Rural women are more likely to use long acting contraceptive in Tigray region, Northern Ethiopia: a comparative community-based cross sectional study.
BACKGROUND
In the latest report of Ethiopian Demographic and Health Survey (EDHS) 2011, the maternal mortality ratio (MMR) was estimated at 676/100,000 live births, with total fertility rate at 4.8 and contraceptive prevalence rate at 29 %. Knowledge and utilization of long acting contraceptive in the Tigray region are low. This study aims at comparing and identifying factors related to the utilization of long acting contraceptive in urban versus rural settings of Ethiopia.


METHODS
A comparative community-based cross-sectional study, comprised of quantitative and qualitative methods, was conducted among 1035 married women in Wukro (urban area) and Kilteawlaelo district (rural area) in March, 2013. Stratified sampling technique was employed to approach the study participants. Data were analyzed using SPSS version 20. Multiple logistic regression analysis was used to identify the respective effect of independent predictors on utilization of long acting contraceptive.


RESULTS
The proportion of long acting contraceptive use among the respondents was 19.9 % in the town of Wukro and 37.8 % in the district of Kilteawlaelo. Implanon was the most common type of contraceptive used in both districts, urban (75 %) and rural (94 %). The odds of using the long acting contraceptive method were three times higher among married women in the rural areas as compared with the urban women [AOR = 3. 30; 95 %, CI:2.17, 5.04]. No or limited support from male partners was an obstacle to using long acting contraceptive method [AOR = 0. 24, 95 of CI: 0.13, 0.44]. Moreover, married women whose partner did not permit them to use long acting contraceptive [AOR = 0. 47, 95 % of CI: 0.24, 0.92] and women who attended primary education [AOR = 0.24, 95 %, CI: 0.13, 0.44] were significantly associated with long acting contraceptive use.


CONCLUSIONS
Overall, the proportion of long acting contraceptive use has found to be low. Rural women were more likely to use long acting contraceptives as compared to urban women. Moreover, educational status and the partner's permission to use contraception could influence the utilization of long acting contraceptives.
Department of Public Health, Mekelle University, College of Health Sciences, Mekelle, Ethiopia. mossalex75@gmail.com.|JSI/L10K, Tigray region branch, Tigray, Ethiopia. mossalex75@gmail.com.|School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. mossalex75@gmail.com.
Mussie
M
Alemayehu
JSI/L10K, Tigray region branch, Tigray, Ethiopia. asterkalayu@yahoo.com.
Aster
A
Kalayu
Department of Public Health, Mekelle University, College of Health Sciences, Mekelle, Ethiopia. wuneha@gmail.com.
Alem
A
Desta
School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. hagept@yahoo.com.
Hailay
H
Gebremichael
School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. tesfalemhm2003@yahoo.com.
Tesfalem
T
Hagos
Department of Public Health, Mekelle University, College of Health Sciences, Mekelle, Ethiopia. henokyebyo@yahoo.com.
Henock
H
Yebyo
D000328:Adult; D002755:Choice Behavior; D016001:Confidence Intervals; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008393:Marriage / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
D003271:Contraceptive Agents, Female