Determinants of long-acting family planning utilization among reproductive age women in Ethiopia: Further Analysis of recent demographic and health survey

Melsew Setegn Alie ^1* Gossa Fetene Abebe ² Yilkal Negesse ³ Desalegn Girma ²

• ¹ School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
• ² Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
• ³ 2Department of publicCollege of Medicine and Health Science, Debre Markos University, Debre Markos, Amhara, Ethiopia

Background: Despite advancements in modern contraceptive use in Ethiopia, the uptake of longacting family planning services remains low due to various factors. To our knowledge, there is currently no national evidence regarding the prevalence of long-acting family planning methods.Therefore, this study aimed to identify the determinants of long-acting family planning utilization among women of reproductive age in Ethiopia.A secondary data analysis was conducted using the 2019 Ethiopian Demographic and Health Survey (EDHS) data. The data were extracted from the child record file using STATA version 15. A total of 4,782 reproductive-age women were selected for the study. After applying appropriate weighting, generalized estimating equations (GEE) modeling was performed using the xtgee command in STATA. Model selection was based on the quasi-likelihood criteria (QIC), and model fitting was carried out using two proposed working correlation structures: exchangeable and independent. The generalized estimating equations modeling of the study parameters was assessed accordingly.The magnitude of long-acting family planning utilization in this study was 8.6[95% CI: 7.8, 9.4]. Determinants of long-acting family planning utilization were age of women 40-49 year (OR=1.87 [95%CI: 1.7, 4.7]), rural residence (OR= 0.47[95%CI: 0.19, 0.89]), female household head (OR=1.67[95%CI:1.5,2.2]), family size ≥13 (OR=0.04[95CI:0.003,0.68]) and number of underfive children ≥4 (OR=0.26[95%CI:0.09,0.68]).The utilization of long-acting family planning methods among women in Ethiopia is relatively low compared to the Ethiopian government's plan. Key factors influencing this utilization include age, place of residence, household headship, family size, and the number of children under five. These findings suggest that the country should enhance the use of longacting family planning by focusing on improving access for young and adolescent women, empowering women, and addressing the needs of households with larger family sizes.Reproductive health interventions, including family planning services, should specifically target rural, male-headed households with young women who have more than four children under five to increase the uptake of long-acting family planning methods.