Trend, geographical distribution, and determinants of modern contraceptive utilization among married reproductive-age women, Based on 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Survey

Background: The most common family planning method is modern contraception. It is a cost-effective way to reduce maternal and neonatal morbidity and mortality and enable women to make informed choices about their reproductive and sexual health. The trend of modern contraceptive utilization has shown drastic change in Ethiopia, and identifying the major factors contributing to such a drastic change is vital to improving plans and strategies for family planning programs. Therefore, this study analyzed the trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women in Ethiopia. Method A population-based cross-sectional study design was conducted using secondary data analysis from the 2000–2016 EDHS among married reproductive-age women (15–49 years of age). The trend in modern contraceptive use was analyzed using descriptive analyses, which were examined in three phases: 2000–2005, 2005–2011, and 2011–2016. Both bivariable and multivariable logistic regression analyses were done to identify determinant factors. Finally, a P-value of 0.05 and an adjusted OR with the correspondence 95% confidence interval were used to declare the significant variables. Analysis was conducted using STATA.14 and R. Spatial analysis was done using ArcGIS version 10.8 and SatScan ™ version 9.6. Result A weighted total of 33,478 women are included in the study, with a mean age of 31.4 years (8.6 SD). There was a significant increase in the trend of modern contraceptive use among married women over the study period, from 2000 to 2016, from 7.2% in 2000 to 15.7% in 2005, to 30% in 2011, and to 39.5% in 2016. The maximum increase was seen in the second phase (2005–2011), with a 14.3% increase. Factors like age of respondents, educational status, religion, residence, region, wealth index, number of living children, husbands' desire to have more children, and media exposure were found to be predictors for modern contraceptive utilization. Conclusion Although modern contraceptive use among young married women has shown an increase over the last 15 years in Ethiopia, we need to work hard since the contraceptive prevalence is below 50%. There is evidence of wide geographical variation in modern contraceptive use in Ethiopia.