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Gedefaw Abeje Fekadu ( MPH/RH , PhD candidate) Akinyinka O. Omigbodun , Professor (UI)

Factors associated with long acting and permanent contraceptive methods use in Ethiopia; further analysis of the 2016 DHS data. Gedefaw Abeje Fekadu ( MPH/RH , PhD candidate) Akinyinka O. Omigbodun , Professor (UI) Olumuyiwa A. Roberts (PhD UI)

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Gedefaw Abeje Fekadu ( MPH/RH , PhD candidate) Akinyinka O. Omigbodun , Professor (UI)

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  1. Factors associated with long acting and permanent contraceptive methods use in Ethiopia; further analysis of the 2016 DHS data GedefawAbejeFekadu (MPH/RH, PhD candidate) AkinyinkaO. Omigbodun, Professor (UI) OlumuyiwaA. Roberts (PhD UI) AlemayehuWorkuYalew (Profesor, AAU) Hilton Addis, April 4, 2019

  2. Presentation outline • Introduction • Objectives • Methods • Result and discussion • Conclusion • Recommendations

  3. Introduction …#1 • About 50% of women in developing regions of the world want to avoid pregnancy • but only three quarters could do so

  4. Introduction …#2 • Long acting and permanent methods (LAPMs) are better options to reduce unintended pregnancies • more effective • save cost • enable women to control their reproductive lives • increase contraceptive prevalence rate

  5. Introduction …#3 • Globally, LAPM accounted for 56% of contraceptive use • 19% of married or in-union women relied on female sterilization and 14% on IUD. • Yet most contraceptive users in Africa depend on short term methods

  6. Introduction …#4 • In Ethiopia, • government planned to increase CPR to 55% by 2020 • implant 33% and IUD 15% • All contraceptives provided free in Ethiopia • Many organizations are providing long acting methods • Task shifted to increase access • All levels of care can provide contraceptives • Regardless of all these efforts • LAPM use is low • High unmet need • dominated with short acting methods

  7. Objectives • To identify trends of LAPM use among married or in union reproductive age women in Ethiopia • To identify factors associated with LAPM use among married or in union reproductive age women in Ethiopia

  8. Methods …#1 Data • For trend analysis, all four EDHS data sets were used • To identify factors, the 2016 EDHS data was used. • The EDHS data • was collected by the CSA • Cross-sectional survey collected from January 18, 2016 to June 27, 2016. • sample was stratified (in to urban and rural) and selected in two stages. • stage 1 selection of EA, stage 2 selection of hhs • information about contraceptive use from all reproductive age women • The data collectors were trained and experienced • There were team supervisors, field editors, interviewers and secondary editors • Data was collected and transferred to the CSA electronically

  9. Methods …#2 Measurement • Outcome variable • Contraceptive use • Independent variables • Socio-demographic • fertility and decision making • Family planning program exposure

  10. Methods …#3 Analytical methods • analysis was done using Stata 15.1. • Open EPI software was used for trend analysis • The data were weighted • SVY set used • multicollinearitywas assessed • variables not correlated with other predictor variables were included to the multinomial logistic regression model

  11. Result and discussion …#1

  12. Result and discussion …#2 Participant characteristics • Majority of the women were • aged 20-34 years • rural residents (83.5%). • did not attend formal education(62%) • not working at the time of survey (68.5%)

  13. Result and discussion …#3 Fertility related characteristics • Only 23% know ovulation period • Only 56.5% know when pregnancy may occur after birth • 37% want no more children • Husband wants more children among 25.8% women • Nearly half of women (48.1) had 4 or more living children • 79.1% cohabited before age of 20

  14. Result and discussion …#4 Decision making • 17.8% reported that only partner decide to visit HF • 60.7% reported that their first marriage was decided by parents

  15. Result and discussion …#5 Exposure • Never read newspaper - 91.7% • Never listen radio - 69.7% • Never watch TV – 76.7% • Own mobile phone - 78.8% • never used internet - 97.6% • FP message on • Radio - 14.1% • Tv - 14.1% • Mobile – 2.1% • News paper - 3.3%

  16. Result and discussion …#6 Contraceptive use • 59% (95%CI: 55.9% – 63.0%) ever used contraceptives • About one fourth of mothers (95%CI 26.4% – 30.9%) were using short acting methods • 11.6% (95%CI 10.2% – 13.1%) were using LAPMs • 8.8% (95%CI: 7.7% – 10.1%) -implant • 2.3% (95%CI: 1.7% – 3.0%) - IUD

  17. Result and discussion …#7 Trends in LAPMs

  18. Result and discussion …#8 Percent change in LAPM use

  19. Result and discussion …#9 Factors associated with LAPM use • richer wealth index - 2.6(1.2 – 5.4) • sales worker - 2.1(1.1 – 3.9) • female headed – 0.2(0.1 – 0.5) • history of abortion – 0.2 (0.1 – 0.5) • ideal number of children is 1-5 - 4.2 (1.4 – 13.0)

  20. Conclusion • LAPM use is low in Ethiopia • Richer women, women who are sales workers and women whose ideal number of children is 1 – 5 were more likely to use LAPMs • Women with female headed households and those who had history of abortion were less likely to use LAPMs

  21. Recommendation • Further qualitative study • Focus on the poor, women with abortion, female headed households • Better to improve exposure to mass media

  22. I thank you

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