The Level of Unmet Need for Family Planning and Its Predictors among HIV-Positive Women in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Background. Studies indicated that the need for family planning appears to be greater for human immuno-deficiency virus- (HIV-) positive women than the general population to reduce the risk of pediatrics HIV infection and related consequences of unintended pregnancy. We aimed to assess the level of unmet need for family planning and its predictors among HIV-positive women in Ethiopia. Methods. Online databases such as PubMed, SCOPUS, EMBASE, HINARI, Google Scholar, and digital libraries of universities were used to search for studies to be included in this systematic review and meta-analysis. Quality assessment of included studies was conducted using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data were extracted using the format prepared on Excel workbook and analyzed by the Stata 11 software. Cochran ( $Q$ test) and $I^2$ test statistics were used to assess the heterogeneity of studies. Similarly, the funnel plot and Egger’s regression asymmetry test were used to assess publication bias. Result. This systematic review and meta-analysis was conducted using nine primary studies with a total of 6,154 participants. The pooled prevalence of unmet need for family planning among HIV-positive women was found to be 25.72% (95% CI: 21.63%, 29.81%). Participants age 15-24 years (( $\text{OR}=3.12$ ; 95% CI: 1.59, 6.11) $I^2=27.5$ %; $p=0.252$ ), being illiterate (( $\text{OR}=2.69$ ; 95% CI: 1.69, 4.26) $I^2=0.0\%$ ; $p=0.899$ ), failure to discuss FP with partner (( $\text{OR}=3.38$ ; 95% CI: 2.20, 5.18) $I^2=0.0$ %; $p=0.861$ ), and no access to family planning information (( $\text{OR}=4.70$ ; 95% CI: 2.83, 7.81) $I^2=0.0$ %; $p=0.993$ ) were found to be a significant predictors of unmet need for family planning among HIV-positive women. Conclusion. The level of unmet need for family planning among HIV-positive women was found to be high in Ethiopia. Being young age, illiteracy, failed to discuss family planning issues with a partner, and no access to family planning information were found to be the significant predictors of unmet need for family planning among HIV-positive women in Ethiopia. Improving information access and encouraging partners’ involvement in family planning counseling and services could reduce the level of unmet need for family planning.