Reason and Associated Factors for Nonuse of Contraceptives Among Ethiopian Rural Married Women: A Multilevel Mixed Effect Analysis

INTRODUCTION: Contraception has a clear impact on the health of women and families in developing countries. This study aims to identify multilevel determinants of nonuse of modern contraceptives among Ethiopian rural married women in their productive age group. METHOD: The study relied on data from the 2016 Ethiopian Demographic and Health Surveys. A multilevel logistic regression model was used for analysis. RESULT: In rural areas, nonuse of modern contraceptives is surprising high (81.7%), primarily due to fear of side effects (12.89%) and breastfeeding (8.2%). Among women aged 35 to 49 years (adjusted odds ratio [AOR] = 0.66; 95% confidence interval [CI]: 0.540.81), husbands with secondary and above education levels (AOR = 0.83; 95% CI: 0.7–1), those in the high wealth index (AOR = 0.61; 95% CI: 0.51–0.72), and those who have had 1 to 2 children in the past 5 years (AOR = 0.28; 95% CI: 0.24–0.33), there was a lower chance of not using contraception. Muslims are less likely to want to use modern contraceptives (AOR = 1.2; 95% CI: 0.96–1.4). Women living in Afar (AOR = 20.9; 95% CI: 9.6–44.7), Oromia (AOR = 1.5; 95% CI: 1.01–2.3), Somali (AOR = 71.1; 95% CI: 24.1–209.2), Gambela (AOR = 2.3; 95% CI: 1.4–3.9), Harari (AOR = 4.4; 95% CI: 2.24–8.72), and Dire Dawa (AOR = 3.2; 95% CI: 1.5–6.9), regional states, were less likely to want to use modern contraceptives as compared to those in Tigray. CONCLUSION: Family planning interventions should target younger women, women living in rural areas, the poor, and Muslim women. In order to maximize the effectiveness of family planning promotion policies, it's important to address the reasons for nonuse of contraceptives identified in each region and contextual differences regarding women of reproductive age.