Modern Contraceptive Use Behavior among Young Married Women in Urban Settings of Ethiopia: A Multilevel Analysis

Abstract

Abstract Background Based on the Ethiopia Demographic and Health Survey, there has been low contraceptive utilization among young married women in Ethiopia, as well as unmet needs. This situation has had adverse consequences on the reproductive health outcomes of young women. Thus, this study was conducted to identify main determinants of young women’s contraceptive use in selected urban cities of Ethiopia. The findings of this study informed the design strategies to increase young women’s contraceptive use. Methods A dataset consisting of 680 young married women aged between 18 and 29 years was extracted from a secondary source and analyzed using STATA version 18 from a cross-sectional study, which was conducted from December 12, 2021 to January 21, 2022, in 13 selected urban cities. A multilevel logistic regression modeling techniques was used to identify the determinants of contraceptives (individual-level factors) and control for variations caused by differences between cities. Results Four hundred one (59% CI: 0.55–0.63) young women used contraceptives at the time of data collection. The most common contraceptive methods were injectables (42%) and implants (35%). High contraceptive use variability was observed across cities. About 16% variability of contraceptive use was observed at the intercept model analysis without factors and a 13% variability in contraceptive use across cities at the final model of multilevel analysis. The lowest contraceptive use was observed in Jigjiga (10%, CI = 0.03–0.24) and the highest was in Hawassa (81%, CI = 0.70–0.89). The analysis result indicated that individual-level variables such as young women who had more than two family members (AOR = 3.3, 95% CI = 2.04–5.27), who had knowledge of contraceptive methods (AOR = 2.6, 95% CI = 1.43–4.83) and who had radio exposure (AOR = 1.6, 95% CI = 1.13–2.32) were significantly associated with their contraceptive use behavior. Conclusion The study shows higher levels of contraceptive use among young women in the selected cities as compared with the national target of 50% for 2024/25. Increasing radio listenership about contraceptive use, supported by other interventions that enhance comprehensive knowledge can be an effective strategy to improve contraceptive use among young married women in cities.