmed-7482466 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-74824662020-09-18 Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study Alemayehu, Mussie Medhanyie, Araya Abrha Reed, Elizabeth Mulugeta, Afework BMJ Open Epidemiology OBJECTIVE: The study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia. DESIGN: A community-based cross-sectional study was conducted in September 2018. Data were analysed using R software. To determine the fixed effect of individual-level and community-level factors of FP use, a two-level mixed-effects logistic regression was used. The result was described using the Adjusted OR (AOR), and the variance partition coefficient. SETTING AND PARTICIPANTS: Afar, Ethiopia (2018; n=891) married women of reproductive age (15–49) years. PRIMARY OUTCOME MEASURES: FP use or non-use. RESULTS: The current use of FP was 18.7% (16.31%–21.43%). Women who need to walk 1 hour and more to the nearest health facility (AOR 0.14, 95% CI 0.05 to 0.3), have ANC visit of 4 and above (AOR 6.02, 95% CI 1.74 to 20.8), had their last birth at a health facility (AOR 2.71 95% CI 1.27 to 5.81), have five and more children (AOR 4.71, 95% CI 1.86 to 11.9), have high knowledge on FP (AOR 2.74, 95% CI 1.11 to 6.74) and had high intentions to use FP (AOR 10.3, 95% CI 3.85 to 27.6) were more likely to report FP use. The magnitude of the effect of for FP use was smaller than that of 9 of the 13 individual factors. Apart from this 19.4% of the total variance in the odds of using FP attributed to between community difference (intraclass correlation coefficient=0.194). Regarding the community-level characteristics, clusters of having higher electronic media possession (AOR 2.84, 95% CI 1.2 to 6.72) and higher women decision making on FP (AOR 8.35, 95% CI 2.7 to 27.1) were significantly associated with increased FP use compared with clusters with lower reports of these aspects. CONCLUSION: FP use among the pastoralist community is influenced by both individual cluster/community-level characteristics or factors. Even though the effect of clustering in FP use was large in comparison with the unexplained between-cluster variation, it was lower than the individual-level factors. TRAIL REGISTRTION NUMBER: NCT03450564 BMJ Publishing Group 2020-09-09 /pmc/articles/PMC7482466/ /pubmed/32907899 http://dx.doi.org/10.1136/bmjopen-2019-036519 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Epidemiology Alemayehu, Mussie Medhanyie, Araya Abrha Reed, Elizabeth Mulugeta, Afework Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study |
title | Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study |
title_full | Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study |
title_fullStr | Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study |
title_full_unstemmed | Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study |
title_short | Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study |
title_sort | individual-level and community-level factors associated with the family planning use among pastoralist community of ethiopia: a community-based cross-sectional study |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482466/ https://www.ncbi.nlm.nih.gov/pubmed/32907899 http://dx.doi.org/10.1136/bmjopen-2019-036519 |
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