Contraceptive use and its determinants among adolescent women in Tigray, Ethiopia: a multilevel modeling

Haftom Temesgen Abebe; Abate Bekelle Belachew; Letekirstos Gebreegziabher Gebretsadik; Yodit Zewdie Berhe; Haftu Berhe Gebru; Alemayohu Bayray Kahsay; Atkilt Girma Gebrekidan

doi:10.1515/ijamh-2020-0107

Article

Contraceptive use and its determinants among adolescent women in Tigray, Ethiopia: a multilevel modeling

Haftom Temesgen Abebe , Abate Bekelle Belachew , Letekirstos Gebreegziabher Gebretsadik , Yodit Zewdie Berhe , Haftu Berhe Gebru , Alemayohu Bayray Kahsay and Atkilt Girma Gebrekidan

Published/Copyright: September 2, 2020

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From the journal International Journal of Adolescent Medicine and Health Volume 34 Issue 5

Abstract

Background

Adolescent women are central for intergenerational health of human populations. Adolescent women are the most vulnerable to a range of reproductive health problems. One of the leading causes of death for adolescent women is complications from childbirth and pregnancy. Contraceptive prevents the occurrence of unwanted pregnancies and its complications, thus potentially lower the death rate for adolescent women. However, contraceptive use assumed to be affected by multilevel factors thus needs statistical modeling that account the effect of these factors. Understanding multilevel factors affecting contraceptive use among adolescent women is important for improving the access to and quality of health services.

Objective

The aim of this study was to assess the contraceptive use and its multilevel determinants among adolescent women in Tigray region.

Methods

A community based cross-sectional study was conducted. Women who were 15–19 years of age residing in the selected households at the time of data collection were included in the survey. Multi-stage cluster sampling was used to select study units. A multivariable two-level mixed effect binary logistic regression model was fitted to assess the effect of the explanatory variables on contraceptive use.

Results

A total of 1,755 adolescent women were participated. Of these 12.3% were contraceptive users. Pills (40%) and intrauterine device (30%) were commonly used contraceptive methods. Educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media were the most important determinants for use of contraceptive among adolescent women. Study participants who were not at school currently had more likely to use contraceptive methods compared to those who were at school (Adjusted odds ratio [AOR]=2.05; 95% confidence interval [CI]: 1.502, 4.183). Similarly, adolescent women who had no history of health facility visit had less likely to use contraceptive methods than those have history of health facility visit (AOR=0.057; 95% CI: 0.034, 0.096). Adolescent women who heard of contraceptive through median had two times (AOR=2.103; 95% CI: 1.207, 3.664) more likely to use contraceptive methods than those not heard contraceptive through media.

Conclusion and recommendation

The factors affecting use of contraceptive method among adolescent women were educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media. This study recommends that in order to increase use of contraceptive method among adolescent women, interventions should continue like the promotion of contraceptive methods through media.

Keywords: adolescent women; mixed effect logistic regression model; multilevel determinants

Corresponding author: Haftom Temesgen Abebe, Department of Biostatistics, Mekelle University College of Health Sciences, Mekelle, 1871, Tigray, Ethiopia, E-mail: haftoma@gmail.com

Research funding: None declared.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Competing interests: The authors declare no conflicts of interest regarding this article.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: Ethical clearance was obtained from Institutional Review Board of Mekelle University, College of Health Science.

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Received: 2020-05-07

Accepted: 2020-07-28

Published Online: 2020-09-02

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Articles in the same Issue

https://doi.org/10.1515/ijamh-2020-0107

Keywords for this article

adolescent women; mixed effect logistic regression model; multilevel determinants