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Contraceptive intention is an important woman-centered indicator for family planning. Yet, few studies have examined the determinants of women or couples actualizing their contraceptive intentions. We leverage panel data from the Performance Monitoring for Action (PMA) survey in Ethiopia to examine these dynamics among a pregnancy cohort, over the first year postpartum. Using cluster analysis on intent-to-use trajectories, we find distinct patterns across wealth categories, education levels, and regions. Additionally, we find that receiving family planning counseling in both antenatal and postnatal care visits led to a higher likelihood of intending to use. However, counseling did not increase the odds of actualization. We argue that examining actualization through model-based approaches like cluster analysis generates better insight into woman-centered contraceptive demand and provides stronger evidence for strengthening postpartum family planning interventions, than quantifying contraceptive use alone. Modeling postpartum actualization trajectories can shed light on the barriers to women's and couple's reproductive autonomy and inform future investments in both upstream development of better contraceptive methods and downstream implementation., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: The burden of pediatric HIV/AIDS, mother-to-child transmission rate, and unintended pregnancy among HIV-positive women remain high in sub-Saharan Africa, including Ethiopia. Provision of contraceptives is an undeniable strategy to overcome the risks. However, pooled data to provide informed decisions on modern contraceptive use among HIV-positive women attending ART clinics in Ethiopia are meager. Hence, this review aimed to estimate the magnitude of modern contraception, and revisable long act contraceptives methods (RLCM) use and associated factors among HIV positive ART clinic attending women., Methods: A systematic review and meta-analysis was conducted using PubMed, Google, Cochrane library, Web of Science, Google Scholar, and Scopus database. A funnel plot and Egger's regression test were used to assess publication bias. Heterogeneity of studies was assessed using I-square statistics and the Joanna Briggs Institute (JBI) quality assessment tool was applied to ensure the quality of the included articles. We employed a random-effect model to pool the national utilization of modern contraceptives and the effect size of associated factors. We conducted sub-group analysis by regions to control heterogeneity and to detect variation., Results: A total of 21 studies were included in the meta-analysis. The magnitude of pooled utilization of modern contraceptive and RLCM was 60% [95% CI: 52-68] and 11%, [95% CI: 8-14], respectively. In the random effect model, young women [OR = 2.36, 95% CI: 1.78-3.13], attending secondary school and above [AOR = 1.34, 95% CI: 1.06-1.69], having two or more live children [AOR = 1.84, 95% CI: 1.46-2.34], discussion with a husband [AOR = 2.92, 95% CI: 2.39-3.57], CD4 > 250cells/mm 3 [AOR = 1.59, 95% CI: 1.08-2.33], and using HAART [AOR = 1.71, 95% CI: 1.35-2.15] increased odds of modern contraceptive methods utilization., Conclusion: Overall the utilization of RLCM among modern contraceptive users HIV positive women is low. Therefore, to improve the uptake of RLCM among modern contraceptive users HIV positive women, policymakers and program designers need to take into account age and educational levels of women and programs which enhance reproductive health consultation habit between couples. Moreover, integration of family planning services to ART clinics needs to be strengthened., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Contraceptive methods are techniques used to prevent pregnancy during sexual intercourse. The primary goal of contraception is to inhibit the fertilization of an egg by sperm or to prevent the implantation of a fertilized egg in the uterus. Unwanted pregnancy is a major challenge for street beggar women. Due to limited use of modern contraception, unwanted pregnancy and STDs are key issues faced by this population. This study aims to assess modern contraceptive utilization and explore factors influencing contraceptive choices among street beggar women in the Sidama region, Ethiopia by using Bayesian logistic approaches., Methods: A cross-sectional quantitative study was conducted on reproductive-aged (15-49) street beggar women in the Sidama Region. Data was collected using a pre-tested, structured interview questionnaire in the local language from each town in the Sidama region. Descriptive and inferential statistics were used to analyze the data using STATA version 17. A Bayesian logistic approach, with Markov Chain Monte Carlo methods, was used to model the association between modern contraceptive utilization and independent variables, allowing for estimation of model parameters and credible intervals., Result: The study found that 38.9% of street women in the Sidama region used modern contraceptives, primarily implants and injections. Bayesian logistic regression identified key factors influencing contraceptive use including, women aged 25-34 (AOR: 2.69 (95% CI: 1.57, 4.26)), married women (AOR: 4.91 (95% CI: 2.67, 8.51)), Widowed women (AOR: 2.81 (95% CI: 1.49)) and educated women (AOR: 2.16 (95% CI: 1.48, 3.01)) were more likely to use contraceptives. In contrast, those living on the street (AOR: 0.12 (95% CI: 0.05, 0.27)), with no history of pregnancy (AOR: 0.07 (95% CI: 0.02, 0.16)), and no sexual activity in the last six months (AOR: 0.11 (95% CI: 0.01, 0.03)), had lower usage rates. Additionally, women whose only job was begging (AOR: 0.43 (95% CI: 0.13, 0.92)) and those lacking health advice (AOR: 0.25 (95% CI: 0.07, 0.59)) also showed reduced utilization. Lack of discussion about contraceptives with partners (AOR: 0.18 (95% CI: 0.08, 0.33)) and no women's approval (AOR: 0.18 (95% CI: 0.08, 0.33)) further contributed to lower usage. Conversely, good knowledge of modern contraceptives was positively associated with utilization (AOR: 2.33 (95% CI: 1.44, 3.64))., Conclusion: The findings of this study identified several factors significantly associated with modern contraceptive use among street beggar women in the Sidama region, including age, marital status, Education level, disability, Job in addition to begging, Current living situation, history of sexual assault/rape, History of pregnancy after street life, discussion of modern contraception with a sexual partner, Advice from a health professional, Sexual activity in the last six months, time taken to arrive at a health facility on foot, approval of modern contraception, and knowledge. The main barriers reported were fear of side effects and lack of knowledge about contraceptive methods. The study suggests that concerned stakeholders should intervene to address these factors and improve modern contraceptive uptake in this vulnerable population., Competing Interests: Declarations Ethical approval and consent to participate The study was approved by the department review board (DRB) of the Hawassa University department of statistics with reference number (Ref.No. Stat/069/15). Informed written consent was obtained from study participant. The department review board (DRB) of the Hawassa University department of Statistics was approved the written informed consent of study participants. The information gathered from the patient file will be handled with confidence. The programming of data extraction tools avoids the display of names and other private information. The Declaration of Helsinki's guiding principles were followed during the study's execution. Consent for publication Not applicable. No individual person’s personal details, images, or videos are being used in this study. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Women in the early postpartum period face substantial unmet needs in contraception to encourage birth intervals and reduce unintended pregnancies. The widespread ownership of mobile devices offers an opportunity to employ mobile health strategies for enhancing communication between healthcare providers and clients. However, little is known about the effectiveness of mobile health interventions to improve early adoption of contraceptive methods after childbirth in Ehiopia., Objective: This study aimed to evaluate the effectiveness of a mobile health intervention in enhancing the uptake of modern contraceptive methods in the early postpartum period in Dessie and Kombolcha cities, northeast Ethiopia., Methods: The research was conducted in Dessie and Kombolcha cities zones located in the Amhara region of Northeast Ethiopia from 15th January to 15th June, 2023. Pregnant women with a confirmed gestation of 30 weeks were enrolled and followed up to the 45-day postpartum period. The study employed a cluster randomized control trial involving 764 participants (381 controls and 383 in the intervention group). The intervention group received a new mobile health intervention in addition to the existing healthcare practices, while the control group solely adhered to the current healthcare practices. Data were collected using the Open Data Kit (ODK) and exported to STATA 17 for analysis. The marginal model Generalized Estimating Equations (GEE) through the application of an exchangeable working correlation was applied. The effect of the intervention on the outcome was measured using the odds ratio with a 95% confidence interval at a p-value less than 0.05 significant level., Results: The study found that 78.7% of participants in the control group and 77.3% in the intervention group had sexual practice after childbirth. The proportion of early postpartum contraceptive uptake in the intervention group (51.6%) was significantly higher than in the control group (38%). The odds of adopting modern contraceptive methods during the early postpartum period were 1.6 times higher among mothers who received the mHealth intervention compared to those in the control group (AOR: 1.6, 95% CI: 1.249-2.123). The study identified significant predictors for the uptake of contraceptive methods during the early postpartum period, including having a live newborn (AOR: 3.7, 95% CI: 1.034-13.353), parity (AOR: 1.7, 95% CI: 1.069-2.695), and previous experience with contraceptive initiation (AOR: 0.5, 95% CI: 0.358-0.912)., Conclusion: This study findings demonstrated that the potential effectiveness of mobile health interventions in promoting timely contraceptive adoption during early postpartum period. The mobile health intervention, combined with factors such as timing of previous contraceptive initiation, newborn status, and maternal parity, significantly enhances the likelihood of early contraceptive adoption. These nuanced insights provide a strong foundation for developing targeted health interventions and policies aimed at improving early postpartum contraception., Registration: The trial was registered on December 23, 2022, in the Protocol Registration and Results System (PRS) Clinical Trial Registry, www.ClinicalTrials.gov, ID: ClinicalTrials.gov ID: NCT05666037., Competing Interests: The authors declare that there is no any conflict of interest., (Copyright: © 2024 Cherie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The role of counseling in Family Planning is to care a woman in navigating the process of choosing a contraceptive method that will allow her to fulfill her family planning goals and exercise her reproductive health rights. The effectiveness and appropriateness of family planning counselling play a crucial role in a client's decision-making process regarding contraception. The decision for a client to use contraception with effectively and properly it should be ultimately achieved the quality of family planning counclling. The aim of this research is to assess quality of family planning counseling and associated factors among reproductive age women at Dessie town health facilities, east Amhara, Ethiopia, and 2023., Methods: A facility based cross-sectional study was conducted from December 1, 2022- January 30, 2023. Study subjects were selected by using systematic random sampling method. Data was be collected by exit interview of the women and analyzed by SPSS version 26.  Bivariable and Multi variable logistic regression were executed to identify associated factors with quality of family planning counseling and the P- Value <0.05 on Multi variable analysis was considered as significantly associated with the dependent variable., Result: The proportion of women receiving good quality family planning counselling in this study was 36.5%.  Contraceptive source [AOR=2.03, 95%CI (1.09, 3.75)], Contraceptive currently used [AOR=0.43, 95%CI (0.26, 0.73)], separate room for family planning counseling [AOR=3.38, 95%CI (1.09, 3.75)] and availability of all methods [AOR=3.10, 95%CI (1.85, 5.21)]were significantly associated with quality of family planning counselling., Conclusion: The proportion of women obtaining good quality FP counseling in this study low. Type of contraceptives currently used, source of contraceptives, separate room for providing family planning counseling and availability of all methods of family planning in the facility are significantly associated with quality of family planning counseling. Therefore, all health profession could be given proper counseling to increase the quality of family planning., (© 2024. The Author(s).)

Background: Birth spacing is crucial for ensuring the health of mothers and their children, as well as determining population growth. Short birth intervals represent a universal public health problem associated with adverse maternal, fetal, neonatal, and child outcomes. However, there is limited information in the study area regarding the determinants of suboptimal birth spacing. Thus, this study aimed to identify the determinants of suboptimal spacing among women of reproductive age in the Adama district, Ethiopia., Methods: A community-based unmatched case-control study was conducted among 568 randomly selected reproductive-age women using the multi-stage sampling technique. Data were collected using an interviewer-administered, structured questionnaire. The collected data were entered into Epi Info version 7.2 and analyzed using SPSS version 26. Binary logistic regression analysis was used to model the association between suboptimal birth spacing and independent variables. Adjusted odds ratios with their 95% confidence intervals were calculated to determine the strength of the association. A p-value < 0.05 was considered to declare statistical significance., Result: Educational status (no formal education) (AOR = 2.40; 95% CI: 1.23-1.75), inadequate knowledge of optimal birth space (AOR = 2.60; 95% CI; 1.80-3.90), non-use of modern contraceptives (AOR = 3.00; CI: 1.90-4.20), short breastfeeding duration (AOR = 2.30; 95% CI: 1.50-3.40), and having female index child (AOR = 1.60; 95% CI: 1.13-2.50) were independent determinants of suboptimal birth spacing practice., Conclusion: Encouraging women's education, contraceptive use, and breastfeeding is crucial for birth spacing. Community health initiatives should also focus on preventing sex-based birth intervals., (© 2024. The Author(s).)

Introduction: In Ethiopia, there is a decrease in percentage of women who receive method information index counseling service from 39% (95%CI: 33%, 44%) in 2015 to 12% in 2019 (95% CI: 10%, 14%) nationally, and less than 40% of these services provided are high quality. Therefore, the aim of this study was to identify modern contraceptive users-related factors at individual level and community level associated with missed opportunities of method information index plus counseling., Methods: This study used the datasets from the 2019 Performance Monitoring for Action Ethiopia Survey, which comprised a total of 8,365 households (98.9%) and 7,988 women (98.8%). The data analysis was done with Stata version 14. Using multilevel mixed effect logistics regression, both individual and community-level factors were found to be associated with missed opportunities of method information index plus counseling. a P-value of less than 0.05 was used to declare statistical significance. The association was presented using an adjusted odds ratio with a 95% confidence interval., Results: The study shows that the prevalence of missed opportunity MII + family planning counseling among current modern contraceptive users was 81% (79.15, 82.66) and factors significantly associated with missed opportunities of method information index plus counselling are educational status, low level of media exposure, religion, receiving the service in health centers and health posts, never heard of any other methods, number of children at first contraceptive use and region., Conclusions: In Ethiopia 81% of women had a missed opportunities of MII + counseling service. In order to address this, we recommend policy makers to focus on training of health care workers and pharmacists about MII + counseling, and establishing ways to improve access to media exposure., (© 2024. The Author(s).)

Background: Family planning refers to a conscious effort by a couple to limit or space the number of children they have through the use of contraceptive methods. Contraceptive utilization is a practice that helps individuals or couples avoid unwanted pregnancy. A lack of family planning puts homeless individuals at a higher risk of unwanted pregnancies and sexually transmitted infections. However, there is little data about modern contraceptive utilization among homeless women in the study area., Objectives: It has aimed to assess the utilization of modern contraceptives and associated factors among homeless reproductive-age women in Adama town, 2023., Methods: A community-based cross-sectional study was conducted in Adama town among 286 homeless women. A convenience sampling technique was used. The data were collected through face-to-face interviews using a pretested structured questionnaire. The collected data were cleaned, coded, and entered into Epi Info, and the data were exported to the Statistical Package for Social Sciences (SPSS) version 22. Descriptive statistics were used to characterize the study population. The associations between dependent and independent variables were modeled using binary logistic regression. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to estimate associations, and a P value < 0.05 was considered to indicate statistical significance., Results: Out of the planned 289 respondents, 286 (98.9%) were participated. The prevalence of modern contraceptive utilization was 56.6% [95% CI: (50.7, 62.2)]. Among the utilizers, implants (52.5%), injectables (42%), and pills (5.5%) were used. Homeless women aged 25-34 years [AOR = 4.22, 95% CI: (1.77, 10.05)], a formal education [AOR = 3.04, 95% CI: (1.21, 7.60)], a slept off-street [AOR = 2.81, 95% CI: (1.25, 6.34)], a monthly income greater than or equal to 2400 Ethiopian birr [AOR = 4.18, 95% CI: (2.11, 8.29)], a sexual intercourse AOR = 3.14, 95% CI: (1.17, 8.40)], and a history of pregnancy after joining the street life [AOR = 9.21, 95% CI: (3.67, 23.12)] were factors significantly associated with the utilization of modern contraceptives., Conclusion: The prevalence of modern contraceptive utilization among homeless women was relatively higher than in previous studies. The associated factors for contraceptive utilization included age, education, place for sleeping, income, sexual intercourse and history of pregnancy after joining the street life. The Regional and Adama town Health Bureau and facilities should develop targeted interventions (considering age, educational, and other disparities) to reduce the unmet need for modern contraception and halt unnecessary health outcomes among homeless women, their children, and families., (© 2024. The Author(s).)

Introduction: Modern contraceptive methods are a scientifically effective method to control the fertility of reproductive-aged groups of people. The women's use of contraceptive methods creates a birth gap and limits the number of their children. The main objective of this study is to identify the significant determinant of modern contraceptive use of reproductive-aged women in Ethiopia., Methods: We used data from 2019 Ethiopian Mini Demographic and Health Survey. This data was multi-level, taking into account factors at the individual and community levels. In order to capture the multi-level structure of this data and make more reliable and broadly applicable conclusions about the variables influencing the use of modern contraceptives at the individual and community levels, we employed a two-level mixed-effects logistic regression model. In addition, we used cross-tabulation analysis to know the percentage of modern contraception users (reproductive-aged women) across their socio-economic, demographic, and health characteristics. A total of 8196 reproductive aged (15-49) women were included in this study., Results: From a total of 8196 reproductive-aged women, 2495(30.4%) were using modern contraceptive method and the rest 5701(69.6%) did not use any modern contraceptive methods. Among 2495 contraceptive users, 1657 (67.3%) used injections and 533 (21.7%) used implants/Norplant. At a 5% level of significance, the result from the two-level binary logistic regression model revealed that the predictors; Age of women, education level, religion, wealth index, knowledge of modern contraception method, number of died children, number of living children, family size, total children ever born and contextual region have significant effect on the use of modern contraception method., Conclusion: Reproductive-aged women in Ethiopia with more living children, residing in urban/agrarian region, younger, wealthier, married, and more educated, were more likely to be modern contraceptive users. The concerned bodies in Ethiopia should bring forward the intervention strategy and should expand the existed programs to improve the use of modern contraception methods among reproductive-aged women in Ethiopia. Especially, they should give special attention to reproductive-aged women of less income, resident in pastoralist region, less educated, unmarried, and haven't living child., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gobena, Kassie. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To assess the prevalence of modern contraceptive discontinuation and associated factors among married reproductive age (15-49 years) group women., Study Design, Setting and Participants: A community-based cross-sectional study was conducted in Debre Berhan town among 500 reproductive age group women. Study participants were selected using two-stage sampling procedures. Data were collected using a semistructured face-to-face interview questionnaire. The data were entered in EpiData V.4.2.0 and then exported to SPSS V.25 software for data analysis. Descriptive statistics such as mean, per cent and frequency were used to summarise women's characteristics. Binary logistic regression analysis was used to identify predictors' variables with modern contraceptive discontinuation and p<0.05 was used to declare association., Results: The prevalence of modern contraceptive discontinuation among married reproductive age group women was 35.2% with a mean duration of use of 2.6±2.1 months. This study also revealed that the discontinuation rate was 12.6% within the first year of use. In the current study, those living with their husband (adjusted OR (AOR)=3.81, p<0.001), experiencing side effects while using modern contraceptives (AOR=2.45, p=0.02), getting counselling service (AOR=5.51, p<0.001) and respondent husband acceptance of her modern contraceptive use (AOR=3.85, p=0.01) were significantly associated with modern contraceptive discontinuation., Conclusion: The findings of this study showed that the prevalence of modern contraceptive discontinuation rate of all methods among married reproductive age group women was 35.2%. To reduce modern contraceptive discontinuation, mutually, it is important to create community awareness about the importance of the continued use of modern contraceptives, improve the quality of family planning service in the health institution, strengthen family planning counselling service and give adequate counselling on details of effectiveness and side effects., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Peer-led education interventions are assumed to be an effective means of increasing contraceptive utilization and demand in adolescents. However evidence is lacking on whether peer-led education is effective in promoting the demand for and use of contraceptives in adolescent girls, especially in resource-limited settings., Objective: The present study evaluated the effectiveness of peer-led education interventions in improving contraceptive use, unmet needs, and demand among sexually active secondary school adolescent girls in Gedeo Zone, South Ethiopia., Methods: A single-blinded cluster randomised controlled trial study was performed in six randomly selected secondary schools in the Gedeo Zone, southern Ethiopia. A total of 224 participants were recruited and randomly assigned to the intervention and control groups. The intervention group received peer-led education intervention for six months. A pre-tested and validated questionnaire was used to measure contraceptive use, unmet need, and contraceptive demand. A generalised estimating equation (GEE) model was used to examine the effectiveness of the intervention., Result: After six months of intervention, the Differences-in-difference in contraceptive use, unmet need, and contraceptive demand between the intervention and control groups were 25.1%, 7.4%, and 17.7%, respectively. There was a statistically significant difference in contraceptive use [AOR = 8.7, 95% CI: (3.66, 20.83), unmet need for contraceptives [AOR = 6.2, 95% CI: (1.61, 24.36)] and contraceptive demand [AOR = 6.1, 95% CI: (2.43, 15.11)] between the intervention and control groups., Conclusions: School-based peer education intervention effectively improved contraceptive use and unmet needs in a low-resource setting and created demand in sexually active adolescent girls. These results support the potential utility of this approach in similar settings for the promotion of contraception use and demand.

Background: Timely initiation of modern contraceptive use is vital to prevent unintended pregnancy and its related morbidities and mortalities. However, there is a scarcity of evidence about the duration of time elapsing from childbirth to initiating modern contraceptive use following childbirth and its associated factors in the study area for evidence-based interventions. Therefore, we aimed to assess the time to initiation of modern contraceptive method use and its predictors in Hossana town, southern Ethiopia., Methods: A retrospective follow-up study was conducted at public health facilities in Hosanna town. A total of 503 study participants were included in the study using a systematic random sampling technique. The Box and Whisker plot was used to estimate the time to initiation of modern contraceptive use. A Weibull regression model was applied to identify predictors of time to initiation of modern contraceptive use. Adjusted Hazard Ratio (AHR) with a 95% confidence interval (CI) was used to interpret the strength of the association., Results: The median time to initiation of modern contraceptive use was 6 months, with an interquartile range of 3 months. Husband/partner attending higher education [AHR = 1.64, 95% CI: 1.04, 2.57], women who had parity of more than two [AHR = 1.93, 95% CI: 1.01, 3.67], and women who had communicated with their husband/partner about modern contraceptive methods [AHR = 3.03, 95% CI: 1.41, 6.67] were more likely to initiate modern contraceptive method use within six months after childbirth. In contrast, women with an older age of greater than or equal to 30 years [AHR = 0.32, 95% CI: 0.13, 0.82] and who did not resume sexual intercourse after childbirth [AHR = 0.02, 95% CI: 0.01, 0.03] were less likely to initiate modern contraceptive method use within six months after childbirth., Conclusions: The median time to initiation of modern contraceptive method use after childbirth in the postpartum period was delayed from the World Health Organization recommendation of at most 6 weeks. Emphasis should be given to older women, women with lower parity, and men's participation in contraceptive communication to improve timing for initiation of modern contraceptive use after childbirth and to curb the five-month lag periods., (© 2023. The Author(s).)

Background: Promotion and use of family planning in countries with high birth rates have the potential to avert a third of all maternal deaths and nearly a tenth of childhood deaths. To support government efforts in creating wider access to comprehensive contraceptive methods, EngenderHealth has contributed to the government of Ethiopia's long-term goal of improving maternal health outcomes through its Access to Better Reproductive Health Initiative project., Methods: Difference-in-Difference approach is the main methodology in this analysis to estimate the "contribution" or "effect" of the ABRI intervention by comparing the changes in family planning outcomes from 2005 to 2016 between the ABRI and non-ABRI areas. This analysis was based on pooled data from the 2005 and 2016 Ethiopian Demographic and Health Surveys. To track temporal changes in the family planning indicators in the ABRI and non-ABRI areas, we employed simple trend analysis., Results: The results show that overall contraceptive prevalence rate, use of injectables, women's knowledge of Long-Acting Reversible Contraception (LARC) methods, and their exposure to family planning information/messages from health workers all significantly improved in the ABRI intervention areas beyond what occurred in the non-ABRI areas. The greatest increase in the use of modern contraception was among adolescents aged 15-19 years, with a DID estimate of 22.4% (p=0.007), ABRI areas compared to no-ABRI areas., Conclusion: In the ABRI areas, family planning indicators recorded positive and significant changes. EngenderHealth has contributed its part in improving access to the uptake of comprehensive contraception and supporting government programs., (© 2023 Addisalem Titiyos, et al.)

Objectives: To better understand the relationship between high-quality contraceptive counseling and met family planning needs, we examined the association between quality of counseling and selection of a method postvisit among women requesting contraception in Ethiopia., Study Design: We used post-counseling survey data from women receiving care in public health centers and nongovernmental clinics in three regions in Ethiopia. Among women whose reason for visit was requesting a contraceptive method, we examined the association between scores on the validated quality of contraceptive counseling (QCC) scale and subscales and selection of a method post-counseling (primary analysis) and type of method selected (secondary analysis). We conducted mixed-effects multivariable logistic regression for the primary analysis and multinomial regression for the secondary analysis., Results: There was a nonsignificant increase in odds of selecting contraception with increasing total QCC scale scores (adjusted odds ratio [aOR] 2.35, 0.43-12.95). However, among women experiencing no disrespect and abuse, there was increasing odds of selecting contraception (aOR 3.46, 95% CI 1.09-10.99) and likelihood of selecting injectable contraception (adjusted relative risk ratio 4.27, 95% CI 1.34-13.60) compared to women experiencing disrespect and abuse. Additionally, 168 (32.1%) of women felt pressured by their provider to use a certain method of which>50% selected long-acting reversible contraception., Conclusions: Increasing QCC is associated with selecting contraception among women requesting contraception. Additionally, probing for negative experiences can reveal feelings of disrespect and abuse that could lead women to avoid selecting contraception or feeling pressured to use methods heavily promoted by providers., Implications: Our study assesses contraceptive counseling quality using a validated tool with items on provider pressure and other forms of disrespect and abuse; findings highlight the importance of respectful treatment in meeting women's needs and the potential influence of disrespect on decision to select contraception and type of method selected., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: An intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world. However, only a small proportion of women in developing countries, including Ethiopia, are currently using the method. Therefore, this study aimed to identify why IUD utilization is low in southwestern Ethiopia., Material and Methods: A mixed-method study involving health facilities and communities was conducted. The focus group discussions and key informant interviewees for the qualitative study were selected purposively, whereas 844 women family planning users were selected using systematic random sampling from November 1-30, 2020. Quantitative data was collected using Open Data Kit and analyzed using Stata version 16.0. Multivariable logistic regression analyses were done to identify significant factors influencing IUD use. The qualitative data were tape-recorded, transcribed, and finally, thematic analyses were done., Results: A total of 784 participants were involved in the study yielding a response rate of 92.9%. Among all respondents, only 1.3%, 2.4%, and 30.0% had been using an IUD, preferred an IUD, and had the intention to use an IUD, respectively. The main reported barriers to use an IUD among qualitative participants were fear of side-effects, religious prohibitions of contraception use, husband disapproval, lack of training by health workers, misconceptions, and longer duration of use. IUD information (AOR = 2.19 [CI: 1.56-3.08]), and rich wealth status (AOR = 1.70 [CI: 1.13-2.56]) were associated with the intention to continue or start to use an IUD., Conclusions: IUD use and information on IUDs in the study area was very low. Information about IUDs, wealth status, and partner disapproval were determinant factors for intention to use an IUD. Thus, a regular awareness creation program using accessible media platforms by the government and stakeholders on IUD use is necessary to provide reliable information to the community and resolve misconceptions. In addition, women's empowerment to balance partner dominance on decision-making of contraception use and health care worker training on long-acting reversible contraceptives (LARCs) to increase access to LARC services are necessary to increase uptake of LARCs in general and of IUDs, in particular in the study regions., (© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

Background: Women use modern contraceptive methods, mainly either to limit or space pregnancy and both are not identical in their choices. One method may not best fit an individual's need irrespective of the time of spacing. Cognizant of this, the context with which women base in choice of contraceptives, their lived experiences in using, and factors for early removal/ discontinuation of long-acting reversible contraceptives (LARCs) are not much investigated in the study setting and our study aimed to bridge the gap through exploring the underlying reasons., Method: A phenomenological study design was used to explore sampled women's reasons and experiences. Reproductive-aged women (15-49 years) who removed long-acting methods in the past 6 months were included. A criterion sampling approach was employed to recruit study participants. Data was collected using an interview guide for in-depth (IDIs) and key informant interviews and were tape-recorded with interviewees' consent. Audio data were transcribed verbatim and translated into English. The data was first saved in plain text format and imported into Atlas.ti 7.0 software to facilitate coding and categorizing. The content analysis method was used to classify, organize data, and interpret the qualitative data according to key categories., Results: Several misconceptions about contraceptives (e.g., implants are not appropriate for daily laborers, women who use contraceptives (such as injectables) can only bear girl-child, etc.) were reported by clients and health providers. These misconceptions might not have scientific merit but they are powerful enough to affect actual behaviors toward contraceptives, including early removal. The awareness, attitude, and use of contraceptives tend to be lower in rural areas. For premature removal of LARCs, side effects, and heavy menstrual bleeding, was the most commonly identified reason. The IUCD is the least preferred method and users said it is not comfortable during sex., Conclusion and Recommendation: Our study found different reasons and misconceptions for modern contraceptive methods' non-use and discontinuation. Standardized counseling approaches like the REDI (Rapport Building, Exploration, Decision Making, and Implementation) framework should be implemented in the country consistently. Some of the concrete providers' conceptions should be well-studied considering contextual factors to bring scientific evidence., (© 2023. The Author(s).)

Partner-perpetrated pregnancy coercion inhibits women's reproductive autonomy. However, few studies have quantified pregnancy coercion and its effects on women's health within low- and middle-income countries. Among a national sample of Ethiopian women, this study aimed to: (1) assess the prevalence of past-year pregnancy coercion and explore regional differences; (2) identify correlates; (3) examine the relationship between pregnancy coercion and modern contraceptive use. Analyses utilise cross-sectional data from Performance Monitoring for Action (PMA)-Ethiopia, a nationally representative sample of females aged 15-49 conducted from October to November 2019. Past-year pregnancy coercion was assessed via five items and analysed dichotomously and categorically for severity. Among women in need of contraception, bivariate and multivariable logistic regression examined associations between variables of interest, per aim, accounting for sampling weights and clustering by enumeration area. Approximately 20% of Ethiopian women reported past-year pregnancy coercion (11.4% less severe; 8.6% more severe), ranging from 16% in Benishangul-Gumuz to 35% in Dire Dawa. Increasing parity was associated with decreased odds of pregnancy coercion. Among women in need of contraception, experience of pregnancy coercion was associated with a 32% decrease in odds of modern contraceptive use (aOR = 0.68; 95% CI: 0.53-0.89); when disaggregated by severity, odds decreased for most severe pregnancy coercion (aOR = 0.59; 95% CI = 0.41-0.83). Results indicate that partner-perpetrated pregnancy coercion is prevalent across diverse regions of Ethiopia, and most severe forms could interrupt recent gains in contraceptive coverage and progress to sexual and reproductive health and rights. Providers must be aware of potential contraceptive interference and address coercive influences during contraceptive counselling.

Modern contraception has played a significant role in reducing maternal and child mortality. The study was aimed at assessing the knowledge and practice of modern contraception among agro-pastoral women in the Jigjiga district of the Somali regional state. The study employed a cross-sectional quantitative research design. A total of 383 agro-pastoral women between the ages of 15 and 49 years who were married were randomly taken from 11 kebeles (the smallest administrative unit). The data were collected through a structured and pre-tested questionnaire via the face-to-face interview technique by trained enumerators. Frequency and percentage were used to analyze the collected data. The study found that 21.1% of agro-pastoral women respondents were aware of modern contraception methods. Despite this fact, the prevalence of modern contraception at the time of data collection was 4.7%. Injectables and pills were the modern contraception used by most of the respondent women. The result of the study shows the low level of modern contraception utilization which calls for strong measures to let the agro-pastoral women use various methods. Therefore, it is important to have an awareness creation campaign to motivate women to use modern contraception and improve the family planning service provision in the region.

Background: Adopting contraception on time is a critical intervention for postpartum women, but violence exposure around pregnancy may interfere with postpartum contraceptive use behaviors. Hence, this study aimed to investigate the time duration of the first modern contraceptive adoption and its individual-and community-level predictors among postpartum women in the Wolaita zone, South Ethiopia., Methods: A community-based prospective follow-up study was conducted among 1,292 postpartum women nested in 38 " Kebles" (clusters) using multistage-clustered sampling techniques. A multilevel Weibull regression model was employed to investigate predictors of time-to-method initiation after childbirth using STATA Version 14. Kaplan-Meier curve and Wilcoxon log-rank test were used to estimate time-to-modern contraceptive use across different variables. All variables with p -values <0.05 were considered for multivariate analysis. Adjusted time ratios (ATR) with 95 % CI were computed using Weibull accelerated failure time models., Results: Of the respondents, 62% (95% CI: 59.1-64.5) had started the first modern contraception within a year after childbirth. The restricted mean survival time-to-postpartum modern contraceptive use was 6.28 months. Being a rural dweller (aTR: 1.44; 95% CI: 1.06-1.99) and living in the middle household wealth quintiles (aTR: 1.10; 95% CI: 1.02-1.19) predicted longer time duration to adopt first modern contraception by 44 and 10%, respectively. The women from the community with a high early marriage (aTR: 1.14; 95% CI: 1.01-1.28) took longer time to initiate modern postpartum methods. Furthermore, women who had no history of perinatal abuse took less time than those who had a history of abuse to start postpartum contraception (aTR: 0.71; 95% CI: 0.66-0.78)., Conclusion: Rural residence, poor household wealth status, history of perinatal abuse, and a high rate of early marriage in the community are predicted to lengthen the time duration to start modern postpartum contraception. Thus, community-level women's empowerment, particularly among rural women and integration of intimate partner violence screening into family planning counseling throughout the continuum of care will likely to improve postpartum contraception timing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abota, Gashe and Deyessa.)

Objective: This study examined the association between family planning counselling receipt during the 12 months preceding the survey and postpartum modern contraceptive uptake in Ethiopia. We hypothesised that receiving family planning counselling either within the community setting by a field health worker or at a health facility by a healthcare attendant during the 12 months preceding the survey improves postpartum modern contraceptive uptake., Design: We used a cross-sectional study of the Ethiopian Demographic and Health Survey conducted in 2016., Setting: Ethiopia., Participants: A total of 1650 women who gave birth during the 12 months and had contact with service delivery points during the 12 months preceding the survey., Primary Outcome: A weighted modified Poisson regression model was used to estimate an adjusted relative risk (RR) of postpartum modern contraceptives., Results: Approximately half (48%) of the women have missed the opportunity to receive family planning counselling at the health service contact points during the 12 months preceding the survey. The postpartum modern contraceptive uptake was 27%. Two hundred forty-two (30%) and 204 (24%) of the counselled and not counselled women used postpartum modern contraceptive methods, respectively. Compared with women who did not receive counselling for family planning, women who received counselling had higher contraceptive uptake (RR 1.32, 95% CI 1.04 to 1.67)., Conclusion: Significant numbers of women have missed the opportunity of receiving family planning counselling during contact with health service delivery points. Modern contraceptive uptake among postpartum women was low in Ethiopia. Despite this, our findings revealed that family planning counselling was associated with improved postpartum modern contraceptive uptake., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

The main objective of the study was to assess the magnitude of women's intention to use long-acting and permanent contraceptive methods and associated factors among short term family planning users in Addis Ababa public health centers, Ethiopia, 2020. A Facility-based cross-sectional study design was implemented in Addis Ababa public health center and data was collected using a pretested structured questionnaire on 504 participants, which was selected by multistage cluster sampling methods among family planning users in selected public health centers from March to April 2020. Collected data were coded and entered into EPI INFO version 4.6.0.0 and exported to SPSS version 25.0 for analysis. Multivariate logistic regression model was used to determine independent predictors at a 95% confidence interval and p <0.05 was considered significant. This study found the prevalence of contraception intention to use long acting and permanent methods (LAPMs) among participants were 60%. Predictors of LAPM desired number of children (AOR: 14.55, 95%CI (3.29-6.42), respondent's education (AOR: 0.36, 95%CI (0.20-0.64) and participant's occupation status (AOR: 8.75, 95% C I (1.31-5.84) were significantly associated with contraception intention.

Background: Providing effective, high quality, antenatal and postpartum contraceptive counseling can reduce unintended pregnancies, decrease maternal and fetal morbidity and mortality, and prevent unsafe abortions. The postpartum period is a critical time to address unmet family planning need and to reduce the risks of short interpregnancy interval. This study aimed at determining the impact of assigning a dedicated obstetrics and gynecology resident for postpartum family planning counselling on the uptake of immediate postpartum family planning., Methods: A "pre-post" observational study was conducted at Saint Paul's Hospital Millennium Medical College (SPHMMC), in Addis Ababa-Ethiopia, from May 1, 2021 to June 30, 2021. Immediate postpartum family planning uptake between the months of June (when there was a dedicated resident assigned for postpartum family planning counselling and provison on weekdays) and May (when there was no such dedicated resident for similar purpose) were compared. Data was analyzed using SPSS version 20 software packages. Simple descriptive was used to describe baseline characteristics. Chi-square test of association was done to determine the correlation between dependent and independent variables. Multivariate regression analysis was applied to determine factors associated with uptake of family planning methods in the immediate postpartum period. Odds ratio, 95% CI, and p-value < 0.05 were used to describe results significance., Results: Out of 776 mothers who delivered at SPHMMC in the month of June 2021, 158 (20.4%) of them used immediate postpartum family planning. This finding during the month of June is higher than a 15.4% immediate postpartum family planning uptake observed during the preceding month of May. Having a dedicated resident for postpartum family planning counselling was associated with an increase in immediate postpartum family planning use (AOR = 1.31, 95% CI [1.01, 1.69])., Conclusion: In this study, presence of a dedicated obstetrics and gynecology resident for postpartum family planning counselling was associated with an increase in the uptake of immediate postpartum family planning. This implies the importance of assigning a dedicated care provider for the purpose of postpartum family planning counselling within the immediate postpartum, which gives postpartum women another opportunity of adequate counselling before they are discharge from Hospitals or obstetric service centers., (© 2022. The Author(s).)

Background: Rapid population growth, untended pregnancy, and related consequences remain the concern of Sub-Saharan African countries, including Ethiopia. Despite this, long-acting reversible contraceptives methods are still underutilised and no studies have sought the factors in this study setting. Therefore, this study conducted to assess the prevalence and determining factors of long-acting reversible contraceptives utilisation following an abortion in Northern Ethiopia., Method: Facility-based cross-sectional study design was employed. A total of340 post aborted women selected by a systematic sampling method from August 1 to October 30, 2018. Data were entered into Epi-Info version 7 software and exported to SPSS version 20 for analysis. Both bivariate and multivariate logistic regression models were used to identify factors associated with the outcome variable., Results: The overall post-abortion long-acting reversible contraceptives utilisation was 57(16.76%) with 47(82.46%) implantand 10 (17.54%) intrauterine devices. Age range 20-29 years (AOR = 0.09, 95% CI 0.02-0.37), employed (AOR = 5.22, 95% CI 1.99-13.67), had ≥2 alive children (AOR = 7.02, 95% CI 1.58-31.23), induced abortion (AOR = 8.41, 95% CI 3.28-21.59), surgical abortion (AOR = 5.99, 95% CI 2.25-15.94), previous awareness (AOR = 3.18, 95% CI 1.14-8.82) and history of prior utilisation (AOR = 3.59, 95% CI 1.08-11.97) were the factors significantly associated with utilisation of post-abortion long-acting reversible contraceptives., Conclusion: Long-acting reversible contraceptive methods level of utilisation following an abortion in this study was low. Advocating and raising awareness should always consider on benefits and effectiveness of long-acting reversible contraceptives for all type of abortion and methods of termination as an integral part of reproductive health care services.

Objective: To assess the effect of couple counseling on modern contraception adoption among women receiving abortions., Methods: A cross-sectional study was conducted between October 2019 and May 2020 at the abortion clinic of Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Women receiving abortion care were interviewed using Open Data Kit. Logistic regression was used to assess predictors of modern contraception adoption., Results: During the study period, a total of 326 women receiving abortion care were interviewed and 112 (34.4%) received couple counseling. Of the 112, 89 (79.5%) adopted modern contraception. The odds of using a modern contraceptive method were 2.34 times higher among women whose partner approved (adjusted odds ratio [aOR] 2.34; 95% confidence interval [CI] 1.05-5.22) compared with those without partner approval. The odds of using a modern contraceptive method was 1.78 times higher among women who believed they had partner support (aOR 1.78; 95% CI 1.03-3.10) compared with women without support., Conclusion: Few women received couple counseling for contraception. Partner approval and a woman's belief that her partner supports her contraception decision were associated with contraception adoption., (© 2020 International Federation of Gynecology and Obstetrics.)

Background: The use of modern family planning methods among women of reproductive age (15-49 years) is of public health importance in Ethiopia. Nationally, modern family planning method use remains as low as 35%. Understanding factors associated with the use of modern family planning methods may help to improve maternal and child health. Hence, this study is aimed at assessing modern family planning method use and its determinants among women of reproductive age in the rural districts of Eastern Hararghe zone, Eastern Ethiopia. Methodology . A community-based, cross-sectional survey was conducted among 577 randomly selected, currently married, reproductive-aged women in selected rural districts of Eastern Hararghe, Eastern Ethiopia. Data were collected using a pretested, interviewer-administered questionnaire about women's sociodemographic information, knowledge about contraception, reproductive history, contraceptive use and fertility desire, couple's communication, and decision-making on family planning. Binary and multivariable logistic regression was used to analyze the association between the dependent and independent variables., Result: A total of 555 study participants participated, yielding a 96.2% response rate. The overall modern family planning utilization among the study participants was 18.4%. Knowledge of modern family planning methods (AOR = 16.958, CI: 4.768, 60.316), husband approval (AOR = 3.590, CI: 2.170, 5.936), couple's discussion (AOR = 2.852, CI: 1.759, 4.623), male involvement in decisions about family planning (AOR = 2.340, CI: 1.531, 3.576), desire for additional child (AOR = 2.295, CI: 1.528, 3.447), and previous use of contraception (AOR = 0.018, CI: 0.005, 0.063) were significantly associated with modern contraceptive utilization., Conclusion: Even though knowledge of modern family planning methods was very high, the overall modern family planning method use in the study area was low. The government should focus on increasing modern family planning method availability. It must also ensure family planning method security and create awareness on modern family planning methods through community-based education and proper counselling to empower women to make an appropriate choice., Competing Interests: The authors declare that they have no conflicts of interests., (Copyright © 2020 Teshale Mulatu et al.)

Background: Though long-acting reversible contraceptives (LARCs) are highly effective, have minimal side effects, require minimal follow-up, and are low cost, only 10% of contraceptives used in Ethiopia are LARCs. The reason for this low uptake is not understood at the country or regional level. Therefore, this study identified determinants of LARC utilization in Northwest Ethiopia., Methods: A facility-based unmatched case control study, using LARC users as cases and short- acting reversible contraception (SARC) users as controls, had been conducted at fourteen public health institutions in Northwest Ethiopia. A systematic random sampling technique was used to select participants with a 1:2 case to control ratio (n = 1167). Binary logistic regression analysis was used to identify determinants of LARC utilization among family planning service users., Results: Wealth status [AOR:1.87, 95%CI (1.08, 3.24)], history of abortion [AOR:2.69, 95%CI (1.41, 5.12)], limiting family size [AOR: 2.38, 95%CI (1.01, 5.62)], good knowledge about LARCs [AOR: 2.52, 95%CI (1.17, 5.41)], method convenience [AOR: 0.23, 95%CI (0.16, 0.34)], good availability of method [AOR:0.10 (0.05, 0.19)], less frequent visits to health facility [AOR:2.95, 95% CI(1.89, 4.62)], health care providers advice [AOR:10.69, 95%CI (3.27, 34.87)], partner approval [AOR:0.66, 95%CI (0.45, 0.97)], and favorable attitude towards LARCs [AOR:13.0, 95%CI (8.60, 19.72)] were significantly associated with LARC utilization., Conclusion: Professional support, favorable attitude towards LARC use, high economic status, history of abortion, advantage of less frequent visits, having good knowledge towards LARC and interest of limiting births were significantly associated with LARC Utilization. On the other hand, perceived method convenience, and contraception availability were inversely associated with it. Family planning education about the benefits of LARC should be done by health providers and media. Male involvement in the counselling and decision making about the advantage of using LARC may improve the negative influence of partners on LARC utilization. It is also recommended that, future qualitative research further explore perceptions of LARC use., Competing Interests: The authors have declared that no competing interests exist.

Purpose: This study sought to examine different factors associated with use of contraceptive types among Ethiopian women, as well as to update the literature on general contraceptive use. These analyses can be used to tailor and improve family planning policy and long-acting contraceptive use., Methods: The Ethiopia Demographic and Health Survey 2016 conducted in-person interviews with 15,683 women aged 15-49. Participants were asked about contraceptive use, family planning attitudes, personal and household characteristics, and lifestyle. We used bivariate and multivariate logistic regression to analyse factors associated with general contraceptive use and long-acting contraceptive use., Results: Our study confirms many previously documented determinants of general contraceptive use including marital status, age, religion, decision-making ability, and occupation. Factors associated with long- versus short-term reversible contraceptive use were religion, region, age group, highest level of education, and discussing family planning at a health facility., Conclusion: This study outlines crucial differences between long- and short-acting contraceptive users. Further family planning policy efforts taking into account regional, religious and other personal and socio-economic factors would effectively augment ongoing efforts. Additionally, the role played by discussion with health professionals in supporting long-term contraceptive use reflects the success of the ongoing effort to drive use in Ethiopia. KEY MESSAGE Global and national health actors are focused on improving access to long-acting contraceptives, however there is little evidence on factors that facilitate their uptake compared to the traditionally popular, short-acting contraceptives. Our study found significant religious and regional differences in long-acting contraceptive use which policy makers can use to guide their efforts.. Community health extension workers play a key role in long-term contraceptive access through tailored person-person education, consultation, and provision.

Background: Modern contraceptive methods enable couples to enjoy sexual intercourse without fear of the risk of pregnancy at any desired time. The evidence from different studies done in Ethiopia on modern contraceptive method utilization was highly varied and not conclusive. Therefore, the current study aims to study the magnitude of modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia based on 2016 EDHS data., Method: A nationally representative 2016 EDHS data collected between January 18/ 2016 to June 27/2016 were used. Descriptive studies and logistic regression models were used to summarize descriptive data and measure statistical association respectively. Adjusted odds ratio and confidence interval were respectively used to measure association and its statistical significance. Finally, statistical significance was declared using a confidence interval., Result: In the current study, the overall modern contraceptive utilization among reproductive-age women in Ethiopia was 3203 (20.42%). The injectable contraceptive method was the most commonly used modern contraceptive method, 1886(58.88%) followed by implant/Norplant, 779 (24.32%). The results of multivariable logistic regression showed that age, residence, region, woman's occupation, number of living children, husband's education, age at first sexual intercourse, husband's desire for more children, wealth index and watching TV were independently associated to modern contraceptive utilization among reproductive-age women in Ethiopia., Conclusions: The magnitude of modern contraceptive utilization among reproductive-age women in Ethiopia in the current study is unexpectedly low. Age, residence, region, woman's occupation, number of living children, husband's education, age at first sexual intercourse, husband's desire for more children, wealth index and watching TV were independent predictors of modern contraceptive use among reproductive-age women in Ethiopia. Any intervention strategy that promotes modern contraceptive method utilization should consider these factors for its better success.

Methods: A community-based cross-sectional study was employed among 686 mothers in Burie District from March 16 to March 25, 2017. A multistage sampling technique was used to select the study participants. Data were collected using face to face interviewer administered structured questionnaires. Then, the collected data was entered, coded, and cleaned into EPI Data version 3.1 and exported to SPSS version 20.0 for data analysis. Bivariate and multivariate logistic regression was done to assess the association of factors with postpartum modern contraceptive use. Adjusted odds ratios with 95% confidence intervals were calculated, and p values <0.05 were considered to indicate statistical significance., Result: This study revealed that postpartum modern contraceptive use was found to be 20.7%. Postpartum modern contraceptive use was significantly associated with women's level of education (AOR = 0.15, 95% CI (0.03-0.71)), discussing FP methods with partner (AOR = 0.60, 95% CI (0.40-0.90)), knowing menses return after birth (AOR = 0.39, 95% CI (0.25-0.59)), ever heard about modern FP methods (AOR = 0.06, 95% CI (0.01-0.43)), and contacting health professionals (AOR = 1.85, 95% CI (1.19-2.88)). Conclusion and Recommendations . Postpartum modern contraceptive use was found to be low. Therefore, health professionals should work on improvements in women's educational status, making awareness of the women and counseling of their husbands about the use of postpartum contraception, when fertility returned and risky timing for becoming pregnant., Competing Interests: The authors did not receive payments, funding, or salary from any organization in relation to the work and publication of this paper in the past five years, and there will also be no financial support to be received in the future. There are not any organization affected positively or negatively by the publication of this paper. There are not any competing interests related with patents of the content of the paper. The authors also declare that there are not any other financial or nonfinancial competing interests., (Copyright © 2020 Wassachew Ashebir and Tilahun Tadesse.)

Introduction: All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their child. However, In Ethiopia, the prevalence of contraceptive utilization remains low and it varies in different regions. Therefore, this study was aimed to determine prevalence and determinant factors affecting the utilization of modern contraception in the reproductive age group (15-49 years) in Edaga-Hamus Town., Methodology: A community based Cross-Sectional study was carried out on April 23 to May 10, 2017. A systemic random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. The data were entered into EPI-info version 7.1 and imported to SPSS version 20. Summary statistics and logistic regression analysis were performed using SPSS version 20. Those variables having a P-value of less than 0.2 in the bivariable analysis were fitted in multivariable analysis. AOR with 95% CI and P-value<0.05 were used during multivariable analysis to identify the factors associated with the utilization of modern in reproductive., Result: In this study the overall prevalence of modern contraceptive utilization was 58.5%. Age (AOR = 0.406,95%,Cl: (0.000,0.398)), Educational status (AOR = 0.901,95% Cl (0.340,4.107)), Feeling of husband towards Modern contraceptive (AOR = 0.186, 95% CI (0.056,0.617) had protective effect of utilization of modern contraceptive. But Number of children 1-3 and 4-5 wanted(AOR = 10.802,95%(4.027,28.975)), AOR = 2.624,95% CI (1.437,4.791), was a risk for utilization of modern contraceptive., Conclusion and Recommendation: The prevalence of Modern contraceptive utilization was still to be low (far below the national target). Therefore, providing educational opportunities, creating awareness about contraception and effective counseling would increase modern contraceptive methods utilization., Competing Interests: The authors have declared that no competing interests exist.

Globally, 53% of women in reproductive age group use modern methods of contraception, with less than one percent of which using implants. In Ethiopia and other parts of sub-Saharan Africa, short-term contraceptive methods have been more utilized than long-acting methods like implants. Despite their effectiveness, implants have been underutilized due to various reasons. There is a dearth of stronger evidences on those factors in the country in general and the study area in particular. Therefore, this study aimed to identify determinants of implant utilization among married women of reproductive age at Chencha town, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples' Region (SNNPR) of Ethiopia. A community-based case-control study design was conducted among 324 women of reproductive age, 90 cases (users of implants) and 234 controls (users of short-acting contraceptives) from July to August 2017. Data were collected using a pretested, structured questionnaire through face-to-face interview. The data were entered and coded using Epi info 3.5.1 and then exported to Statistical Package for Social Sciences (SPSS) version 20 for cleaning and analysis. Descriptive analysis was done to quantify proportions, means, and standard deviations of variables. Bivariate and multivariable logistic regressions were done to identify the determinants of implant utilization. A total of 324 married women of reproductive age group were interviewed with response rate of 98%. In this study, the major determinants for implant utilization were desire to have 3-4 children {AOR = 0.104, 95% CI (0.03, 0.4)}, husband disproval {AOR = 0.11, 95% CI (0.038, 0.314)}, joint decision {AOR = 3.11, 95% CI (1.02, 9.48)}, and decision by other persons {AOR = 0.065, 95% CI (0.012, 0.352)}. This study found out that desire to have more children, husband disapproval, joint decision making, and decision by other persons were determinants of implant utilization among the target women. Implant utilization would improve through strengthening existing interventions targeting women with high fertility desire, transformation of gender norms in household decisions, and counseling for informed decisions., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Rahel Abera et al.)

Background: There has been an increase in the uptake of long-acting or permanent contraceptive methods (LAPMs) in Ethiopia. Identifying the factors associated with this change is important for designing interventions that will further accelerate the uptake. This study was done to identify components of, and factors associated with, changes in the use of LAPMs in Ethiopia., Methods: Information about 16,336 married or in-union reproductive-age women were extracted from the 2005 and 2016 Ethiopian Demographic and Health Surveys (EDHS). Normalized weighting was used to compensate for disproportionate sampling and non-response in the survey. The two data sets were merged and analyzed using multivariate decomposition analysis., Result: From 2005 to 2016, the use of LAPMs increased by 12.0 percentage points. Changes in the characteristics of women (compositional factors) were responsible for nearly 7.0% of the observed difference. Most of the change (92.0%) was attributable to differences in the effects of characteristics. Age, working status, woman's occupation, concordance on the desired number of children between women and their partners, and a visit by health workers in the 12 months before the survey were all significantly associated with the change., Conclusion: The contribution of variation in the survey population structure was not significant for the observed change. The change in the use of LAPMs was mainly due to behavioral changes among older, educated and working women, and women visited by health workers., Competing Interests: The authors have declared that no competing interests exist.

Objectives: To identify the determinants of long-acting contraceptive utilization among married women of reproductive age in Aneded district, northwestern Ethiopia. Unmatched case control study was conducted from May 1, 2018 to June 30, 2018. One hundred forty-five households with married reproductive age women who have used long-acting family planning for more than a year (cases) and 290 households with married reproductive age women who have never used long-acting family planning (controls) were selected by systematic random sampling in each kebele (the smallest administrative units of Ethiopia)., Result: In this study, 145 cases and 290 controls participated. Independent positive predictors of utilization of long-acting family planning among married women reproductive age were: primary education level [AOR = 6.99, 95% CI 3.7-13.7], first discussion with providers [AOR = 2.64, 95% CI 1.6-4.5], told what to do if they experience the side effect [AOR = 3.2, 95% CI 1.7-5.9], know the source of long-acting family planning methods [AOR = 3.4, 95% CI 2.01-5.82] and discussion with health professionals [AOR = 2.07, 95% CI 1.2-3.5]. Encouraging women education at least at primary level and advocating the minimal side effect of long-acting contraceptive are recommended to improve long-acting family planning utilization.

Introduction: Despite increasing efforts to address the reproductive health needs of persons living with Human Immuno-Deficiency Virus (HIV), a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. Currently, Ethiopia promotes integration of family planning (FP) services in to HIV chronic care. Yet the contraceptive prevalence rate among clients remains low. The objective of the study was to assess the role of socio-cultural factors on modern family planning use among HIV+ clients attending Anti-Retroviral Therapy clinics in Addis Ababa sub-cities., Methods: The study involved a facility based cross sectional survey. The ten sub cities were initially categorized/stratified into 5 based on direction (East, West, South, North and Central) and from each category one sub city was randomly selected. The total sample size was proportionally allocated to the selected health facilities according to previous monthly average client load per health center. Participants were selected using simple random sampling technique during their routine visit at the health centers. Data were collected through a semi-structured interviewer administered questionnaire. Both descriptive and inferential statistics were generated and results considered significant at 95% confidence level using STATA version 14.0., Results: Six hundred and thirty-six clients participated in the study. Majority of them were age between 30-39 years. Though majority, 607 (95.4%) participants approved the use of modern FP method, current use rate stood at 39%. Condom was the most (14.5%) commonly used single method. The odds of FP use by participants who disclosed their HIV status were almost twice that of their counterparts (AOR= 1.84; 95% CI: 1.14, 2.95). Participants who held discussion with their spouse/partners concerning FP, irrespective of the frequency had an odd of more than four when using FP than their counterparts (AO= 4.35; 95% CI: 2.69, 7.04)., Conclusion: This study revealed that 6 out of every 10 HIV+ clients are not currently using FP methods. Disclosure of HIV status as well as open discussion with spouse/partner were positively associated with family planning use. These study findings call for comprehensive and client focus FP education and counseling in line with disclosure of HIV status and dialogue with spouse/partner in order to increase uptake and utilization of FP among clients. Partners have a great influence on the use and choice of FP methods, so their views are paramount., Competing Interests: The authors declare no competing interests., (© Akateh Derek et al.)

Women living in refugee camps, in addition to the common hardships, such as drought, and famine, are also prone to another peculiar problem: an unintended pregnancy. The impact of unintended pregnancy is so severe that the rate of women who die or suffer an injury while giving birth in crisis settings is almost double the world average death rate. Thus, this study was aimed to investigate the utilization of modern contraceptive and associated factors among women in the reproductive age group in Shimelba refugee camp, Northern Ethiopia. A community-based cross-sectional study was employed and 329 study subjects were selected using simple random sampling technique with a face-to-face interview. The prevalence of using modern contraceptive was 47.7% and the study showed that being older [AOR = 0.017, 95%CI: 0.001, 0.467], being single [AOR = 0.17, 95%CI:0.031,0.914], being unemployed [AOR = 0.21, 95% CI:0.001,0.392], having no partner support [AOR = 0.006, 95% CI:0.001,0.044], and inconvenient service site AOR = 0.089,95% CI:0.013, 0.595] were factors that contributed to women not using modern contraceptive methods. Receipt of counseling on family planning utilization was more likely to helps women to use it [AOR = 3.37, 95% CI: 1.1095, 10.236]. Our study concluded that the current prevalence rate of contraceptive use is fairly good. However, much effort has to be made to improve this result. The situations in refugee can exacerbate the existing barriers to the use of contraceptives. Given its grave consequence on the livelihood of women, the contraceptive issue should be given due emphasis using several techniques including education to expand the awareness on modern contraceptive so as to augment access to family planning., Competing Interests: The authors have declared that no competing interests exist.

Background: Adolescents 360 (A360) is an initiative being rolled out across Ethiopia, Nigeria and Tanzania with the aim of increasing uptake of voluntary modern contraception among sexually active women aged 15 to 19 years. Using evaluation baseline survey data, we described key sexuality, fertility and contraceptive use characteristics of married women aged 15 to 19 years living in three sub-national settings., Methods: Cross-sectional baseline surveys of married women aged 15 to 19 years were conducted in Oromia (Ethiopia), Nasarawa (Northern Nigeria), and Mwanza (Tanzania) between August 2017 and February 2018. We also interviewed the husbands of a sub-group of married respondents to measure spousal acceptance and support for adolescent women to use modern contraception. A clustered sampling design was used in all three countries. We produced descriptive statistics on the socio-demographic and sexual and reproductive health characteristics of married women aged 15 to 19 years by study setting., Results: In Oromia, Nasarawa and Mwanza, 31.4% (327/1198), 27.4% (1321/4816) and 7.5% (15/201) of married women surveyed had no education, and 68.3, 81.3 and 83.1% had ever been pregnant, respectively. Unmet need for modern contraception was 20.5, 21.9 and 32.0% in married women in Oromia, Nasarawa and Mwanza, made up almost entirely of unmet need for spacing. The vast majority of married women surveyed in Oromia (89.1%) and Mwanza (90.1%) had seen or heard about contraception in the last 12 months, compared to 30.1% of those surveyed in Nasarawa. Modern contraceptive prevalence (mCPR) was highest in married women aged 15 to 19 years in Oromia (47.2%), followed by Mwanza (19.4%) and Nasarawa (8.7%). Of those using a modern method of contraception in Oromia, 93.4% were using injectables or long-acting methods, compared to 49.4% in Nasarawa and 69.6% in Mwanza., Conclusions: Overall, unmet need for modern contraception is high among married women aged 15 to 19 years across the three settings. mCPR for married women aged 15 to 19 years is low in Nasarawa and Mwanza. Ultimately, no single intervention will suit all situations, but improving the quality, analyses and utilisation of subnational data can help decision-makers design more context specific interventions.

Objective: This study is aimed at determining the prevalence and factors associated with utilization of long acting and permanent methods among married reproductive age (15-49) females at Janamora district, in 2018., Result: Prevalence of long acting and permanent contraceptive method utilization was 12.9% (95% confidence interval (CI) 10%, 15%).Of those utilizers, 96.8% use implants, 2.1% use female sterilization and 1.1% use Intrauterine Contraceptive Device. Women's occupation, student as compared to housewife (Adjusted odds ratio (AOR) = 3.12, 95% CI 1.05-9.29), a women whose husband was government employed as compared to merchant (AOR = 2.51, 95% CI 1.1-5.75), and women who had high knowledge as compared to poor knowledge (AOR = 4.20, 95% CI 1.32-13.39) were positively associated with utilization of long acting and permanent contraceptive method.

Background: Maintaining quality of care in family planning (FP) counselling in low-resource settings is challenging. Job aids can help providers give more accurate and client-specific advice but require a provider to use them effectively and consistently. Marie Stopes International (MSI) have designed the tablet-computer based Digital Counselling Application (DCA), which prompts structured, supportive, client-specific and unbiased FP counselling. We hypothesise that a systematic exploration of clients' fertility intentions, medical eligibility and preferences will increase their uptake of long acting and permanent methods of contraception (LAPMs)., Methods/design: We will conduct a two-armed, parallel, cluster randomised control trial across all MSI clinics (clusters) in Ethiopia (24) and Vietnam (11), randomising 18 clinics to the intervention group and 17 to the control group. Intervention providers will attend a two-day DCA-use training programme, and use DCA in their FP counselling sessions. Usual care providers will counsel clients as before. We aim to recruit 75 clients who have had FP counselling per clinic (2625 total), following them up via two telephone interviews, initially within 2 days and then at 4 months. The primary outcome is defined as the proportion of clients who report choosing a LAPM following FP counselling and will include switchers (FP counselling clients who switch from using any other FP method) and adopters (FP counselling clients who adopt any FP method having not previously been using one). We will also collect secondary outcomes at the initial follow-up (including the proportion of clients reporting being recommended a LAPM by a provider and a range of measures of client experience and satisfaction) and at the 4-month follow-up (including a range of measures of continuation rates for different FP method types). In the intervention arm, we will also conduct mixed-methods sampling to assess how providers use DCA (using an observational survey of provider-client interactions), and understand users' experiences of receiving and giving DCA-based FP counselling (through in-depth interviews)., Discussion: This trial will provide novel information on the feasibility and acceptability of health worker delivered FP counselling using DCA, with robust evidence on its effectiveness at increasing the uptake of LAPMs in low-resource settings., Trial Registration: ISRCTN, ISRCTN11040557 . Registered on 2 March 2017 (retrospectively registered).

Background: Despite the enormous benefits of family planning services, the contraceptive utilization still remains low in Sub-Saharan Africa. There is regional variation in modern contraceptive utilization in Ethiopia. Therefore, this study was aimed to determine the prevalence of modern contraceptive utilization and determinants in Dabat demographic and health surveillance system site, northwest Ethiopia., Methods: A re-census was carried out in Dabat Health and Demographic Surveillance System (HDSS) site from October to December 2014. Data of 8271 married women collected in the re-census was used. The outcome variable was current utilization of any modern contraceptive methods whereas socio demographic and economic variables were the potential determinants considered. Bi-variable and multivariable binary logistic regression along with odds ratio and 95% confidence interval were used to describe the strength of association., Results: Prevalence of modern contraceptive utilization among married women in Dabat DHSS site was found to be 32.5% (95%CI: 31.5, 33.5%). After adjusting for covariates; the odds of using modern contraceptive were 2.35 times, 1.91 times, and 1.39 times higher among women of secondary and above educational level, urban residents, and women having six and above living children, respectively., Conclusion: Modern contraceptive utilization was found to be very low. Effort has to be applied to improve women's educational level that increases their understanding of reproductive health issues. It is also important to give special emphasis for rural residents, those aged 20-40 years, and those with six or more living children while serving for modern contraceptive methods.

To investigate the effect of innovative means to distribute LARC on contraceptive use, we implemented a three arm, parallel groups, cluster randomized community trial design. The intervention consisted of placing trained community-based reproductive health nurses (CORN) within health centers or health posts. The nurses provided counseling to encourage women to use LARC and distributed all contraceptive methods. A total of 282 villages were randomly selected and assigned to a control arm (n = 94) or 1 of 2 treatment arms (n = 94 each). The treatment groups differed by where the new service providers were deployed, health post or health center. We calculated difference-in-difference (DID) estimates to assess program impacts on LARC use. After nine months of intervention, the use of LARC methods increased significantly by 72.3 percent, while the use of short acting methods declined by 19.6 percent. The proportion of women using LARC methods increased by 45.9 percent and 45.7 percent in the health post and health center based intervention arms, respectively. Compared to the control group, the DID estimates indicate that the use of LARC methods increased by 11.3 and 12.3 percentage points in the health post and health center based intervention arms. Given the low use of LARC methods in similar settings, deployment of contextually trained nurses at the grassroots level could substantially increase utilization of these methods., (© 2018 The Population Council, Inc.)

Background: Use of modern contraceptive methods reduces the risk of unwanted pregnancy, and is influenced by individual-level factors. Willingness to use modern contraceptive methods maybe a useful metric when considering health outcomes as it could predict health behaviors. Therefore, the current study aimed to assess the willingness of women to use modern contraceptives in Afar pastoralist communities., Methods: A community-based cross-sectional study was conducted from May 1 to 30, 2016. Three hundred forty-five women of childbearing age (15-49 years) were systematically sampled with proportionate allocation from seven randomly selected kebeles (neighborhoods) in Aballa District of Afar Region, Ethiopia. All women meeting the inclusion criteria in each selected household were interviewed at home using a semi-structured questionnaire. Construct validity was assured using factor analysis. A combination of individual behavioral models were applied in order to measure willingness to use modern contraceptive methods. Multiple logistic regressions were utilized to identify factors associated with willingness to use contraceptive at P-value of less than 0.05., Results: Three hundred twenty-two women participated in the study, for a response rate of 93.3%. The mean age of respondents was 27 (±6) years. About one-third (N = 106, 32.9%) of the participants reported that they were willing to use modern contraceptives. Orthodox Christians (AOR = 4.22, 95% CI 1.94-8.92), women aged 19 or older at first marriage (AOR = 2.89, 95% CI 1.16-7.23), and women who had never experienced a stillbirth (AOR = 3.85, 95%CI 1.37-10.78) were more likely to report being willing to use modern contraceptives. Additionally, perceived severity of an unwanted pregnancy (AOR = 1.71, 95% CI 1.57-1.93) and perceived self-efficacy to use contraceptives (AOR = 1.26, 95% CI 1.17-1.65) were positively associated with the willingness. Women who had never had an abortion were less likely to express willingness to use modern contraceptives (AOR = 0.41, 95% CI 0.19-0.92) and perceived importance of cultural and religious norms (AOR = 0.85, 95% CI 0.62-0.90) was also negatively associated with willingness., Conclusions: The majority of women in this study were not willing to use modern contraceptive methods. A previous pregnancy outcome of stillbirth was associated with reduced willingness, while a prior abortion was associated with increased willingness. Perceived severity of unwanted pregnancy and higher self-efficacy surrounding contraceptive use were strong predictors of increased willingness to use contraceptives. Religious and cultural norms also appear to influence perception towards modern contraception. Thus, involvement of cultural and religious leaders and consideration of a woman's reproductive history are recommended when designing health education messages on contraception for Afar pastoralist women., Competing Interests: The authors have declared that no competing interests exist.

Background: Family planning is the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. Providing family planning could prevent maternal deaths by allowing women to delay motherhood, space births, avoid unintended pregnancies and abortions, and stop childbearing when they reach their desired family size. Despite the fact that family planning is advantageous for maternal and newborn health and the services and commodities are free of charge, the reason of not using modern family planning methods is unclear in Bale Eco-Region. Therefore, this study assessed the contraceptive prevalence rate and its determinants among women in Bale Eco-Region, Ethiopia., Methods: A community-based cross-sectional study design (both quantitative and qualitative methods) was conducted from December 2016 to February 2017. Five hundred sixty-seven women were successfully interviewed using structured and pre-tested questionnaire. A multistage sampling technique was employed. Data were entered into Epi-data version 3.1 and exported to SPSS version 21. Logistic regression analyses were done and a significant association was declared at p-value less than 0.05. All focus group discussions and key informant interviews were recorded and analyzed thematically., Results: The overall contraceptive prevalence rate was 41.5%. Injectable (48.1%), implants (22.6%) and pills (20.0%) were the most contraceptive methods utilized by study participants. Spousal (husband's) opposition (38.8%), religious beliefs (17.7%), concern and fear of side effects (14.8%), and distance of family planning service (5.9%) were the reasons for not using contraceptive methods. Having more than seven deliveries (AOR = 2.98, CI = 1.91-6.10, P = 0.000) and having birth interval less than 24 months between the last two children (AOR = 3.8, CI = 13.41-21.61, P = 0.003) were significantly associated with utilization of contraceptive methods., Conclusion: Low contraceptive prevalence rate might be attributed by husband opposition, religious beliefs, concern and fear of side effects. Having more than seven deliveries and birth interval less than 24 months between the last two children were determinants of contraceptive use. Family planning consultation opportunities should be created to make male's involved and to increase their responsibility for family planning use.

We examined structural determinants of modern contraceptive use among Ethiopian women from the 2011 Ethiopia's Demographic and Health Survey. We selected a representative sample of 7490 non-pregnant and sexually active women between 15 and 49 years of age. Multivariate logistic regressions were fitted and effects of relevant demographic variables controlled. Only one-in-three women were current users of modern contraceptives. Modern contraceptive use enabling and inhibiting (barrier) environments were significant predictors of use. Exposure to family planning information regardless of the delivery method significantly associated with improved use. Women who visited a health clinic in the last 12 months increased their odds of using modern contraceptives by 54%. Distance and transportation constraints were identified as major barriers.

Introduction: In Ethiopia information on the level of utilization of the long term and permanent contraceptive methods and associated factorsis lacking. The aim of this study was to understand the determinant factors of long acting and permanent contraceptive methods use among married women of reproductive age in Western Ethiopia., Methods: A community based cross-sectional study design was employed. Multi stage sampling was used to select 1003 study participants. Data was collected from April 10 to April 25,2014 using a pre- tested structured questionnaire. The data were entered using Epi-info version 3.5.1 and exported to SPSS version 20 for analysis. Multivariate logistic regression analysis was done to identify predictors of long acting and permanent contraceptive methods at 95% CL., Results: Use of long acting and permanent contraceptive methods in this study was found to be 20%. Survey results showed a significant positive association between utilization of long acting and permanent contraceptive methods and women's education (AOR=1.72, 95%CI=1.02-3.05), women's occupation (AOR=2.01, 95% CI=1.11-3.58), number of live children (AOR=2.42, 95% CI: 1.46-4.02), joint fertility related decision (AOR=6.11, 95% CI: 2.29-16.30), having radio/TV (AOR=2.31, 95% CI: 1.40-3.80), and discussion with health care provider about long acting and permanent contraceptive methods (AOR=13.72, 95% CI: 8.37-22.47)., Conclusion: Efforts need to be aimed at women empowerment, health education, and encouraging open discussion of family planning by couples.

Background: In Ethiopia, the prevalence of modern contraceptive use is very low (27 %) and the percentage of those with unmet needs for family planning is 25 %. The current study identified factors associated with the utilization of modern contraceptive methods among married women in Western Ethiopia., Methods: A community based, cross-sectional study was employed from April 10 to April 25, 2014, among married women of reproductive age in Nekemte Town. A multi-stage sampling procedure was used to select 1003 study participants. A pretested structured questionnaire was used to collect data, and data collectors who had completed high school were involved in the data collection process. A bivariate, multivariable logistic regression model was fit, and statistical significance was determined with a 95% confidence level., Result: The overall utilization rate of modern contraceptives in this study was 71.9%. The most common form of modern contraceptives used was injectable (60.3%). Age (AOR = 2.00, 95 % CI = 1.35-2.98), women's educational level (AOR = 2.50, 95 % CI = 1.62-3.84), monthly income (AOR = 2.26, 95 % CI = 1.24-4.10), respondent's fertility (AOR = 2.60, 95 % CI = 1.48-4.56), fertility-related decision (AOR = 3.70, 95 % CI = 2.45-5.58), and having radio (AOR = 1.93, 95 % CI = 1.37-2.71) showed significant positive associations with the utilization of modern contraceptive methods., Conclusions: The findings showed that women's empowerment, fertility-related discussions among couples, and the availability of the media were important factors that influenced the use of modern contraceptives. Thus, policymakers and implementers should work on those factors to increase the utilization of modern contraceptive methods.

Background: Many countries continue to have high fertility rates and most of the predicted increase in the world's population until 2100 comes from these countries. Among family planning methods, Long Acting and Permanent Methods are convenient for users and effectively prevent pregnancy. The objective of this study was to assess factors associated with unmet need of Long Acting and Permanent Methods of contraception among women in the reproductive age group (15-49) using contraception in health facilities of Shashemene town, Oromia Region, Ethiopia., Methods: Facility based cross sectional quantitative study and stratified sampling technique was used. Total of 382 females in reproductive age group were enrolled in the study in January 2012. Pretested, structured and close-ended questionnaire was used to interview study participants. Collected data was entered by using EPI Info 17 and analyzed by SPSS version 20 statistical software., Results: Utilization of Long Acting and Permanent Methods (LAPMs) of contraception in Shashemene town was found to be 28.4% (104/366). From study participants, 71.6% (262/366) used short acting methods and from these current short acting users, 127(41.5%) desired to use LAPMs and unmet need of LAPMs was 122(33.3%). Factors significantly associated with unmet need of LAMPs of contraception were: Education of women (< secondary level) AOR [3.8, 95 % CI: 2.9, 7.6; P < 0.001]; lack of discussion between partners AOR [2.9, 95 % CI: 1.8, 9.6; P =  .01]; lack of proper counseling for women AOR [5.3, 95 % CI: 1.7, 11.2; P = 0.04]; and women's occupation as a housewife AOR [4.7, 95 % CI: 3.1, 11.3; P = 0.02]., Conclusion: Unmet need of LAPMs of contraception in health facilities in Shashemene town was high. Women education, partner discussion and proper client counseling were found the main factors associated women LAPMs utilization.

In rural Ethiopia, environmental degradation and a shortage of arable land impose a major toll on the population. Population, health, and environment (PHE) programs, such as that of the Ethio-Wetlands and Natural Resources Association (EWNRA), have evolved to address these issues. This article examines the community-based distribution (CBD) of family planning commodities in rural Ethiopia through EWNRA's large, multisectoral PHE program. Participants indicated that the integrated program encouraged acceptance of family planning and reduced geographic barriers to access. Through peer education and collaboration across government ministries, EWNRA leveraged integrated population-environment messages to garner support for its network of CBD providers. These integration strategies are a model for PHE programs worldwide, especially amid the global response to climate change. Because of the complex nature of PHE organizations, researchers often find it difficult to effectively document and evaluate their programs. With this in mind, we propose a framework to assess PHE integration., (© 2015 The Population Council, Inc.)

Background: Sexual and reproductive health communications are most likely promoting healthy sexual development and reduce sexual risks. Communication is the principal means for parents to transmit sexual values, beliefs, expectations and knowledge to their adolescents. However, there is a paucity of evidence about adolescent parent communication in Ethiopia. This study aimed to determine adolescent-parent communication on sexual and reproductive health issues and associated factors among high school students in Dire Dawa, Eastern Ethiopia., Methods: Institution based cross sectional study was conducted among high school students in Dire Dawa administrative council from February to March 2011. Simple random sampling technique was used to select 695 students from 9-12 grades. Qualitative data were collected through focus group discussion separately for female and male parents. Data were entered in Epi info version 3.5.1 and analyzed by SPSS version 16.1. Logistic regression with OR and 95% confidence interval was used to identify the independent predictors of adolescent parent communication., Results: Thirty seven percent of students had ever discussed on at least two sexual and reproductive health topics with their parents. Of which, majority of student preferred to discuss with their peers than parent. Condom use during first intercourse was associated with having communication about sexual and reproductive health [AOR=1.9, 95% CI: 1.0, 3.8]. Cultural taboo, shame and lack of communication skill were reasons that hinder communication between parent and adolescent about sexual matters., Conclusion: Communication on sexual and reproductive health issue between adolescent and their parent was low. School based education is important to improve adolescent parent communication about sexual and reproductive health issues.

Background: Ethiopia's population policy specifically aims to reduce TFR from 7.7 to 4.0 and to increase contraceptive use from 4.0% to 44.0% between 1990 and 2015. In 2011, the use of contraceptive methods increased seven-fold from 4.0% to 27%; and the TFR declined by 38% to 4.8. The use of modern contraceptives is, however, much higher in the capital Addis Ababa (56%) and other urban areas but very low in rural areas (23%) far below the national average (27%). In 2011, one in four Ethiopian women had an unmet need for contraception. The main aim of this study was to assess the pattern and examine the socioeconomic and demographic correlates of unintended childbirth among women 15-49 years in Ethiopia., Methods: Data from the 2011 nationally representative Ethiopia Demographic and Health Survey are used. It covered 16,515 women of which 7,759 had at least one birth and thus included for this study. Multivariate logistic regression is used to see the net effects of each explanatory variable over the outcome variable., Results: The study found that nearly one in three (32%) births was unintended; and about two-thirds of these were mistimed. The regression model shows that the burden of unintended births in Ethiopia falls more heavily on young, unmarried, higher wealth, high parity, and ethnic majority women and those with less than secondary education and with large household size. These variables showed statistical significance with the outcome variable., Conclusion: The study found a relatively high prevalence of unintended childbirth in Ethiopia and this implies high levels of unmet need for child spacing and limiting. There is much need for better targeted family planning programs and strategies to strengthen and improve access to contraceptive services, to raise educational levels, and related information and communication particularly for those affected groups including young, unmarried, multipara, and those with less than secondary level of education. Further quantitative and qualitative research on the consequences of unintended pregnancy and childbirth related to prenatal and perinatal outcomes are vital to document process of change in the problem overtime.

Background: Despite the increase in contraceptive use worldwide over the last decade, there is still discrepancy in the need to limit birth and utilization of modern contraceptives specifically long acting and permanent contraceptive methods in sub-Saharan Africa including Ethiopia. Intention to use long acting and permanent methods of contraception is an important indicator of the potential demand for family planning services., Objective: To assess intention to use long acting and permanent contraceptive methods (LAPMs) and identifying associated factors among currently married women in Adigrat town., Methods: A community based cross sectional study design complemented with a qualitative method was conducted in three selected Kebeles of Adigrat town. A total of 594 study subjects were interviewed. Systematic random sampling method was used to select study subjects. Quantitative data were analyzed using SPSS version 16. Open code software version 3.6.2.0 was used to facilitate coding of the qualitative data. Factors associated with intention were identified using logistic regression model and content analysis was done on the qualitative data., Results: Intention to use LAPMs was 48.4%. Intention to use LAPMs was higher among women who knew at least one of LAPMs (AOR = 4.7, 95% CI = 1.58, 14.01) and women who do not want to have birth within the next 2 years (AOR = 1.9, 95% CI = 1.22, 3.13). Intention to use LAMPs was less among women who perceive poor support from their husbands (AOR = 0.2, 95% CI = 0.09, 0.45) and those who perceive LAPMs are harmful for the womb (AOR = 0.24, 95% CI = 0.14, 0.41). Similarly, participants in the focus group discussion have expressed their concern on the return of fertility after using implants or IUCD as well as insertion and removal procedures., Conclusions: The magnitude of intention to use LAPMs in the study area was low. The main limiting factors were fear of side effect, infertility after LAPMs use, knowledge on LAPMs and perception on partner's support of LAPMs use. To further promote the use of LAPMs addressing associated misconceptions through effective communication strategies and involving spouses in family planning programs is essential.