Abstract:
Background: Unmet need for family planning is the number of reproductive-age women, who
want to space or limit births but are not currently using any family planning methods. Exploring
the Spatial distribution and identifying factors of these outcomes is important to design programs
to reduce unmet for family planning need. Thus, this study aimed to identify factors that affect
unmet need for family planning in Ethiopian administrative woredas using the multilevel
multinomial logistic regression model from 2016 EDHS data .
Method: In this study, a total of 8716 women who were fecund, married, and/or sexually active
were included in the analysis from 2016 EDHS data. The study was evaluated by spatial and
multilevel multinomial logistic regression models. In the bi-variable multilevel multinomial
analysis, those variables with p-value < 0.2 were considered for multivariable multilevel
multinomial analysis. Finally, predictors with p-value<0.05 were significantly associated for
unmet need of FP.
Results: The overall prevalence of unmet need for family planning in this study was 21.04%, of
which unmet need for spacing and limiting was 12.84% and 8.20% in Ethiopia respectively. This
study also revealed that the spatial distribution of unmet needs for family planning was random
with spacing and dispersed with limiting in Ethiopian administrative woreda with Moran’s index
statistics ( 0.107017 and 0.486040 with p values 0.428860 and 0.017026) respectively. In multile
vel multinomial logistic regression analysis, knowledge of FP (AOR: 1.758, 2.446), women having
more than four living children (AOR: 1.397, 10.041), and place of residence by father occupation
(AOR: 1.982, 2.415) times more likely to have unmet need for spacing and limiting of family
planning relative to respectively.
Conclusions: This study revealed that the prevalence of unmet needs among reproductive-age
women varies across woredas in Ethiopia. Random intercept with cross-interaction effects
multilevel multinomial model was preferred, with low AIC value. Addressing unmet needs for
family planning targeted rural residents with low and middle-wealth status, more knowledge of
family planning and women aged above 20 should be given top priority.
Keywords: unmet need for spacing, unmet need for limiting, spatial analysis, multilevel
multinomial regression, Ethiopia