Peer-reviewed article
Trend and determinants of unmet need for family planning among married women in Ethiopia, evidence from Ethiopian demographic and health survey 2000-2016; multilevel analysis.
Meseret Desalegn Alemu, Shimelash Bitew Workie, Sintayehu Kussa, Tesfaye Tsegaye Gidey, Tezera Moshago Berheto ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analysed data from four Ethiopian Demographic and Health Surveys between 2000 and 2016 to understand unmet need for family planning among married women. Unmet need—the gap between women's desire to limit fertility and their actual contraceptive use—declined significantly by 40.2% over this period, from 37.3% to 22.3%. The research identified multiple individual and community-level factors associated with unmet need, including rural residence, age, education, wealth, and prior family planning experience. The findings show that unplanned pregnancies pose risks including miscarriage, poor maternal health outcomes, and underweight babies.
Key points
- Unmet need for family planning in Ethiopia fell from 37.3% in 2000 to 22.3% in 2016, a 40.2% decline
- Rural women had 42% higher odds of unmet need compared to urban women
- Women with knowledge of at least one family planning method had 57% higher odds of unmet need
- Older women (ages 45-49) had 79% lower odds of unmet need compared to younger age groups
- Previous use of family planning was associated with 27% higher odds of unmet need
Limitations
This is a secondary analysis of survey data and cannot establish causation, only associations. The cross-sectional design at each survey point means changes over time reflect population-level trends rather than individual trajectories.
Abstract
BACKGROUND: Unmet need refers to the gap between women's desires and contraception use to monitor their fertility level. According to the data, unplanned pregnancies are more likely to result in miscarriage and other obstetric difficulties, have poor maternal health care usage, and have a higher risk of having babies who are underweight. Information on the trend of unmet family planning needs in Ethiopia is scarce. The aim of this study was to examine the trend and determinants of unmet need for family planning among married or in union women in Ethiopia from 2000 to 2016. METHOD: Cross-sectional study design from secondary data was performed. Data for the study was obtained from four consecutive Ethiopian Demographic Health Surveys 2000 to 2016. The survey employs a nationally representative sample of households using a multistage stratified sampling technique. A descriptive analysis was done to see the trend in unmet need. Multivariable, multilevel logistic regression was performed to assess individual and community-level determinants. An adjusted odds ratio (AOR) at a 95% confidence interval and a p-value of 0.05 were used to declare the level of significance. RESULT: Unmet need declined by 40.2%, from 37.3% to 22.3%, from 2000 to 2016. Rural (AOR = 1.42; 95% CI: 1.27-1.59), number of living children > = 5 (AOR = 1.14 (1.04-1.24), age at first marriage > = 18 years (AOR = 1.15; 95% CI: 1.09-1.21), knowing at least one method of Family Planning (FP) (AOR = 1.57; 95% CI: 1.43-1.72), and no previous use of FP (1.27 (1.20-1.36) were associated with increased unmet need. While women between the ages of 20 and 24 (AOR = 0.71; 95% CI: 0.64-0.79), 25-29 (AOR = 0.62; 95% CI: 0.55-0.70), 40-44 (AOR = 0.43; 95% CI: 0.39-0.50), 45-49 (AOR = 0.21; 95% CI: 0.18-0.24), the richest wealth index (AOR = 0.88; 95% CI: 0.80-0.96. CONCLUSION: The level of unmet need has decreased significantly in Ethiopia over the past 16 years. Age, educational level, media exposure, number of living children, age at first marriage, parity, previous use of FP, knowledge of FP, wealth index, regional setting, residence (rural), and survey year all have an association with an unmet need for family planning.