Multilevel analysis on magnitude and factors associated with unmet need for family planning among reproductive age women in world poorest countries: Further analysis of recent demographic health survey data

Abstract

Abstract Background Unmet need for family planning is the contributor and devastating issue of maternal health. Meting the unmet need of contraceptive averts the maternal and newborn death. Unmet need for family planning is one factor for low improvement of maternal health and contribute to high population growth especially in Africa. Therefore, describing prevalence of unmet need and its determinants is very important to intervene and design appropriate program umbrella. Objective To describe the factors associated with unmet need for family planning among reproductive age women in poorest world countries. Method This study analyzed secondary data from Demographic and Health Surveys of which contained detailed family planning for all interviewed women aged 15 to 49 years. The variables of the study were extracted from women’s individual record (IR) data set using STATA version 15. The data were weighted using sampling weight before any statistical analysis to account the sampling design. STATA version 15 was used for editing, recoding, exploratory and multivariable analysis. Appropriateness of multilevel analysis were done and null model, model with individual variable, model with community level variable and model with both individual and community level variable were built. Both bivariable and multivariable multilevel analysis was done. Variable with p-value < 0.25 were selected for multivariable multilevel logistic regression analysis. Variables with p-value ≤ 5% declared as statistical significant with outcome variable. Results The magnitude of unmet need among reproductive age women in poorest countries were 27.55% (95% CI 23.44, 28.9). Factors associated with unmet need family which was identified in this study were women age group of 25–35 years [AOR = 0.89; 95% CI 0.85–0.94], women’s in age group of > = 36[AOR = 1.14; 95% CI 1.07,1.22], women’s residing in Urban area [AOR = 0.85; 95% CI 0.8,0.91], and households lead by female [AOR = 1.26; 95% CI 1.2, 1.32] were the determinants of unmet need for family planning. Conclusion Unmet need for family planning contributes for unintended pregnancy and unsafe abortion that finally results maternal mortality. In the current study, unmet need for family planning were high. Living in rural, divorced or widowed or separated, maternal age 25–35 year, maternal educational status primary and above, women who had any work, exposure on FP in newspaper, media exposure, intention to use family planning were the protective factors. Whereas age of women greater than 35, women currently working, female headed household, desire of child, husbands desire for a child were the risk factors for unmet need for family planning. Factor specific with considering the same socioeconomic status of the country should be consider to design the policies and programs.