PDF(Pubmed)
Abstract：
BACKGROUND: Women\'s decision-making autonomy has a positive effect on the scale-up of contraceptive use. In Ethiopia, evidence regarding women\'s decision-making autonomy on contraceptive use and associated factors is limited and inconclusive. Therefore, this study was intended to assess married women\'s decision-making autonomy on contraceptive use and associated factors in Ethiopia using a multilevel logistic regression model.
METHODS: The study used data from the 2016 Ethiopia Demographic and Health Survey that comprised of a weighted sample of 3668 married reproductive age women (15-49 years) currently using contraceptives. A multilevel logistic regression model was fitted to identify factors affecting married women\'s decision-making autonomy on contraceptive use. Akaike\'s information criterion was used to select the best-fitted model.
RESULTS: Overall, 21.6% (95% confidence interval = 20.3%-22.9%) of women had decision-making autonomy on contraceptive use. Community exposure to family planning messages (adjusted odds ratio = 2.22, 95% confidence interval = 1.67-3.05), media exposure (adjusted odds ratio = 2.13, 95% confidence interval = 1.52-3.23), age from 35 to 49 years (adjusted odds ratio = 2.09, 95% confidence interval = 1.36-4.69), living in the richer households (adjusted odds ratio = 1.67, 95% confidence interval = 1.32-3.11), and visiting health facility (adjusted odds ratio = 2.01, 95% confidence interval = 1.34-3.87) were positively associated with women\'s decision-making autonomy on contraceptive use. On the contrary, being Muslim (adjusted odds ratio = 0.53, 95% confidence interval = 0.29-0.95), being married before the age of 18 years (adjusted odds ratio = 0.33, 95% confidence interval = 0.12-0.92), and residing in rural residence (adjusted odds ratio = 0.48, 95% confidence interval = 0.23-0.87) were negatively associated with women\'s independent decision on contraceptive use.
CONCLUSIONS: Less than one-fourth of married reproductive age women in Ethiopia had the decision-making autonomy on contraceptive use. Media exposure, women\'s age, household wealth, religion, age at marriage, visiting health facilities, community exposure to family planning messages, and residence were the factors associated with women\'s decision-making autonomy on contraceptive use. The government should promote women\'s autonomy on contraceptive use as an essential component of sexual and reproductive health rights through mass media, with particular attention for adolescent women, women living in households with poor wealth, and those residing in rural settings.
METHODS: The study used data from the 2016 Ethiopia Demographic and Health Survey that comprised of a weighted sample of 3668 married reproductive age women (15-49 years) currently using contraceptives. A multilevel logistic regression model was fitted to identify factors affecting married women\'s decision-making autonomy on contraceptive use. Akaike\'s information criterion was used to select the best-fitted model.
RESULTS: Overall, 21.6% (95% confidence interval = 20.3%-22.9%) of women had decision-making autonomy on contraceptive use. Community exposure to family planning messages (adjusted odds ratio = 2.22, 95% confidence interval = 1.67-3.05), media exposure (adjusted odds ratio = 2.13, 95% confidence interval = 1.52-3.23), age from 35 to 49 years (adjusted odds ratio = 2.09, 95% confidence interval = 1.36-4.69), living in the richer households (adjusted odds ratio = 1.67, 95% confidence interval = 1.32-3.11), and visiting health facility (adjusted odds ratio = 2.01, 95% confidence interval = 1.34-3.87) were positively associated with women\'s decision-making autonomy on contraceptive use. On the contrary, being Muslim (adjusted odds ratio = 0.53, 95% confidence interval = 0.29-0.95), being married before the age of 18 years (adjusted odds ratio = 0.33, 95% confidence interval = 0.12-0.92), and residing in rural residence (adjusted odds ratio = 0.48, 95% confidence interval = 0.23-0.87) were negatively associated with women\'s independent decision on contraceptive use.
CONCLUSIONS: Less than one-fourth of married reproductive age women in Ethiopia had the decision-making autonomy on contraceptive use. Media exposure, women\'s age, household wealth, religion, age at marriage, visiting health facilities, community exposure to family planning messages, and residence were the factors associated with women\'s decision-making autonomy on contraceptive use. The government should promote women\'s autonomy on contraceptive use as an essential component of sexual and reproductive health rights through mass media, with particular attention for adolescent women, women living in households with poor wealth, and those residing in rural settings.
摘要：
背景：妇女的决策自主权对避孕药具使用的扩大具有积极作用。在埃塞俄比亚,关于妇女在避孕药具使用和相关因素方面的决策自主权的证据是有限且无定论的。因此,本研究旨在使用多水平逻辑回归模型评估埃塞俄比亚已婚妇女在避孕药具使用方面的自主决策及相关因素.
方法：该研究使用了2016年埃塞俄比亚人口与健康调查的数据，该调查包括目前使用避孕药具的3668名已婚育龄妇女（15-49岁）的加权样本。采用多水平logistic回归模型来确定影响已婚妇女避孕药具使用自主决策的因素。使用Akaike的信息准则选择最佳拟合模型。
结果：总体而言，21.6％（95％置信区间=20.3％-22.9％）的妇女对避孕药具的使用具有决策自主权。社区接触计划生育信息(调整后比值比=2.22，95%置信区间=1.67-3.05)，媒体曝光(调整后的赔率比=2.13，95%置信区间=1.52-3.23)，年龄从35岁到49岁(调整后优势比=2.09，95%置信区间=1.36-4.69)，生活在富裕家庭(调整后的优势比=1.67，95%置信区间=1.32-3.11)，和就诊医疗机构(调整后的比值比=2.01,95%置信区间=1.34-3.87)与女性使用避孕药具的自主决策呈正相关.相反,作为穆斯林(调整后的赔率比=0.53，95%置信区间=0.29-0.95)，在18岁之前结婚(调整后的赔率比=0.33，95%置信区间=0.12-0.92)，和居住在农村地区（调整后的比值比=0.48，95％置信区间=0.23-0.87）与妇女对避孕药具使用的独立决定呈负相关。
结论：在埃塞俄比亚，不到四分之一的已婚育龄妇女在使用避孕药具方面拥有自主决策。媒体曝光，女人的年龄,家庭财富,宗教,结婚年龄,参观卫生机构，社区接触计划生育信息，和居住地是与女性避孕药具使用自主决策相关的因素。政府应通过大众媒体促进妇女在使用避孕药具方面的自主权，将其作为性健康和生殖健康权利的重要组成部分，特别关注青春期女性，生活在贫富家庭中的妇女，以及居住在农村地区的人。
方法：该研究使用了2016年埃塞俄比亚人口与健康调查的数据，该调查包括目前使用避孕药具的3668名已婚育龄妇女（15-49岁）的加权样本。采用多水平logistic回归模型来确定影响已婚妇女避孕药具使用自主决策的因素。使用Akaike的信息准则选择最佳拟合模型。
结果：总体而言，21.6％（95％置信区间=20.3％-22.9％）的妇女对避孕药具的使用具有决策自主权。社区接触计划生育信息(调整后比值比=2.22，95%置信区间=1.67-3.05)，媒体曝光(调整后的赔率比=2.13，95%置信区间=1.52-3.23)，年龄从35岁到49岁(调整后优势比=2.09，95%置信区间=1.36-4.69)，生活在富裕家庭(调整后的优势比=1.67，95%置信区间=1.32-3.11)，和就诊医疗机构(调整后的比值比=2.01,95%置信区间=1.34-3.87)与女性使用避孕药具的自主决策呈正相关.相反,作为穆斯林(调整后的赔率比=0.53，95%置信区间=0.29-0.95)，在18岁之前结婚(调整后的赔率比=0.33，95%置信区间=0.12-0.92)，和居住在农村地区（调整后的比值比=0.48，95％置信区间=0.23-0.87）与妇女对避孕药具使用的独立决定呈负相关。
结论：在埃塞俄比亚，不到四分之一的已婚育龄妇女在使用避孕药具方面拥有自主决策。媒体曝光，女人的年龄,家庭财富,宗教,结婚年龄,参观卫生机构，社区接触计划生育信息，和居住地是与女性避孕药具使用自主决策相关的因素。政府应通过大众媒体促进妇女在使用避孕药具方面的自主权，将其作为性健康和生殖健康权利的重要组成部分，特别关注青春期女性，生活在贫富家庭中的妇女，以及居住在农村地区的人。
