Assessment of Intention to Use Contraceptive Methods with Spatial Distributions and Associated Factors Among Women in Ethiopia: Evidence from EDHS 2016

Background: Modern contraceptive methods have immense influences on the health of mothers and their children. Using contraceptive methods is seen to control family size and unnecessary pregnancies. Considering different factors like resources and various cultural aspects, assessing the intention to use contraception might bring areas with these problems into the light for intervention.

Methods: We analyzed the cross-sectional survey data from EDHS 2016, which comprised 5651 reproductive-age women. Spatial autocorrelation was checked with global Moran's statistics, at ±1 for dispersion and clustering. Aselin Local moran's statistics also indicated types of clusters. Hot spot(Getis-Ord Gi) statistics further used to measure autocorrelation over different spatial locations. The significance level was checked by calculating Z-score and hot and cold spots indicated the variation in intention to use contraceptives per catchments. Interpolation was also applied to see the number of intents to use contraceptive areas other than the sampled using ordinary Kriging spatial interpolation. We used Kulldorff's SatScan for specific local clustering and the Bernoulli model test was applied to check significance. Individual and community-level factors were examined using multilevel logistic regression. Due to the clustering nature of data where p-value< 0.05 signaled associations. The disproportional nature of data was adjusted using sampling weights.

Result: From the total sample of women, the intention to use contraceptive methods was 2366.08(44.11%) and was highly clustered in North and Western Ethiopia. The mean number of children was (4.5 ± 2.90); age at first cohabitation was (16.9 ± 3.99); the ideal number of children was (4.77 ± 2.00). Age and the ideal number of children were negatively associated with the use of contraception. Primary education, number of children, counseling at health facilities, and age at first cohabitation were negatively associated.

Conclusion: We observed various distributions among regions. Educational status and various socio-cultural including working with the religious organization might need serious considerations to increase the intention to use contraceptive methods. Besides the efforts done, policy decisions might need to consider this finding and uphill the intervention against the negatively associated socio-cultural and demographic variables in outplayed areas.