Trends and predictors of modern contraceptive use among married women: Analysis of 2000-2016 Ethiopian Demographic and Health Surveys

Objectives: Accessing family planning is a key investment in reducing the broader costs of health care and can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is still low but it is steadily increasing. Identifying the contributing factors to the changes in contraceptive use among women helps to improve women's contraceptive use and helps to plan strategies for family planning programs. Thus, the current study aimed to analyze the trends and predictors of changes in modern contraceptive use over time among married women in Ethiopia. Data source and study design: Secondary data analysis of the national representative data of 2000-2016 Ethiopian Demography and Health Survey was employed. Methods: This secondary data analysis was considered using 2000 through 2016 Ethiopian Demographic and Health Surveys. The study used data from the four DHSs conducted in Ethiopia (2000-2016). The data from all EDHS was collated so as to follow the trends throughout the period considered for the survey. Married women aged 15-49 years with sample sizes of 36,721 (9,203 in 2000, 8,438 in 2005, 9,478 in 2011, and 9,602 in 2016) were included. The analysis involved three levels, including trend analysis (to see changes from 2000 to 2005, 2005-2011, 2011-2016 and 2000-2016). Bivariate and multivariate analysis were also considered to identify predictors of modern contraceptive use. Data was extracted from the EDHS datasets for which authorization was obtained from the DHS Program/ICF International using a data extraction tool. SPSS 24 was employed for data management and analysis. Results: Among married women of reproductive age, modern contraceptive prevalence increased from 6.2% in 2000 to 35.2% in 2016. This 5-fold increment in modern contraceptive use was due to being in the age group of 25-29 years (AOR = 1.4; 95%CI (1.1, 1.7)), having two children (AOR = 1.3; 95%CI (1.1, 1.6)), the richest wealth category (AOR = 3.0; 95% CI (2.5, 3.5)), currently working (AOR = 1.3; 95%CI (1.2, 1.5)) and attending secondary and above education (AOR = 1.2; 95%CI (1.1, 1.6)) were found to be predictors. Conclusions: Over the past 15 years, an annual average of a 1.9% point increment has been observed in modern contraceptive use, but the country lags behind the SDGs's 2030 target of achieving zero unmet needs for contraception. Program interventions, and continued education of women, are mandatory, as education is one of the major factors contributing to increasing contraceptive use.