Spatial patterns and predictors of unintended pregnancy among reproductive age women in Ethiopia

Unintended pregnancy is amajor sexual and reproductive health problem that imposes substantial health, economical and psychosocial costs to individuals and society as well as significant emotional distress to women, families, and society. The main aim of this study was to investigate the spatial distribution and predictors of unintended pregnancy in Ethiopian regions and administrative zones.

This study was conducted based on data from 2016 Ethiopian Demographic and Health Survey. The prevalence of unintended pregnancy across regions and or zones was assessed using spatial analysis, and the effect of different factors on unintended pregnancy in Ethiopia was investigated using a generalized linear mixed model with a multistage clustered sampling strategy. The crude and best linear unbiased predictor estimations of zones were integrated with the shape file data to demonstrate the performance of each zone on maps.

The prevalence of unintended pregnancy for reproductive women in Ethiopia was29.49%. The highest rates of unintended pregnancy were recorded in the North Gondar zone of the Amhara region and the Jima zone in the Oromiya region. The mixed effects model revealed that age [AOR = 0.78, 95% CI, 0.62-0.97], residence [AOR = 2.62, 95%CI, 1.94, 7.27], marital status [AOR = 0.05, 95%CI, 0.01-0.38], women education [AOR = 1.34, 95%CI, 0.75-2.39], smoking cigarettes [AOR = 3.67, 95CI, 1.17-11.56], and poorer wealth index [AOR = 1.89, 95% CI, 1.51-2.31] were significantly associated with unintended pregnancy.

In Ethiopia, unintended pregnancy is a public health issue, and prevention stratagem for unintended pregnancy among reproductive women need to be focused based on the identified predictors. The spatial distribution of unintended pregnancy varied greatly at zonal and regional levels in Ethiopia. Hence, we recommended that, creating awareness of sexual and reproductive health with special priority to the identified hotspot areas (Amhara, Oromiya and SNN regions) to reduce unintended pregnancy. Emphasis on fertility and contraceptive techniques should be given to couples by health professionals.