WOMEN’S CONTRACEPTIVE USE, FERTILITY INTENTION, AND ASSOCIATED FACTORS: EVIDENCE FROM HEALTH AND DEMOGRAPHIC SURVEILLANCE SYSTEM, EASTERN ETHIOPIA

Background: Improving maternal health condition is a critical global health concern. Optimizing pregnancy through contractive is a crucial intervention to improve maternal and reproductive health, which help to reduce maternal mortality. But 222 million women who want to avoid pregnancy are not using contraceptives in developing countries. The research evidence has indicated that unmet need for modern contraceptive contributed to more than 80% of unintended pregnancies  The main purpose of this study was to assess women’s contraceptive use and fertility intention, and the associated factors in eastern Ethiopia.

Methods: We used a community-based cross-sectional study data which was conducted at Harar Urban Health Demographic Surveillance System (HDSS) among 2,072 women (aged 15-49 years) in Harar city, eastern Ethiopia from September 1, 2015 to February 2, 2016. Data were extracted from the HDSS database by the data manager, and recorded in Microsoft Excel©(2013) sheet. Then recorded raw data were exported into SPSS version 23.0 for analysis. Descriptive, binary and multiple logistic regression analysis were carried-out. A statistical association was declared using adjusted odds ratio at 95% confidence interval and p values <0.05.

Results: Almost all (99.5%) of the women have ever heard about family planning methods. Health professionals (62.1%) were the main source of information about the family planning methods. The women who had ever used contraceptive and who were using currently (during study period) were 89.4% and 73.0%, respectively. Injectable method (52.3%) was the most popular method, followed by pills (24.8%). Implanon, Intrauterine Contraceptive Device and surgical methods were used 15.5%, 2.1% and 0.2%, respectively. Forty seven percent of the women had no desire to have a baby in the next two years. Nevertheless, eight percent of them did not have access for contraceptives. The women’s age ranged 30-39 years (AOR=0.49), women’s age ranged from 40-49 years (AOR=0.25), women unable to read and write (AOR=0.64), women who had >2 deliveries (AOR=3.70), women who had >2 alive children (AOR=0.28) had significant association with their contraceptive use. Also, women’s age ranged 30-39 years (AOR=0.68), women’s age ranged from 40-49 years (AOR=0.24), women who had no alive children (AOR=5.42) and had <2 alive children (AOR=2.42) were associated with women’s fertility intention.

Conclusion: The women’s contraceptive use and an intention not to have a baby were very high. But significant portion of the women who have lived in the cities had no access for contraceptives. Age, educational status, and having alive children were the factors associated with women’s contraceptive use and fertility intention. Therefore, we recommend that concerned stakeholders focus on the associated factors to address the contraceptive use and realize the women’s fertility intention. In addition, the factors that affect women’s access to contraceptive in the urban area should be researched for further action to be taken.

Keywords: Contraceptive Use, Fertility Intention, Associated factors Harar, Eastern Ethiopia