Correlates of unplanned pregnancy in Ethopia: beyond individual and household factors
Date
2016-04-08
Authors
Olarewaju, Olajumoke Kiito
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Abstract
INTRODUCTION
Nearly all maternal and newborn deaths take place in low and middle-income countries; and
most of these deaths could be prevented. Unplanned pregnancy is a major concern from both
human rights and public health perspectives. Women who experience unplanned pregnancy are
not only exposed to unsafe and illegal abortion but also maternal and child morbidity and
mortality. Unplanned pregnancy is a pregnancy that has been reported to be unwanted at the
time of pregnancy. Studies on unplanned pregnancy in Ethiopia have focused mainly on
individual-level determinants of unplanned pregnancy. The efforts to reduce the incidence of
unplanned pregnancy in Ethiopia have remained weak; therefore there is the need for continued
research aimed to reducing unplanned pregnancy. Hence, this study will go beyond both
individuals and household levels to examine to what extent community factors moderate the
association between individual or socio-demographic factors and unplanned pregnancy.
The theoretical frameworks used for this study are: framework for “Analyzing the
Determinants of Maternal Mortality” by James McCarthy and Deborah Maine, and “The
Ecological Determinants of Health” framework by Bronfenbrenner in 1979. McCarthy and
Maine framework was based on the effort to reduce maternal mortality; the concept behind the
framework is the basic stages in the process that result into maternal morbidity and maternal
mortality. Bronfenbrenner’s ecological theory takes into consideration that ecological model
will give a holistic approach to analyze both the multilevel and the interactive influences of
health outcomes.
METHOD
This study utilizes data from the 2011 Ethiopian Demographic and Health Survey (EDHS).
The study population is women aged 15-49, who wanted pregnancy now, later or did not want
pregnancy when they became pregnant (7 764). The method of analysis for this study will
include descriptive analysis which includes the calculation of the rates of unplanned pregnancy,
chi-square test will be carried out to identify the individual factors, household factors and
community factors associated with unplanned pregnancy in Ethiopia; and then a multi-level
analysis will be done to determine the extent to which contextual factors account for variations
in unplanned pregnancy in Ethiopia.
RESULT
The preliminary results indicate that 32% of women experienced unplanned pregnancy in
Ethiopia in 2011. The bivariate analysis established association between unplanned pregnancy
and a number of factors such as; marital status, number of surviving children, wealth index,
use of contraception, knowledge of contraception, region, community poverty, community
family planning services, community female employment and community level of female
education. The multilevel analysis result also identified region of residence, community
poverty, community family planning services and community female employment as important
contextual factors of unplanned pregnancy during the period of study. For instance, women
residing in southern Ethiopia had the highest odds of unplanned pregnancy compared to other
regions (odds ratio-2.8; p<0.05); those in communities with moderate concentration of family
planning services had relatively higher odds compared to other groups (odds ratio-1.7; p<0.05);
and those in communities with low concentration of female employment had the highest odds
of experiencing unplanned pregnancy (odds ratio-2.3; p<0.05). The contextual factors in this
study explained 23% of the variations in the full model.
DISCUSSION AND CONCLUSION
The findings of this study has demonstrated that community contexts are very important
characteristics that impact on regional variations in unplanned pregnancy in Ethiopia, the
results from this study suggests that there is a need to take the effects of community contexts
into consideration if significant improvement is to be achieved on unplanned pregnancy.
Description
A RESEARCH REPORT SUBMITTED TO,
THE FACULTY OF HUMANITIES,
UNIVERSITY OF THE WITWATERSRAND, JOHANNESBURG
IN FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF THE DEGREE
OF MASTERS IN DEMOGRAPHY AND POPULATION STUDIES