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Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys

BACKGROUND: According to the 2017 estimate, around 214 million reproductive-age women in developing regions who want to avoid pregnancy do not use a modern contraceptive method. Although there are studies done on factors associated with modern contraceptive utilization in individual East African cou...

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Autores principales: Tessema, Zemenu Tadesse, Teshale, Achamyeleh Birhanu, Tesema, Getayeneh Antehunegn, Yeshaw, Yigizie, Worku, Misganaw Gebrie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7971875/
https://www.ncbi.nlm.nih.gov/pubmed/33735305
http://dx.doi.org/10.1371/journal.pone.0247992
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author Tessema, Zemenu Tadesse
Teshale, Achamyeleh Birhanu
Tesema, Getayeneh Antehunegn
Yeshaw, Yigizie
Worku, Misganaw Gebrie
author_facet Tessema, Zemenu Tadesse
Teshale, Achamyeleh Birhanu
Tesema, Getayeneh Antehunegn
Yeshaw, Yigizie
Worku, Misganaw Gebrie
author_sort Tessema, Zemenu Tadesse
collection PubMed
description BACKGROUND: According to the 2017 estimate, around 214 million reproductive-age women in developing regions who want to avoid pregnancy do not use a modern contraceptive method. Although there are studies done on factors associated with modern contraceptive utilization in individual East African countries, as to our search of the literature, there is limited evidence on the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Therefore, this study aimed to estimate the pooled prevalence and determinants of modern contraceptive utilization in the East African region. METHODS: The pooled prevalence of modern contraceptive utilization and the strength of determinants were estimated using STATA version 14. Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance were used for model fitness and comparison. The multilevel logistic regression model was fitted to identify determinants of modern contraceptive use in the region. Adjusted Odds Ratio with its 95% Confidence Interval was presented, and variables with a p-value ≤of 0.05 were declared significant determinants of modern contraceptive utilization. RESULTS: Overall, about 20.68% (95%CI:-20.46.,20.91)of women used modern contraceptive, ranging from 9.08% in Mozambique to 61.49% in Comoros. In the multilevel logistic regression model; maternal age group 25–34 (AOR: 0.79, 95%CI:0.76,0.82) and 35–49 (AOR:0.49, 95%CI:0.46,0.51). Being married (AOR:0.85, 95%CI:0.82,0.88), mothers with primary education (AOR:1.48, 95%CI:1.43,1.54) and secondary and above education level (AOR:1.60, 95%CI:1.52,1.69), husbands with primary education (AOR:2.43, 95%CI:2.35,2.51) and secondary and above education level (AOR:2.92, 95%CI:2.76,3.05). The mothers who had occupation (AOR:2.11, 95%CI:1.23,1.33), mothers from households with middle wealth index (AOR:1.23, 95%CI:1.19,1.28) and rich wealth index (AOR:1.28, 95%CI:1.23,1.33) were found to be significant determinants of modern contraceptive use. CONCLUSION: We found that modern contraceptive utilization in the 12 East Africa countries was low compared to SDG target 2030(75%). The governmental and non-governmental organizations should scale up their public health programs to the poor and marginalized communities to scale up modern contraceptive utilization uptake in the region. In addition, reforming the health system and reproductive health education through mass media to create awareness of modern contraceptive use benefits are effective strategies to improve modern contraceptive use among East Africa women.
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spelling pubmed-79718752021-03-31 Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys Tessema, Zemenu Tadesse Teshale, Achamyeleh Birhanu Tesema, Getayeneh Antehunegn Yeshaw, Yigizie Worku, Misganaw Gebrie PLoS One Research Article BACKGROUND: According to the 2017 estimate, around 214 million reproductive-age women in developing regions who want to avoid pregnancy do not use a modern contraceptive method. Although there are studies done on factors associated with modern contraceptive utilization in individual East African countries, as to our search of the literature, there is limited evidence on the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Therefore, this study aimed to estimate the pooled prevalence and determinants of modern contraceptive utilization in the East African region. METHODS: The pooled prevalence of modern contraceptive utilization and the strength of determinants were estimated using STATA version 14. Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance were used for model fitness and comparison. The multilevel logistic regression model was fitted to identify determinants of modern contraceptive use in the region. Adjusted Odds Ratio with its 95% Confidence Interval was presented, and variables with a p-value ≤of 0.05 were declared significant determinants of modern contraceptive utilization. RESULTS: Overall, about 20.68% (95%CI:-20.46.,20.91)of women used modern contraceptive, ranging from 9.08% in Mozambique to 61.49% in Comoros. In the multilevel logistic regression model; maternal age group 25–34 (AOR: 0.79, 95%CI:0.76,0.82) and 35–49 (AOR:0.49, 95%CI:0.46,0.51). Being married (AOR:0.85, 95%CI:0.82,0.88), mothers with primary education (AOR:1.48, 95%CI:1.43,1.54) and secondary and above education level (AOR:1.60, 95%CI:1.52,1.69), husbands with primary education (AOR:2.43, 95%CI:2.35,2.51) and secondary and above education level (AOR:2.92, 95%CI:2.76,3.05). The mothers who had occupation (AOR:2.11, 95%CI:1.23,1.33), mothers from households with middle wealth index (AOR:1.23, 95%CI:1.19,1.28) and rich wealth index (AOR:1.28, 95%CI:1.23,1.33) were found to be significant determinants of modern contraceptive use. CONCLUSION: We found that modern contraceptive utilization in the 12 East Africa countries was low compared to SDG target 2030(75%). The governmental and non-governmental organizations should scale up their public health programs to the poor and marginalized communities to scale up modern contraceptive utilization uptake in the region. In addition, reforming the health system and reproductive health education through mass media to create awareness of modern contraceptive use benefits are effective strategies to improve modern contraceptive use among East Africa women. Public Library of Science 2021-03-18 /pmc/articles/PMC7971875/ /pubmed/33735305 http://dx.doi.org/10.1371/journal.pone.0247992 Text en © 2021 Tessema et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Tessema, Zemenu Tadesse
Teshale, Achamyeleh Birhanu
Tesema, Getayeneh Antehunegn
Yeshaw, Yigizie
Worku, Misganaw Gebrie
Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys
title Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys
title_full Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys
title_fullStr Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys
title_full_unstemmed Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys
title_short Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys
title_sort pooled prevalence and determinants of modern contraceptive utilization in east africa: a multi-country analysis of recent demographic and health surveys
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7971875/
https://www.ncbi.nlm.nih.gov/pubmed/33735305
http://dx.doi.org/10.1371/journal.pone.0247992
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