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ORIGINAL RESEARCH article
Front. Glob. Womens Health
Sec. Contraception and Family Planning
Volume 6 - 2025 | doi: 10.3389/fgwh.2025.1505789
This article is part of the Research Topic Spotlight on Women's Health in Ethiopia View all 7 articles
Spatial Disparities and Determinants of Modern Contraceptive Use among Reproductive Age Women in Ethiopia: Application of Multilevel Spatial Analysis
Provisionally accepted
Bisrategebrial Tesfaye Muchie 1
Ashenafi Abate Woya 2
Awoke Seyoum Tegegne 2
Maru Zewdu Kassie 3*
Muluhabt Alene 1
WONDAYA FENTA ZEWDIA 1*- 1 Bahir Dar University, Bahir Dar, Amhara Region, Ethiopia
- 2 Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia
- 3 Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
Background: Contraception aims to prevent unintended pregnancies, significantly impacting maternal and infant mortality in Sub-Saharan Africa, especially Ethiopia. This study investigates factors influencing modern contraceptive use among reproductive-age women in Ethiopia.Methods: We analyzed the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) dataset, which includes 8,196 weighted samples of women aged 15-49. Data management utilized STATA version 17, R version 4.2.2, and Arc GIS 10.8 for mapping. We employed multilevel and spatial analyses to identify determinants.Results: Only 26% of women used modern contraceptives, with notable spatial clustering (Global Moran’s Index = 0.237776, p <0.001). Hotspots were identified in Benishangul Gumuz, Gambela, SNNP, and eastern Oromia. Age group (25-34) (AHR=1.346, 95% CI: 1.143, 1.585), education level: higher (AOR=1.919, 95% CI: 1.380, 2.669), Secondary (AOR=1.554, 95% CI: 1.261, 1.914), and primary (AOR: 1.3514, 95% CI: 1.1624, 1.5712), Married (AOR=25.953, 95% CI: 20.397, 32.942), Higher Community Wealth (AOR=1.497, 95% CI: 1.114, 2.011) were positively associated with contraceptive usage, whereas women aged 35-49 (AOR=0.538, 95% CI: 0.446, 0.649), having three or more children (AOR=0.634, 95% CI: 0.460, 0.872), and Somali region (AOR=0.114, 95% CI: 0.045, 0.2882) were negatively associated with contraceptive usage. The best-fitting model included individual, community, and spatial variables, with an intra-class correlation coefficient (ICC) indicating that 15.57% of variability in contraceptive use was due to cluster differences. Conclusions: Modern contraceptive use among Ethiopian women is low and varies by cluster. Factors positively associated include age (25-34), education, marital status, and community wealth. Conversely, women aged 35-49, those with three or more children, and those in the Somali region showed lower usage. Community-level interventions are necessary to improve modern contraceptive adoption.
Keywords: Modern contraceptive use, Women, Multilevel Analysis, spatial analysis, Ethiopia
Received: 03 Oct 2024; Accepted: 26 Mar 2025.
Copyright: © 2025 Muchie, Woya, Tegegne, Kassie, Alene and ZEWDIA. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Maru Zewdu Kassie, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
WONDAYA FENTA ZEWDIA, Bahir Dar University, Bahir Dar, 378, Amhara Region, Ethiopia
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