Determinants of intention to use family planning methods in the four emerging regions of Ethiopia: an ideation score based assessment

BACKGROUND: Ideation refers to the ideas and views that people hold; it has been identified as an important explanation for differences in contraceptive use within and across countries. This study aimed to identify ideational factors that influence intention to use family planning (FP) methods among women of reproductive age (WRA) in the four emerging regions of Ethiopia. METHODS: A quantitative cross-sectional survey of 2891 WRA was carried out in the four emerging regions of Ethiopia. A multistage, stratified systematic random sampling technique was employed to select the study participants. Data were collected by trained enumerators, using tablets equipped with Open Data Kit. To assess the impact of ideation on intention to use FP, the research team used 41 items distributed across five broad ideational factors: contraception awareness, self-efficacy, rejection of myth and rumor, intra-family discussion and family support. Confirmatory factor analysis was employed to test the fit of these items into the five ideational factors. A multiple binary logistic regression analysis was employed to assess the combined effect of these ideational factors with different sociodemographic variables on intention to use contraceptive methods. In all the statistical analysis, a p-value < 0.05 was considered statistically significant. RESULTS: Different proportions of women in the four regions intended to use contraceptives in the future: 74.9% in Benishangul-Gumuz, 50.1% in Gambela, 21.8% in Afar, and 20.1% in Somali. The proportion of women who intended to use contraceptives varied with ideation scores. The multiple binary logistic regression revealed that self-efficacy was an important ideational factor of intention to use contraception in all four regions. Rejection of myth and rumor was also an important factor in all regions except in Somali. Contraception awareness and family support were significant predictors of intention to use contraception in the Afar region only. Intra-family discussion was not found significant in any region. CONCLUSIONS: Regional/district health offices should focus on increasing self-efficacy for FP use. Demystifying rumors would contribute to improved intention to use FP among women in Afar, Benishangul-Gumuz, and Gambela regions. Raising contraception awareness and encouraging family support would improve intention to use FP in Afar region.