Background By spacing births and preventing unintended pregnancies, family planning is a crucial technique strategy for controlling the fast expansion of the human population. It also improves maternal and child health. women who are thought to be sexually active but who do not use modern contraception methods, who either do not want to have any more children (Limiting) or who want to delay having children for at least two years are considered to have an unmet need for family planning (Spacing). Objective This study carried out to determine which socio-demographic factors are the key contributors to the discrepancies in the unmet need for family planning among women of reproductive age between surveys years 2005 and 2016. Methods The data for this study arrived from the Ethiopia Demographic Health Surveys in 2005, 2011, and 2016 to investigate trends and Predictors of change of unmet need for family planning among reproductive age women in Ethiopia. Pooled weighted sample of 26,230 (7761 in 2005, 9136 in 2011 and 9,333 in 2016 Ethiopian demographic health surveys) reproductive-age women were used for this study. For the overall trend (2005-2016) multivariable decomposition analysis for non-linear response outcome was calibrated to identify the factors that contributed to the change of unmet need for family planning. The Logit based multivariable decomposition analysis utilizes the output from the logistic regression model to assign the observed change in unmet need for family planning over time into two components. Stata version 16.0 was used to analyze the data. Result The percentage of Ethiopian women of reproductive age who still lack access (unmet need) for family planning declined from 39.6% in 2005 to 23.6 percent in 2016. The decomposition analysis revealed that the change of unmet need for family planning was due to change in characteristics and coefficients. The difference in coefficients accounted for around nine out of 10 variations in unmet family planning need. Education level, birth order, and desired number of children were all factors that changed over the course of the last 11 years in relation to the unmet need for family planning. Conclusion Between 2005 and 2016, there were remarkable changes in unmet need for family planning. Women with birth orders of five and up, women with secondary education, and women who wanted fewer children overall were the main causes of the change in unmet need for family planning.
Using dataset of 2005, 2011, and 2016 Ethiopian Demographic Health Surveys (EDHS), this study looked at trends and predictors of change in the unmet demand for family planning among Ethiopian women of reproductive age. Those surveys were conducted using cross sectional study design and through the application of a two-stage cluster sampling method. In the first stage, 540 Enumeration Areas (EAs) in EDHS 2005, 624 EAs for EDHS 2011, and 645 EAs in EDHS 2016 were randomly selected proportional to their EA size and in the second stage, on average 27 to 32 households from each containing EA were selected. For this study, a pooled weighted sample of 26,230 (7,761 in EDHS 2005, 9,136 in EDHS 2011 and 9,333 in EDHS 2016) reproductive-age women were utilized. The detailed information about sampling procedures of the survey is presented at each EDHS report [19, 20]. The outcome variable is an unmet need for FP, which is composed of an unmet need for spacing and limiting. Unmet need refers to the proportion of women who desired to either delay the current or next pregnancy or limit future pregnancies but not using any method of the modern contraception [21]. The outcome variable was categorized as “unmet need” if women had unmet need either for spacing or for limiting purpose were coded as 1, while those using FP methods for spacing or limiting or with no unmet need were “met need” coded as 0. The independent variables included in this study were: respondent’s age, respondent’s educational status, religion, husband’s education status, marital status, place of residence, women working status, husband working status, wealth status, media exposure, termination of pregnancy, knowledge about family planning, visited health facility last 12 months, visited by field workers in the last 12 months, perceived distance to health facility, age at first marriage, birth order, sex of household head, region and desired number of children. Knowledge about family planning. According to EDHS, having good knowledge to FP is defined as, Percentage of all respondents, currently married respondents, and sexually active unmarried respondents aged 15–49 who have heard of any contraceptive method, according to specific method. Important variables were extracted from the Individual Record (IR) dataset. Sample of each DHS were weighted using the “svyset” STATA command and it was applied for each descriptive analyses. The weight variable (v005), primary sampling unit (v021), and strata (v023) are the variables required to develop the “svyset” command. Trend and decomposition analysis of the unmet need for family planning was done. The trend analysis has been done by separating based on period as (2005–20011), (2011–2016) and the overall trend (2005–2016). For the overall trend (2005–2016) multivariable decomposition analysis for non-linear response outcome was calibrated to identify the factors that contributed to the change of unmet need for family planning across the two surveys. For our study, Logit based decomposition analysis was employed. The Logit based multivariable decomposition analysis utilizes the output from the logistic regression model to assign the observed change in unmet need for family planning over time into components. For our study, the 2016 EDHS data was appended to the 2005 EDHS data using the “append” Stata command, and the Logit based multivariable decomposition analysis (using mvdcmp STATA command) was used to identify factors that contributed to the change in unmet need for family planning over the last 11 years. The change in unmet need for family planning can be explained by the compositional difference between surveys (i.e. differences in characteristics) and/or the difference in effects of explanatory variables (i.e. differences in the coefficients) between the surveys. Hence, the observed decrease in unmet need over time is additively decomposed into a compositional difference of respondents of each survey (endowments) component and a coefficient (or effects of characteristics) component. For logistic regression, the Logit or log-odd of unmet need for family planning is taken as: [22] X indicates independent variables (unmet need for FP in this study) β denotes that, the regression coefficient of each selected contributing variables The E component refers to the part of the differential owing to differences in endowments or characteristics. The C component refers to that part of the differential attributable to differences in coefficients or effects. Authors have requested DHS Program through an online request by written letter of objective and significance of the study. Permission for data access was granted to download and use the data from http://www.dhsprogram.com. The EDHS programs permitted data access, and data were used for only the current study.