Prevalence and determinants of modern contraceptive utilization among women in the reproductive age group in Edaga-hamus Town, Eastern zone, Tigray region, Ethiopia, June 2017

Introduction All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their child. However, In Ethiopia, the prevalence of contraceptive utilization remains low and it varies in different regions. Therefore, this study was aimed to determine prevalence and determinant factors affecting the utilization of modern contraception in the reproductive age group (15–49 years) in Edaga-Hamus Town. Methodology A community based Cross-Sectional study was carried out on April 23 to May 10, 2017. A systemic random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. The data were entered into EPI-info version 7.1 and imported to SPSS version 20. Summary statistics and logistic regression analysis were performed using SPSS version 20. Those variables having a P-value of less than 0.2 in the bivariable analysis were fitted in multivariable analysis. AOR with 95% CI and P-value<0.05 were used during multivariable analysis to identify the factors associated with the utilization of modern in reproductive. Result In this study the overall prevalence of modern contraceptive utilization was 58.5%. Age (AOR = 0.406,95%,Cl: (0.000,0.398)), Educational status (AOR = 0.901,95% Cl (0.340,4.107)), Feeling of husband towards Modern contraceptive (AOR = 0.186, 95% CI (0.056,0.617) had protective effect of utilization of modern contraceptive. But Number of children 1–3 and 4–5 wanted(AOR = 10.802,95%(4.027,28.975)), AOR = 2.624,95% CI (1.437,4.791), was a risk for utilization of modern contraceptive. Conclusion and recommendation The prevalence of Modern contraceptive utilization was still to be low (far below the national target). Therefore, providing educational opportunities, creating awareness about contraception and effective counseling would increase modern contraceptive methods utilization.

The authors have declared that no competing interests exist. NO

Abstract
Introduction: Although the family planning services are available in most places, the national, as well as the regional CPR, is still low, besides, there is an insufficient distribution of modern contraception and wide range of modern contraceptive choice is also lacking to meet the demand of clients. Factors found to be associated with the utilization of contraceptives vary.
Objectives: This stud aimed to identify prevalence and determinant factors affecting the utilization of modern in reproductive age group  in Edaga hamus town.
Methodology: Community-based cross-sectional quantitative study design was conducted in Edaga-hamus town from April 13-29, 2017. The participants of the study were selected by systemic random sampling. A total of 383 participants were interviewed by using interviewers administered structured questionnaires. The data were entered into EPI-info version 7.1 and imported to SPSS version 20. Summary statistics and logistic regression analysis were performed using SPSS version 20.
Those variables having P-value less than 0.2 in the bivariable analysis was fitted in multivariable analysis.AOR with 95% CI and P-value<0.05 were used during multivariable analysis to identify the factors associated with the intention of pregnant mothers to use maternity waiting home.

Result:
The prevalence of modern contraceptive utilization in Edaga hamus was 58.5%. in Ethiopia from 1990 to 2015 (1).In developing regions the overall MMR is 239, which is faces the most serious population and reproductive health challenges including the highest maternal mortality, population growth rate, total fertility rate and much unmet need for family planning in the world. Ethiopia is considered to be one of the most populous countries in Africa; only less than 23% of women in the reproductive age group are currently using contraception, which is still low to affect fertility following Nigeria and Egypt (6). The current population of Ethiopia was estimated to be 82,949,541 million with a growth rate of 2.6%. Total fertility rate (TFR) -estimated to be 7.7 children per woman in 1999 but 4 in 2016 (3,7). The 1990 nationwide populationbased family and fertility survey revealed that the overall contraceptive prevalence rate was 4.8 among currently married and non-pregnant women of reproductive age (8).
Modern contraceptive prevalence rate was found to be 27.3% (urban 49.5%, rural 22.5%) (7). . There is variation in contraceptive prevalence rates across the country's regions in Addis Ababa(56.3%)(8), Debre Birhan district (46.9%) (9). Factors found to be associated with the utilization of contraceptives vary. These include educational level, socio-cultural beliefs and practices, level of knowledge, myths, fear of side effects, partner's objection, convenience, fertility intentions, accessibility, providers' skill and competence, and other factors in the service area. These factors go a long way to influence the type of contraceptive one decides to use and use (10). Therefore this study was aimed at determining the prevalence and associated factors of modern contraceptive utilization among married women of the reproductive age group in Edaga hamus town.

Methodology Study setting
A community-based cross-sectional study was conducted from April 23 to May 10,

Participants
All women of reproductive age who reside in Edagahamus were taken as the study population. All women in the reproductive age group  are included, while women who were not mentally competent or who had any psychiatric disorders and critically ill during data collection were excluded.

Sample Size Determination
A sample size of 383 was determined by using sample size formula from the single population proportion. With the assumption of a margin of error 5%, confidence interval 95%, 10% expected non-response rate and 32.5 % prevalence of modern contraceptive in Tigray region (11).

Sampling Procedure
The probability sampling technique was employed. Edagahamus is divided into four kebeles then, the sample size was allocated to each selected kebeles proportionally based on their expected number of women in reproductive age in each kebeles. The study participant was selected by systematic random sampling method for the households every 8 th household.

Study Variables Dependent Variables
Modern contraceptive utilization

Independent Variables
Socio-demographic and economic variables, Reproductive history, Socio-psychological factors, Source of information and Knowledge, attitude and practice of modern contraceptive

Operational Definition
Utilization: use of any modern contraceptive method to space the child and to protect unwanted pregnancy. Current use: -A woman who is using a modern contraceptive method at the time of the study. Ever user: -A woman who has practiced modern contraceptive methods sometime in the past but not using at the time of this study.

Data quality assurance and control
Five health professional data collectors and two supervisors were recruited from the Health Center and they were given training for one day. The supervisors followed the process of data collection daily, checked the data completeness consistency and communicate with principal investigator daily.

Data Processing and Analysis
data was coded, cleaned, recorded and entered Epi info 7and finally export to SPSS version 22.00 for analysis. Simple descriptive summary statistics were done. Tables, statements, charts, and graphs were used to present the result of the analyzed data. Associations between independent and dependent variables were analyzed first using bivariate logistic regression analysis. Variables that had p<0.2 on bivariate analysis were entered multivariable logistic regression analysis. The statistical association between the different independent variables about dependent was measured using OR, AOR, 95% CI and P-values <0.05 was considered statistically significant.     .032). In this study mother who went to have several children, 1-3 and 4-5 were eleven and three times more likely to used modern contraceptive than who went 6 and above children.

Limitation
Since it was assessing modern contraceptive utilization limited in assessing knowledge and attitude towards contraceptives. Since it was assessing modern contraceptive utilization limited in assessing knowledge and attitude towards contraceptives.