Postpartum family planning use and women’s intention on contraception in Ethiopia: Disparities in the agrarian and pastoral contexts from community-based cross- sectional study

Postpartum family planning use and women’s intention on contraception in Ethiopia: Disparities in the agrarian and pastoral contexts from community-based cross- sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Postpartum family planning use and women’s intention on contraception in Ethiopia: Disparities in the agrarian and pastoral contexts from community-based cross- sectional study Agumasie Semahegn, Gizachew Tadele Tiruneh, Alemnesh Hailemariam, and 31 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5953712/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Postpartum family planning (PPFP) is the initiation of contraceptive methods immediately after childbirth. It is impactful intervention to reduce the risk of maternal and child deaths through spacing pregnancies. However, the magnitude of women’s access to and use of modern PPFP methods remains low, context-based evidence is crucial in addressing these gaps to inform policies. Therefore, this study aimed to assess women’s current use and intention on contraception in agrarian and pastoral contexts of Ethiopia. Methods A community-based house-to-house survey was conducted as a baseline study to embedded implementation research in 10 selected woredas from the agrarian and pastoral contexts of Ethiopia. Data were collected among randomly selected 3097 women using a structured questionnaire through a SurveyCTO platform and analyzed using Stata 18. A multi-level mixed-effect logistic regression was used to identify the factors associated with women’s current of PPFP uses and intention to use contraception it in agrarian and pastoral contexts. Results The overall current modern PPFP use was 25.3% (95%CI: 23.8%-26.9%), with significant variations in agrarian (60.6%) and pastoral (0.9%) contexts. Additionally, 37.5% (95%CI: 35.8–39.2%) of women had the intention to use modern PPFP. Injectable and implant contraceptives were the most preferred PPFP methods. Factors influencing both current and future PPFP use included women’s antenatal care visits (AOR:3.46; 95% CI:2.25–5.32), strong social support (AOR:1.75; 95% CI:1.23–2.49), autonomy on FP use (AOR:3.25; 95% CI:1.89–5.59), and favorable attitude towards equitable gender norms (AOR:1.51; 95% CI:1.12–1.71). Nevertheless, women who have no access to health facilities (AOR:0.70; 95% CI:0.49–0.99), history of homebirth (AOR:0.53; 95% CI:0.39–0.72), being from pastoral communities (AOR:0.03; 95% CI:0.01–0.06), and being Muslim women (AOR:0.29; 95% CI:0.19–0.46) are less likely to current PPFP use and intention to use contraception. Conclusions Women’s current use of modern PPFP and intentions to use contraception are extremely low in Ethiopia with significant disparities between agrarian and pastoral communities. Improving antenatal care, increasing social support, promoting women's autonomy and transforming gender equitable norms are crucial facilitators for increasing the contraceptive use. Addressing low utilization of PPFP requires culturally tailored interventions for agrarian and pastoral contexts, and promote women's autonomy, and improve service accessibility. Postpartum family planning intention on contraception pastoral agrarian Ethiopia Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Background Family planning (FP) is the practice of using contraception to control the number and timing of pregnancies ( 1 ). It is a crucial intervention in ending preventable maternal deaths due to pregnancy and childbirth which plays a key role in reducing poverty ( 2 ); and enables women to make informed decisions about their reproductive health ( 3 ). Postpartum family planning (PPFP) is of the use of modern contraceptives immediately after childbirth plays a proven record of protecting against unintended pregnancy and is highly recommended intervention by the World Health Organization (WHO) to improve maternal and child health outcomes ( 1 ). Postpartum contraceptives have significant contributions in reducing maternal, perinatal and child deaths by reducing the risk of closely spaced pregnancies ( 4 ). In low- and middle-income countries (LMICs), over half of the 1.6 billion women of reproductive age have a desire to control and delay their pregnancy ( 5 ). However, 218 million women had an unmet need to access modern contraception. In addition, approximately half of the pregnancies that occur every year in LMICs are unintended ( 5 ). In sub-Saharan Africa, PPFP use remains low, particularly in Ethiopia( 6 ). In Ethiopia, around 4.5 million women, lack access to modern contraception 7 . Existing evidence shows that PPFP use ranges from 25%( 7 ) to 45.4% ( 6 , 8 ), with huge disparities between regional states that ranged from the highest (55%) in Ethiopia( 9 ) and lowest (12.3%) in the Somali ( 10 ). Gender dynamics are pivotal in shaping women’s access to and use of PPFP in Ethiopia ( 11 ). Gender discrimination limits access to quality family planning services for both women and men, with women facing greater challenges due to traditional roles, while men also experience gender-related barriers ( 12 ). Although postpartum modern contraception uses vary significantly across different geographical regions in LMICs ( 13 ). Women still have limited access to the right family planning information and services related to modern contraception; poor partner or community support; cultural or religious opposition; patriarchal culture in Ethiopia's pastoralist and agrarian communities drives gender inequalities in labor; resource access; healthcare decisions; health literacy; traditional customs; gender-based challenges; and even lack of contraceptive availability with the process of choice that has minimal side effects concerns ( 11 ). The disparity across agrarian and pastoral contexts has not recognized but been not well explored and comprehensively documented through previous studies. In response to this, the Improve Primary Health Care Service Delivery (IPHCSD) project which is being implemented by Amref Health Africa and JSI, designed a maternal and newborn community-based lifesaving intervention package including offering postpartum contraceptives to ensure access to modern family planning services. This study aims to assess the magnitude of current modern PPFP method use, intentions to use and disparities among postpartum women who gave birth during the previous 12 months in agrarian and pastoral contexts of Ethiopia. Methods Study context Ethiopia, the second populus country in Africa, has an estimated, 120 million population with a growth rate of 2.6%( 1 , 14 ). Although the nation strives to avail access to maternal health through primary healthcare ( 2 , 3 ), the uptake of PPFP is extremely low and is characterized by a high variation in agrarian and pastoral communities. This cross-sectional study was part of a larger community-based quasi-experimental implementation research. Ten woredas from five regional states, namely Chifra and Telalek woredas from Afar; Degahbur, Gursum and Gunagado woredas from Somali region with pastoral contexts; Seka Chekorsa and Shebe Sambo woredas from Oromia region; Bensa and Bona Zuria woredas from Sidama region and Shay Bench woreda from Southwest Ethiopia region which were representing the agrarian contexts were included. These sites were selected purposively due to having high home birth rates across both agrarian and pastoral contexts and data collection was conducted from August to October 2023. Project description As part of the IPHCSD project, Maternal and Newborn Health (MNH) supplement intervention is being implemented to improve access to lifesaving interventions for vulnerable pregnant women. It includes home-based distribution of lifesaving packages for pregnant mothers and newborns and is supplemented with a community empowerment intervention using a participatory learning for action (PLA) ( 15 ) strategy in agrarian and pastoral woredas. Formative research was conducted to establish baseline values and inform stakeholders to implement adaptative management of the community-based delivery of lifesaving interventions (i.e. distribution of postpartum family planning services). The JSI and Amref partnership hypothesize that informed by the systematic understanding of context, co-designing and implementing the package of life-saving MNH interventions for women would reduce the deaths of mothers and their newborns (Fig. 1 ). Evidence-based effective interventions, delivery models, and tools will be further integrated into the IPHCSD platform. Study design and participants The community-based cross-sectional study was conducted among women who gave birth during the previous 12 months in ten agrarian and pastoral woredas of Ethiopia. Villages or kebeles, the lowest administrative units, are far from the woreda capital and with low utilization of health services were selected from agrarian and pastoral contexts. This cross-sectional study is part of a larger community-based quasi-experimental implementation research that served as a baseline for the embedded implementation research( 16 , 17 ) of community-based delivery of lifesaving interventions and a participatory learning and action (PLA) approach roach ( 15 , 18 ). The interventions include promoting facility births, educating communities on birth preparedness and complication readiness, and facilitating the advance distribution of progesterone-only family planning pills (POP). Whereas the PLA approach( 15 , 18 ) enhances women’s agency to address existing structural barriers to PPFP uptake. Eligibility criteria Eligible women were residents of the 107 kebeles located in 10 selected woredas with low facility-based maternal health service (skilled birth attendance) uptake and communities residing more than two hours walking distance from the woreda hub, and mothers aged 15–49 years who gave birth during the previous 12 months Sampling methods The sample size was calculated using EPI Info StatCalc ( 19 ), considering the double population formula for a comparative cross-sectional household study design. The sample size calculation considered a 95% confidence level (Z α/2 =1.96), a margin of error (d = 5%), a design effect of (e = 1.5), a power of 80%, and a two-sided significance level of 0.05 to detect 12% points change in the uptake of institutional delivery and women’s decision-making autonomy on maternal health services at the end of the project; and stratified by pastoralist and agrarian settings. Accordingly, 3,097 mothers (1,242 from agrarian and 1,855 from pastoral contexts) who gave birth during the previous 12 months at the time of data collection were included in the study. A two-stage cluster sampling technique was used to select the households for in-person interviews. In the first stage, Primary Health Care Units (PHCUs) having a catchment population with a high rate of home birth were purposefully selected. There were 54 Kebeles in the catchments of the selected PHCUs, which were the primary sampling units. Kebele is the smallest functional administrative structural unit in Ethiopia. In each sub-woreda, samples were allocated proportionally to the estimated population size. The updated list of households with mothers of infants 0–11 months of age with their unique household identifiers( 20 ) was obtained from the family folder of respective health posts, which was used as a sampling frame by the data collectors. In the second stage, a systematic random sample technique was used to identify women for interviews from targeted households. Data collection Data were collected through a house-to-house survey using a structured interview questionnaire that was customized from the Ethiopian demographic and health survey (EDHS). The questionnaire was translated into local dialects (Amharic, Affaan Oromo, and Af-Somali). Experienced data collectors were recruited and trained for two days. The women's interviews yielded data on sociodemographic and previous obstetric history including women’s autonomy to seek maternal and newborn health (MNH) services across the continuum of care, men's engagement, and access to and control over financial resources for MNH care. SurveyCTO, a web-based digital platform was used to collect the data among women (15–49 years) who gave birth during the previous 12 months. The interviews took 45 to 60 minutes. Measurements of the outcome and exposures The outcome variables of this study are two: current use of PPFP and Intention to use in the future. The women’s current use and intention to use modern contraception during their extended postpartum period was the outcome variable and was assessed based on women’s self-reported binary responses (yes = 1, no = 0). The PPFP uptake was assessed by asking a woman whether she or her partner currently doing something or using any modern contraceptive methods to delay or avoid pregnancy during her extended postpartum period. Women’s intention to use family planning was assessed by asking whether the woman or partner will use contraceptive methods to delay or avoid pregnancy at any time in the future. The exposure variables included women’s autonomy to seek MNH services, men’s engagement, gender equitable attitude, and access to and control over financial resources. The gender-related barriers were grouped into women’s autonomy in decision-making ( 21 – 26 ), and societal gender norms and attitudes ( 24 , 27 – 32 ). In addition, the social capital study( 33 ) was indirectly assessed through the social support to the women for maternal health service uptake. So, social support was measured using the Oslo-3 scale ( 33 ). Gender equitable attitude was measured using a six-item tool rated using a Likert scale ranging from 1(“agree”), 2(“somehow agree”), and 3(“disagree”). The mean values of the response from the six items were used as cut-off points for gender-equitable norms less than the mean value for gender-equitable and above the mean for gender-inequitable norms. Women’s experience of disrespect or abuse by healthcare providers during maternal health use was measured using the two-item tool and considered disrespect if a woman has experienced at least one of the disrespectful treatments. Data management and analysis Collected data were exported from Excel Sheet to Stata v. 18( 34 ) for cleaning and analysis. Stratified descriptive statistical analysis were used to compute the frequencies and proportions in agrarian and pastoral contexts. The characteristics of women in the two contexts were examined using Pearson’s chi-square statistics test. Most of the exposure variables were categorical. Descriptive statistics were carried out to compute the proportion of exposure and outcome variables cross-tabulated with clusters. The primary health care units (PHCUs) were the clustered sampling unit, in which access to PPFP within the PHCUs catchment was similar but women’s current and future PPFP use varies across PHCUs. In this paper, women’s current and future PPFP use were the two outcome variables fitted independently. Eventually, multilevel mixed-effects logistic regression analysis( 35 , 36 ) was fitted to determine the relationship between explanatory variables and postpartum family planning uptake and future intention stratified by agrarian and pastoral settings. Adjusted odds ratio (AOR) at 95% CI were determined on the final model declaring significant association. Results Demographic and socio-economic profiles of study participants Nearly one-half (44.3%) of women included in the study were in the age group of 25-30 years old. The majority (97.8%) of them were ever married. Approximately three-fourths (73.4%) of the women were Muslim. Of these, 99.9% of women in the pastoral setting were Muslim. The women’s sociodemographic characteristics from agrarian and pastoral settings are significantly different ( Table 1 ). Sources of PPFP information Among 3,097 women who gave birth in the past 12 months, 68.4% (n=2,119) of them gave birth at home and 60% of them received information about modern PPFP methods from either Health Extension Workers (HEWs) or other healthcare providers (HCP). Nearly one-in-five (19.7%, n=609) women discussed with the HEW or other HCPs about PPFP. Of these, 99.7% (607) of them obtained necessary information about birth control methods to be taken within 45 days of the postpartum period. Most of the women were told about injectables (86.5%), implants (71%), and pills (59.9%) to avoid immediate pregnancy during postpartum. Nevertheless, discussion about contraceptives with HCPs was extremely low with significant variation in agrarian (43.5%, n=540) and pastoral (3.7%, n=69) contexts. Reproductive history Among women who gave birth for the past 12 months (n=3097), 12.9% of them were primigravida and para. Two-thirds (65.5%) of women attended antenatal care follow up, and 84(2.7%) of women experienced pregnancy within a year of their postpartum period were from the pastoral communities ( Table 2 ). Postpartum FP uptake Among 3097 women who had given birth in the past 12 months and included in the study, 3013 (97.3%) of them were interviewed about either themselves or their partner currently using any modern family planning methods to delay or prevent pregnancy. Of these, women’s current use of postpartum contraceptives was 25.3% (95%CI: 23.8-26.9%) with significant disparity between agrarian and pastoral contexts ( Fig 2 ). Additionally, of those women who used PPFP (n=762), only 2.5% (19) of women used PPFP immediately within 48 hours. Nearly three-quarters (71.3%, n=543) of them started PPFP within six weeks ( Fig 3 ). Preferred PPFP methods Of those women who gave birth in the past 12 months, approximately three-fourths (73.1%, n=557) of them used injectable methods. Although it has low uptake in pastoral contexts, injectables and implants were preferred methods ( Table 3 ). Sources of PPFP service Among the studied women, a significant majority used the health centers as main access point to postpartum family planning methods, followed by the health posts ( Fig 4 ). Among women who used postpartum family planning, 96.0% (n=752) of them obtained their preferred method of choice. The remaining 4% (31) of women didn’t get the preferred method for various reasons including method stock out, no trained skilled personnel, and absence at the specific facility during women’s visits for PPFP. Reasons for not using PPFP Women had several reasons for not using postpartum contraceptives. The major reasons religious prohibition (40%), being lactating (21.1%) and want to have more children (18.1%) ( Table 4 ). Women’s intention to use contraception We assessed women’s intention to use contraception, overall slightly more than one-third (37.5% 95%CI: 35.8-39.2%) of women expressed intention to use PPFP in the future. Nevertheless, only 5.4% of women who live in pastoral setting had an intention to use PPFP in the future ( Fig 5). Injectable (57.1%), implant (34.9%) and pills (3%) were the preferred methods by women for future use. Factors determining the women’s use of PPFP A total of sixteen explanatory variables were considered in the mixed effect logistic regression analysis. Of these, nine of them have significant associations. being Muslim women (AOR: 0.29; 95%CI: 0.19-0.46); living more than an hour's walking distance from the health facilities (AOR: 0.70; 95%CI: 0.49-0.99); residing in pastoral contexts (AOR: 0.03; 95%CI: 0.01-0.06); women’s previous history of home birth(AOR: 0.53; 95%CI: 0.39-0.72) and women who had autonomy to jointly decide on place of delivery (AOR: 0.38; 95%CI: 0.22-0.66) were significantly associated barriers to PPFP use of women in agrarian and pastoral contexts of Ethiopia. Women who had strong social support (AOR: 1.75; 95%CI: 1.23-2.49); had the autonomy to decide on FP use: 3.25; 95%CI: 1.89-5.59) and had antenatal care follow-up (AOR: 3.46; 95%CI: 2.25-5.32) were significantly associated with women’s uptake of PPFP in Ethiopia ( Table 5 ). The null model of the regression analysis considering the inter-cluster variability between PHCUs as cluster (Table 6). Factors determining women’s intention use contraception A total of sixteen explanatory variables were considered in the mixed effect logistic regression analysis to identify independent predictors of women’s intention to use postpartum family planning in the future. Of these, six of them positively influence women’s postpartum family planning use for the next birth. Women attended secondary school and above (AOR: 1.87; 95% CI:1.14-3.04); women from rich groups (AOR:1,76; 95% CI: 1.07-2.89); women lived in families who have favorable attitudes towards equitable gender norms (AOR: 1.64 95% CI:1.19-2.26); women who had antenatal care (AOR: 1.9295% CI:1.35-2.74); women who had strong social support (AOR: 2.01 95% CI:1.34-3.02) and women who have the autonomy to use FP (AOR: 2.57 95% CI:1.61-4.10) were the factors significantly associated with positive intention of women to use PPFP in their subsequent births. Nevertheless, women from pastoral context (AOR:0.07; 95% CI: 0.04-0.16); Muslim women (AOR: 0.14; 95% CI: 0.08-0.27); women who gave their previous birth at home (AOR: 0.35; 95% CI: 0.25-0.49); and live far from the health facility (more than an hour walking distance) (AOR: 0.62; 95% CI: (0.61-0.93) were less likely to use the PPFP in the future in Ethiopia (Table 7). The null model of the regression analysis considering the inter-cluster variability between PHCUs as cluster (Table 8). Discussion The findings from this study indicate significant differences in the current and future PPFP use among women in the agrarian and pastoral context in Ethiopia. Women who had previous antenatal care visits, strong social support, autonomy on FP use, live in a community who have a favorable attitude towards equitable gender norms were crucial facilitators for the current and future use of PPFP. Nevertheless, lack of access to health facilities, home birth, being pastoral community, and being Muslim by religion were the barriers to current and future PPFP use in agrarian and pastoral contexts of Ethiopia. This highlights the potential influence of socio-cultural factors on family planning behaviors, where religious and cultural norms could play a role in contraceptive uptake. The current study reveals a current PPFP use of 25.3%, which was consistent with global, African, and Ethiopian evidence; 28.5% in Malawi ( 37 ), 28% in Uganda( 9 , 23 , 38 ) and 24.6 in Pakistan( 39 , 40 ), and in Ethiopia ranged from 21%( 41 ) to 23%( 42 ). Nevertheless, this study finding was slightly lower than 29.3% in Tigray( 43 ) and 31.7% in Aroressa woreda in Southern Ethiopia ( 44 ). However, the prevalence of PPFP varies significantly across different regions of Ethiopia. In the Somali Region, low uptake of 12.3% ( 45 , 46 ), 31.7%( 44 ), 77.9%( 47 ) in SNNP, 45.8%( 48 ) to 46.7%( 47 ) in Amhara Region; 48%( 49 ) to 68.1%( 50 , 51 ) in Tigray Region while 80.3%( 50 , 51 ) in Addis Ababa. These higher rates reflect successful interventions in particular areas but also suggest that efforts should be tailored to address regional disparities in culture, norms, and access to health services. Although the pastoral contexts are extremely low, the overall current use of PPFP is higher than findings from studies conducted in Liberia (11.9%) ( 52 ), the Democratic Republic of Congo (6.9%) ( 53 ), some parts of Ethiopia (10.3%) ( 54 ), that underscores the challenges some countries face in expanding family planning services. Similarly, the method choice, such as injectables and implants by women, is consistent with other studies previously conducted in Ethiopia, implants were most used (57%), followed by injectables (35.5%) ( 41 ). These results emphasize the need to promote diverse contraceptive options to address varying family planning preferences. This study explored factors influencing PPFP uptake among Ethiopian women, highlighting the impact of sociodemographic and access-related variables. Multilevel analysis revealed key determinants, including religious background, healthcare access, gender-equitable attitudes, social support, and healthcare autonomy have key roles in PPFP uptake and future acceptance. Similarly, research in Liberia found an inverse relationship between distance and PPFP use ( 52 ). while a study in Tigray ( 49 ) reported higher odds of contraceptive use among women who have access to health facilities ( 52 ). These findings underscore the importance of proximity in improving family planning access and utilization. The study highlights that women with gender-equitable attitudes are significantly more likely to adopt PPFP emphasizes the importance of progressive gender norms in reproductive health and aligns with findings from Indonesia ( 55 ). Empowered women in gender-equal societies make autonomous decisions on contraception. Furthermore, a study in pastoralist Somali communities in Kenya ( 56 ) revealed that the low uptake of modern contraceptives among Somali women is influenced by socio-cultural norms, such as polygamy, and a preference for large families. Studies in Ghana ( 24 ) and other sub-Saharan Africa( 56 ) indicate the common use of covert contraception using birth control without a partner’s knowledge indicates differing partner beliefs about family size and contraception. Strong social support networks play a critical role in increasing the likelihood of PPFP adoption, as evidenced by this study. Community and family support, particularly from spouses, is instrumental in encouraging the use of PPFP. This finding aligns with the existing evidence in Ethiopia ( 41 ), in Indonesia ( 55 ), in Kenya ( 57 ), and in Nigeria( 30 ) which highlights the importance of strong social support as a significant factor influencing PPFP uptake. Similarly, this study shows that women with autonomy to seek family planning (FP) services are significantly more likely to use PPFP, emphasizing the critical role of empowerment in reproductive health decisions. The agreement is found with a sub-Saharan African studies ( 58 ), Indonesia ( 55 ), in Kenya ( 57 ), that highlighted joint decision-making with partners as a stronger determinant of contraceptive use than women’s independent decisions, who noted that limited spousal support often hinders FP participation. Observed covert contraceptive use driven by inadequate spousal support, suggesting that autonomy alone may not address deeply rooted gender dynamics. This study examines women’s intention to use contraception in Ethiopia, highlighting significant variations influenced by demographic, socioeconomic, and community-level factors. The findings indicate that 37.5% of women expressed an intention to use PPFP, with a notably higher rate of 84.5% in agrarian communities compared to only 5.4% in pastoral communities. These disparities emphasize the influence of context and access to resources on PPFP intentions. Additionally, the intention rate reported in this study aligns closely with the finding of 37% in Benin ( 59 ), where similar challenges related to healthcare access and cultural factors persist. Other studies conducted in Ethiopia reveal significantly higher intention rates. And 84.3% intention in Northern Ethiopia ( 48 , 49 ), showcasing the impact of urban infrastructure, healthcare access, and community-based education on PPFP intentions and A study in the Oromia region found an intention rate of 66.6%( 60 ) reinforcing the idea that health education and local acceptance of family planning significantly influence PPFP intentions. Strengths and limitations of this study The study was a community-based and multisite study with a representative sample of women from agrarian and pastoral contexts. Data were collected using computer-assisted personal interviews (CAPI) using a reliable tool adapted from the Ethiopian Demographic and Health survey tool. Nevertheless, the reports depend on the women’s self-report data which may have a recall basis. The study is unable to determine the causal impact of these variables on women’s PPFP uptake and intention due to the limitation of a cross-sectional study. Conclusions Women’s current and future PPFP use are extremely low in Ethiopia with significant disparities between agrarian and pastoral communities. Moreover, the current and future PPFP use vary by only 12.2 percentage points implying there is no significant aspiration in the future. Socio-demographic factors such as maternal age, religion, gender-equitable attitudes, women’s autonomy for FP, antenatal care use, and strong social support play pivotal roles in influencing both the uptake and intention to use PPFP. The findings highlight the need for tailored interventions addressing the unique challenges faced by women in pastoral settings, including access to health facilities, socio-cultural barriers, and limited autonomy in decision-making. This finding is critical and informative to design a participatory learning and action (PLA) platform and transform gender equitable norms, promote women’s autonomy, and strengthen social support in agrarian and pastoral contexts of Ethiopia. Abbreviations AIC: Akaike’s information criterion; AOR: Adjusted Odds Ratio; CI: Confidence Interval; DIC: Deviance information criterion, HCP: Healthcare providers; HEW: Health Extension Workers; ICC: Intra-class correlation coefficient; PPFP: postpartum family planning; SE: Standard error; WHO: World Health Organization Declarations Ethical approval and consent to participate Ethical clearance to conduct the study was obtained from the Ethiopian Public Health Association (EPHA) Research Ethical Review Board. The study was conducted by the declaration of Helsinki. Informed verbal and written consent were obtained from each study participant voluntarily to be included in the study. Informed consent from participant/legal guardian and assent from them were obtained from study participants who were younger than 18 years old, and had not attended formal education. The collected data was kept confidential anonymously through the de-identification of names and other personal identifiers from the record/sheet. Parents/guardians in case of minor study participants and legally authorized representatives in case of illiterate participants. Consent for publication: Not applicable Availability of data and materials: All related data are presented fully within the paper, and available upon reasonable request to the lead author and the corresponding author. Competing interests: The authors declare that they have no conflict of interest. Funding: This study was financially supported by the Bill & Melinda Gates Foundation (BMGF) [INV-002643 to MM and INV-037995 to DE]. But the funder has no role on the interpretation of the finding which is the full responsibility of the authors. Authors’ contributions TA, DE, MM, GTT, NB, AH, NF, and MD, have involved since inception of the study design. GTT, AS, MT, HT, NF, AD, MB, CT, OM, ZF, MY, AM; AG, MA and RD involved in the data acquisition and quality assurance measures. AS*& GTT carried out the data analysis and interpretation of the findings. AS*, GTT, OM, and MDA develop the manuscript, and GTT, MDA, NB, AH, WM, BB, SM, AW, & NF reviewed the manuscript for intellectual contents. AT, MT, SA, SS, LT, DTA, FD, TA , DE, ZM, MDM, AW, and MM gave high-level critical comments and oversee project implementation. All authors have reviewed the manuscript critically for important intellectual contents and approved the final manuscript for submission. Acknowledgments We would like to acknowledge Bill & Melinda Gates Foundation (BMGF) for financial support, Amref Health Africa and JSI for the overall admirative support, the study participants, data collectors, supervisors for their willingness to give their time and information for this study. Authors information 1 Amref Health Africa, Addis Ababa Ethiopia; 2 JSI, Addis Ababa, Ethiopia; 3 School of Public Health, Addis Ababa, Ethiopia 4 Ministry of Health, Addis Ababa, Ethiopia; and 5 Bill &Melinda Gates Foundation (BMGF), Addis Ababa, Ethiopia; 6 MERQ Consultancy P.L.C, Addis Ababa, Ethiopia; and 7 Fenot project-Harvard T.H. Chan School of Public Health, Addis Ababa, Ethiopia References WHO. Family planning/contraception methods [Internet]. Geneva; 2023 Sep [cited 2025 Jan 27]. Available from: https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception UNFPA. State of World Population. 2022: The case for action in the neglected crisis of unintended pregnancy [Internet]. 2022 [cited 2025 Jan 27]. Available from: https://www.unfpa.org/swp2022 UN. World Family Planning 2022 Meeting the changing needs for family planning: Contraceptive use by age and method [Internet]. New York; [cited 2025 Jan 27]. 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Tables Table 1: Basic characteristics of women (15-49 years) in 10 woredas from agrarian and pastoral Ethiopia August-October 2023 (n=3,097) Variables Categories Agrarian Pastoral Total P value Age 15-24 446(35.9) 378(20.4) 824(26.65) <0.001 25-30 604(48.6) 768(41.4) 1372(44.3) 31-35 148(11.9) 453(24.4) 601(19.4) 36-49 44(3.5) 256(13.8) 300(9.7) Religion Christian 822(66.2) 1(0.05) 823(26.6) <0.001 Muslim 419(33.8) 1853(99.9) 2272(73.4) Marital status Ever married 1229(98.9) 1,809(97.0) 3029(97.8) <0.001 Never married 13(1.05) 55(2.9) 68(2.2) Women education Not attended formal school 548(44.1) 1665(89.8) 2213(71,5) <0.001 Primary 346(27.8) 117(6.3) 463(15.0) Secondary & plus) 348(28.0) 73(3.9) 421(13.6) Husband education Not attended formal school 355(28.6) 1430(77.1) 1785(57.6) <0.001 Primary 332(26.7) 1148(8.0) 480(15.5) Secondary & plus) 555(44,7) 277(14,9) 832(26.9) Women occupation Unemployed 1146(92.4) 1672(90.43) 2818(91.2) <0.001 Engaged in job 94(7.6) 177(9.6) 271(8.8) Husband occupation Unemployed 12(0.9) 191(10.6) 2036.7) <0.001 Engaged in job 1212(99.0) 1613(89.4) 2825(93.3) Distance from health facilities <1 hour 1,033(83) 1,353(72.9) 2386(77.0) <0.001 ≥ 1hours 209(16.8) 502(25.1) 711(27.9) Family size ≤5 members 532(42.8) 382(20.6) 914(29.51) 5 Members 710(57.2) 1473(79.4) 2183(70.5) Wealth index Poor 65(5.2) 968(52.2) 1033(33.4) <0.001 Middle 340(27.4) 692(37.3) 1032(33.3) Rich 837(67.4) 195(10.5) 1032(33.3) Social support Poor 284(22.9) 417(22.5) 701(22.6) Moderate 478(38.5) 1176(63.4) 1654(53.4) Strong 480(38.7) 262(14.1) 742(23.9) Membership to VHL Yes 168(13.5) 50(2.7) 218(7.0) <0.001 Membership to CBHI Yes 691(55.6) 17(0.92) 708(22.9) <0.001 Table 2: Women’s obstetric history in agrarian and pastoral settings in Aug-Oct, 2023 (n=3097) Variables Categories Agrarian Pastoral Total P value Gravida q36a primigravida 261(21.0) 137(7.4) 398(12.9) <0.001 multigravida 981(78.99) 1,718(92.6) 2,699(87.1) Para q36b Primipara 261(21.0) 137(7.4) 398(12.9) 5 331(26.7) 520(28.0) 851(27.5) Antenatal care Had follow up 1093(88.0) 934(50.4) 2,017(65.5) <0.001 Place of birth Home birth 502(40.4) 1617(87.2) 2119(68.4) <0.001 Facility birth 740(59.6) 238(12.8) 978(31.6) Pregnancy status Yes 3(0.24) 81(4.37) 84(2.7) <0.001 No 12291(99.0) 1674(90.2) 2903(93.7) Not sure 10(0.8) 100(5.4) 110(5.6) Table 3: Women’s preferred contraceptive choices for PPFP in agrarian and pastoral Ethiopia (n=762) Family planning methods Total Agrarian Pastoral Injectable 557(73.1) 553(74.0) 4(26.7) Implants 175 (23.0) 171(22.9) 4(26.7) Pill 17(2.2) 15(2.0) 2(13.3) IUD 3(0.4) 3(0.4) 0 Others* 10(0.01) 5(0.01) 5(0.33) Table 4 : Women’s common reasons for not using PPFP in agrarian and pastoral context of Ethiopia, Aug-Oct, 2023(n=3097) Reason for not using PPFP Variable Total Agrarian Pastoral Religious prohibition 905(40.3) 19(3.9) 886(50.4) Breastfeeding 474(21.1) 147(30.3) 327(18.6) Want to get pregnant 406(18.1) 22(4.5) 384(21.8) Husband/partners opposed 215(9.6) 42(8.6) 173(9.8) Postpartum amenorrhoeic 198(8.8) 181(37.2) 17(1.0) Knows no method 113(5.0) 6(1.2) 107(6.1) Method of choice not available 106(4.7) 8(1.7) 98(5.6) Women themselves opposed contraceptive 94(4.2) 10(2.1) 84(4.8) Not have sex 92(4.1) 68(14.0) 24(1.4) Other family members opposed 86(3.8) 0 86(4.9) Fear of Side Effects 75(3.4) 9(1.9) 66(3.8) Know no source 62(2.8) 1(0.2) 61(3.5) Lack of access/far 32(1.4) 16(3.3) 16(0.9) Health concern 18(0.8) 4(0.8) 14(0.8) Infrequent sex 18(0.8) 9(1.9) 9(0.5) Cost too much 16(0.7) 4(0.8) 12(0.7) Inconvenient to use 7(0.3) 2(0.4) 5(0.3) Table 5: Multilevel mixed-effects logistic regression model of the factors affecting women’s uptake of PPFP in Ethiopia in Ethiopia, Aug-Oct 2023 Variables Categories (COR 95% CI) Model 2: Intercept model AOR (95% CI) Age of women (ref: 15-24) 23-30 0.84(0.64-1.10) 1.01(0.72-1.40) 31-35 0.70(0.47-1.05) 0.92(0.57-1.50) ≥36 0.69(0.37-1.30) 0.84(0.41-1.72) Maternal education (ref: not attended school) Primary 1.32(0.97-1.80) 0.94(0.68-1.33) Secondary 2.28(1.64-3.18) 1.43(0.97-2.11) Religion (ref: Christian) Muslim 0.10(0.05-0.23) 0.29(0.19-0.46) Husband education (ref: not attended school) Primary 1.47(1.05-2.08) 1.22(0.85-1.74) Secondary+ 1.79(1.29-2.49) 1.08(0.74-1.57) Wealth index (ref: poor) Middle 1.46(0.87-2.43) 1.04(0.60-1.79) Rich 1.92(1.16-3.22) 0.99(0.57-1.72) Distance to HF (ref: <1 hour walking distance) ≥1 hour 0.72(0.51-1.03) 0.70(0.49-0.99)* Gender-equitable attitude (ref: No) Yes 1.62(1.23-2.13) 1.51(1.12-1.71)* Family size (ref: <5 family members) ≥5 members 0.63(0.49-0.81) 0.79(0.57-1.10) Social support (ref: poor) Moderate 1.29(0.93-0.1.78) 1.35(0.96-1.89) Strong 1.60(1.15-2.23) 1 .75(1.23-2.49)* Being member of VHL (ref: No) Yes 1.58(1.05-2.39) 1.29(0.85-1.95) Being member of CBHI (ref: No) yes 1.31(0.98-1.74) 1.00(0.74-1.35) Autonomy to seek FP (ref: No) Yes 2.51(1.74-3.62) 3.25(1.89-5.59)* ANC follow up (ref: No yes 4.07(2.70-6.16) 3.46(2.25-5.32)* Place of delivery (ref: Health Facility) Home birth 0.42(0.30-0.57) 0.53(0.39-0.72)* Autonomy to delivery place (ref: Husband) Jointly or alone 1.23(0.85-1.78) 0.38(0.22-0.66)* Residence/community livelihood (ref: agrarian) Pastoral 0.004(0.002-0.007) 0.03(0.01-0.06)* NB: *significant association at p-values <0.05; HF: health facility; ANC: antenatal care; FP: family planning Table 6: Random effects (measures of variations) and model fitness for the factors affecting women’s uptake of PPFP in Ethiopia by Multilevel mixed-effects logistic regression modeling, Aug-Oct 2023 Parameters Null model (empty model) Model-III Model-0 Final model Community-level intercepts (SE) -1061.757 -786.578 Random-effect (measures of variation) Cluster level variance (SE) 14.644(3.337) 0.231(0.125) Loglikelihood (LL) -928.267 -7779.555 Model fit statistics ICC (SE) 0.0.817(0.034) 0.0658(0.331) AIC(BIC) 1860.534(1872.534) 1607.109(1751.35) AIC: Akaike’s information criterion, DIC: Deviance information criterion, ICC: Intra-class correlation coefficient, SE: Standard error, Table 7: Multilevel mixed-effects logistic regression model of the factors affecting women’s intention to use contraception in Ethiopia, Aug-Oct 2023 Variables Categories COR 95% CI Model 2: Intercept model AOR (95% CI) Age of women (ref: 15-24 year) 25-30 years 0.71(0.52-0.96) 0.65(0.45-0.95) 31-35 years 0.49(0.32-0.73) 0.49(0.29-0.80) ≥36 years 0.53(0.31-0.94) 0.47(0.25-0.89) Maternal education (ref: not attended school) Primary 1.82(1.26-2.63) 1.19(0.79-1.77) Secondary+ 3.13(2.02-4.84) 1.87(1.14-3.04)* Religion (ref: Christian) Muslim 0.01(0.004-0.03) 0.14(0.08-0.27)* Husband education (ref: not attended school) Primary 1.46(1.01-2.11) 1.13(0.77-1.68) Secondary+ 1.99(1.42-2.81) 1.10(0.74-1.62) Wealth (ref: Poor) Middle 2.02(1.31-3.13) 1.40(0.89-2.19) Rich 3.84(2.37-6.22) 1,76(1.07-2.89) Distance to HF (ref: walking hours<1) ≥1 hour 0.74(0.48-0.1.08) 0.62(0.61-0.93)* Gender-equitable attitude (ref: No) Yes 1.75(1.30-2.36) 1.64(1.19-2.26)* Autonomy to HF delivery (ref: husband) Alone or joint 1.75(1.25-2.46) 0.69(0.41-1.12) Place of delivery (ref: HF) Home birth 0.22(0.16-0.31) 0.35(0.25-0.49)* ANC follow (ref: No) Yes 2.81(2.03-3.92) 1.92(1.35-2.74)* Family size (ref: family size <5) ≥5 members 0.81(0.61-0.1.08) 1.39(0.96-2.02) Social support (ref: poor) Moderate 0.1.36(0.96-1.93) 1.33(0.95-1.92) Strong 2.11(1.44-3.08) 2.01(1.34-3.02)* Autonomy to seek FP (ref: Husband) Joint or alone 261(1.87-3.62) 2.57(1.61-4.10)* Member of VHL (ref: No) Yes 1.43(0.81-2.52) 1.26(0.84-1.90) Member of CBHI (ref: No) Yes 1.73(1.19-2.52) 0.99(0.55-1.77) Residence/community livelihood Agrarian 1.0 1.00 Pastoral 0.005(0.002-0.009) 0.07(0.04-0.16* NB: *significant association at p-values <0.05; HF: health facility; ANC: antenatal care; FP: family planning Table 8: Random effects (measures of variations) and model fitness for the factors affecting women’s intention to use PPFP in Ethiopia by Multilevel mixed-effects logistic regression modeling, Aug-Oct 2023 Parameters Null model (empty model) Model-III Model-0 Final model Community-level intercepts (SE) -1063.232 -741.214 Random-effect (measures of variation) Cluster level variance (SE) 12.659(2.479) 0.555(0.197) Loglikelihood (LL) -913.031 -0.741.214 Model fit statistics ICC (SE) 0.794(0.032) 0.1444(0.044) AIC(BIC) 1830.61(1842.138) 1530.429(1675.33) AIC: Akaike’s information criterion, DIC: Deviance information criterion, ICC: Intra-class correlation coefficient, SE: Standard error, Additional Declarations No competing interests reported. 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Africa","correspondingAuthor":false,"prefix":"","firstName":"Shegaw","middleName":"","lastName":"Mulu","suffix":""},{"id":414743533,"identity":"68bb313d-44d7-458b-b71b-36a7dc90cbe4","order_by":6,"name":"Wubegzier Mekonnen","email":"","orcid":"","institution":"School of Public Health, Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Wubegzier","middleName":"","lastName":"Mekonnen","suffix":""},{"id":414743534,"identity":"42fe00f7-20d7-4b25-b46a-e4f6053cb510","order_by":7,"name":"Addis Girma","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Addis","middleName":"","lastName":"Girma","suffix":""},{"id":414743535,"identity":"dae914ea-fb7b-433b-9625-9f31bafc9bc9","order_by":8,"name":"Chala Tesfaye","email":"","orcid":"","institution":"JSI","correspondingAuthor":false,"prefix":"","firstName":"Chala","middleName":"","lastName":"Tesfaye","suffix":""},{"id":414743536,"identity":"783fcc5f-55c9-4cbf-b2bf-668ebb9686d2","order_by":9,"name":"Mikiyas Teferi","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Mikiyas","middleName":"","lastName":"Teferi","suffix":""},{"id":414743537,"identity":"2c331db4-10ac-460f-8fd4-5cf6f1dc72bd","order_by":10,"name":"Biruk Bogale","email":"","orcid":"","institution":"JSI","correspondingAuthor":false,"prefix":"","firstName":"Biruk","middleName":"","lastName":"Bogale","suffix":""},{"id":414743538,"identity":"77a5fe9b-bcf7-4f65-8014-78480ec0767a","order_by":11,"name":"Hillina Tadesse","email":"","orcid":"","institution":"JSI","correspondingAuthor":false,"prefix":"","firstName":"Hillina","middleName":"","lastName":"Tadesse","suffix":""},{"id":414743539,"identity":"5cd982db-633a-4a7d-8630-c54f506e1fd1","order_by":12,"name":"Derbe Tadesse Abate","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Derbe","middleName":"Tadesse","lastName":"Abate","suffix":""},{"id":414743540,"identity":"c7d320bb-7037-40a7-938c-12153eec1311","order_by":13,"name":"Meskerem Abebaw","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Meskerem","middleName":"","lastName":"Abebaw","suffix":""},{"id":414743541,"identity":"c85b5aab-6315-46db-940e-a64ae2d3c324","order_by":14,"name":"Mebrie Belete","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Mebrie","middleName":"","lastName":"Belete","suffix":""},{"id":414743542,"identity":"ff96097f-1ad9-4568-a45e-330acb944c48","order_by":15,"name":"Zehara Fenataw","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Zehara","middleName":"","lastName":"Fenataw","suffix":""},{"id":414743543,"identity":"01953b64-231b-4f57-ba65-44669b693c97","order_by":16,"name":"Miftah Yasin","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Miftah","middleName":"","lastName":"Yasin","suffix":""},{"id":414743544,"identity":"3f7e9323-1827-495b-9690-9fb0db9e4ac1","order_by":17,"name":"Hassen Musse","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Hassen","middleName":"","lastName":"Musse","suffix":""},{"id":414743545,"identity":"681c2e8a-96df-4f42-b66d-602421230816","order_by":18,"name":"Netsanet Belete","email":"","orcid":"","institution":"JSI","correspondingAuthor":false,"prefix":"","firstName":"Netsanet","middleName":"","lastName":"Belete","suffix":""},{"id":414743546,"identity":"3f975a95-2e38-438b-82d0-c5c6345c1c28","order_by":19,"name":"Rediet Daniel","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Rediet","middleName":"","lastName":"Daniel","suffix":""},{"id":414743547,"identity":"b3a2ef59-c1fc-48eb-b71a-8007c5f982a8","order_by":20,"name":"Abdu Mohammed","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Abdu","middleName":"","lastName":"Mohammed","suffix":""},{"id":414743548,"identity":"e5ff95de-b102-4134-b3d5-0e457f9bbee4","order_by":21,"name":"Yenegeta Walelegn","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Yenegeta","middleName":"","lastName":"Walelegn","suffix":""},{"id":414743549,"identity":"7042f845-4872-45f6-a3de-07b1ba23ddf6","order_by":22,"name":"Salsawit Shiferraw","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Salsawit","middleName":"","lastName":"Shiferraw","suffix":""},{"id":414743550,"identity":"9aa9a9f1-c6f7-41dc-bf8e-867a1802f008","order_by":23,"name":"Zemzem Mohammed","email":"","orcid":"","institution":"Ministry of Health","correspondingAuthor":false,"prefix":"","firstName":"Zemzem","middleName":"","lastName":"Mohammed","suffix":""},{"id":414743551,"identity":"f0c0b188-6885-4e02-8aa8-502d456414d1","order_by":24,"name":"Lidiya Tefera","email":"","orcid":"","institution":"Bill \u0026Melinda Gates Foundation (BMGF)","correspondingAuthor":false,"prefix":"","firstName":"Lidiya","middleName":"","lastName":"Tefera","suffix":""},{"id":414743552,"identity":"3b3cd82f-d54b-45a6-bd7b-220f97f02149","order_by":25,"name":"Frank DelPizzo","email":"","orcid":"","institution":"Bill \u0026Melinda Gates Foundation (BMGF)","correspondingAuthor":false,"prefix":"","firstName":"Frank","middleName":"","lastName":"DelPizzo","suffix":""},{"id":414743553,"identity":"5496266b-6bc8-47b0-8190-750a97559794","order_by":26,"name":"Yibeltal Kifle","email":"","orcid":"","institution":"MERQ Consultancy P.L.C, Addis Ababa","correspondingAuthor":false,"prefix":"","firstName":"Yibeltal","middleName":"","lastName":"Kifle","suffix":""},{"id":414743554,"identity":"6886eeee-4785-4e3b-8a36-b3c30dd0adfc","order_by":27,"name":"Abdulhalik Workicho","email":"","orcid":"","institution":"Ministry of Health","correspondingAuthor":false,"prefix":"","firstName":"Abdulhalik","middleName":"","lastName":"Workicho","suffix":""},{"id":414743555,"identity":"ead7fb31-6612-4b56-93e2-58140122eb27","order_by":28,"name":"Muluken Dessalegn Muluneh","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Muluken","middleName":"Dessalegn","lastName":"Muluneh","suffix":""},{"id":414743557,"identity":"816dc7ea-8f7c-45b4-bab4-2fb310b06779","order_by":29,"name":"Addis Tamire","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Addis","middleName":"","lastName":"Tamire","suffix":""},{"id":414743558,"identity":"bcf8fce5-3d93-46c7-9922-896ac495c3cf","order_by":30,"name":"Temesgen Ayehu","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Temesgen","middleName":"","lastName":"Ayehu","suffix":""},{"id":414743559,"identity":"0edc1ed6-dc4c-4af6-b14d-655e63edd5b5","order_by":31,"name":"Dessalew Emaway","email":"","orcid":"","institution":"JSI","correspondingAuthor":false,"prefix":"","firstName":"Dessalew","middleName":"","lastName":"Emaway","suffix":""},{"id":414743560,"identity":"31b98b13-e44a-49ca-908b-6ae8a1cc1c6e","order_by":32,"name":"Misrak Makonnen","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Misrak","middleName":"","lastName":"Makonnen","suffix":""},{"id":414743561,"identity":"af8c9086-72ff-4c74-87ca-79feaaa2ff54","order_by":33,"name":"Mesele Damte Argaw","email":"","orcid":"","institution":"Amref Health Africa","correspondingAuthor":false,"prefix":"","firstName":"Mesele","middleName":"Damte","lastName":"Argaw","suffix":""}],"badges":[],"createdAt":"2025-02-03 21:08:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5953712/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5953712/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":76297628,"identity":"636a6256-0b20-43e2-a1f6-92f94c65301a","added_by":"auto","created_at":"2025-02-14 13:29:10","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1148894,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eTheory of change\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5953712/v1/17df77de03987a368c04d2ff.png"},{"id":76298327,"identity":"a17257f8-406f-4dfd-9661-8ffd997e1583","added_by":"auto","created_at":"2025-02-14 13:37:10","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":3952,"visible":true,"origin":"","legend":"\u003cp\u003eWomen’s current use of PPFP in agrarian and pastoral Ethiopia, Aug-Oct 2023 (n=3,013)\u003c/p\u003e","description":"","filename":"Onlinedrawingimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5953712/v1/b3a72d7f0896263af8f37276.png"},{"id":76298326,"identity":"396aafd5-7703-451b-8315-c5b77f76b976","added_by":"auto","created_at":"2025-02-14 13:37:10","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":6486,"visible":true,"origin":"","legend":"\u003cp\u003eWomen’s postpartum FP use by period in agrarian and pastoral settings of Ethiopia, Aug-Oct, 2023 (n=762)\u003c/p\u003e","description":"","filename":"Onlinedrawingimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-5953712/v1/6b64d114d0de155d9fdf8f99.png"},{"id":76297627,"identity":"af533c2d-4d4c-485a-818a-20fa171f7ef3","added_by":"auto","created_at":"2025-02-14 13:29:10","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":7870,"visible":true,"origin":"","legend":"\u003cp\u003eSources of postpartum family planning methods in agrarian and pastoral settings of Ethiopia,\u003c/p\u003e","description":"","filename":"Onlinedrawingimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-5953712/v1/dadf17786fc647a82c8504cb.png"},{"id":76297636,"identity":"50981d34-4156-4fe8-ba79-b3ba34a3b326","added_by":"auto","created_at":"2025-02-14 13:29:10","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":4130,"visible":true,"origin":"","legend":"\u003cp\u003eWomen’s intention to use contraception in agrarian and pastoral Ethiopia Aug-Oct, 2023\u003c/p\u003e","description":"","filename":"Onlinedrawingimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-5953712/v1/c76081291caa79e52d1af214.png"},{"id":90621848,"identity":"a87065a3-5d47-439c-be77-8b9ec45040e5","added_by":"auto","created_at":"2025-09-04 20:46:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2096680,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5953712/v1/4022390d-14b5-48ed-82f3-383ac1abe708.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Postpartum family planning use and women’s intention on contraception in Ethiopia: Disparities in the agrarian and pastoral contexts from community-based cross- sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003eFamily planning (FP) is the practice of using contraception to control the number and timing of pregnancies (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). It is a crucial intervention in ending preventable maternal deaths due to pregnancy and childbirth which plays a key role in reducing poverty (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e); and enables women to make informed decisions about their reproductive health (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Postpartum family planning (PPFP) is of the use of modern contraceptives immediately after childbirth plays a proven record of protecting against unintended pregnancy and is highly recommended intervention by the World Health Organization (WHO) to improve maternal and child health outcomes (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Postpartum contraceptives have significant contributions in reducing maternal, perinatal and child deaths by reducing the risk of closely spaced pregnancies (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). In low- and middle-income countries (LMICs), over half of the 1.6\u0026nbsp;billion women of reproductive age have a desire to control and delay their pregnancy (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). However, 218\u0026nbsp;million women had an unmet need to access modern contraception. In addition, approximately half of the pregnancies that occur every year in LMICs are unintended (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn sub-Saharan Africa, PPFP use remains low, particularly in Ethiopia(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). In Ethiopia, around 4.5\u0026nbsp;million women, lack access to modern contraception\u003csup\u003e7\u003c/sup\u003e. Existing evidence shows that PPFP use ranges from 25%(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) to 45.4% (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), with huge disparities between regional states that ranged from the highest (55%) in Ethiopia(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) and lowest (12.3%) in the Somali (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Gender dynamics are pivotal in shaping women\u0026rsquo;s access to and use of PPFP in Ethiopia (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Gender discrimination limits access to quality family planning services for both women and men, with women facing greater challenges due to traditional roles, while men also experience gender-related barriers (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Although postpartum modern contraception uses vary significantly across different geographical regions in LMICs (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Women still have limited access to the right family planning information and services related to modern contraception; poor partner or community support; cultural or religious opposition; patriarchal culture in Ethiopia's pastoralist and agrarian communities drives gender inequalities in labor; resource access; healthcare decisions; health literacy; traditional customs; gender-based challenges; and even lack of contraceptive availability with the process of choice that has minimal side effects concerns (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe disparity across agrarian and pastoral contexts has not recognized but been not well explored and comprehensively documented through previous studies. In response to this, the Improve Primary Health Care Service Delivery (IPHCSD) project which is being implemented by Amref Health Africa and JSI, designed a maternal and newborn community-based lifesaving intervention package including offering postpartum contraceptives to ensure access to modern family planning services. This study aims to assess the magnitude of current modern PPFP method use, intentions to use and disparities among postpartum women who gave birth during the previous 12 months in agrarian and pastoral contexts of Ethiopia.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy context\u003c/h2\u003e \u003cp\u003eEthiopia, the second populus country in Africa, has an estimated, 120\u0026nbsp;million population with a growth rate of 2.6%(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Although the nation strives to avail access to maternal health through primary healthcare (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), the uptake of PPFP is extremely low and is characterized by a high variation in agrarian and pastoral communities. This cross-sectional study was part of a larger community-based quasi-experimental implementation research. Ten woredas from five regional states, namely Chifra and Telalek woredas from Afar; Degahbur, Gursum and Gunagado woredas from Somali region with pastoral contexts; Seka Chekorsa and Shebe Sambo woredas from Oromia region; Bensa and Bona Zuria woredas from Sidama region and Shay Bench woreda from Southwest Ethiopia region which were representing the agrarian contexts were included. These sites were selected purposively due to having high home birth rates across both agrarian and pastoral contexts and data collection was conducted from August to October 2023.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProject description\u003c/h3\u003e\n\u003cp\u003eAs part of the IPHCSD project, Maternal and Newborn Health (MNH) supplement intervention is being implemented to improve access to lifesaving interventions for vulnerable pregnant women. It includes home-based distribution of lifesaving packages for pregnant mothers and newborns and is supplemented with a community empowerment intervention using a participatory learning for action (PLA) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) strategy in agrarian and pastoral woredas. Formative research was conducted to establish baseline values and inform stakeholders to implement adaptative management of the community-based delivery of lifesaving interventions (i.e. distribution of postpartum family planning services). The JSI and Amref partnership hypothesize that informed by the systematic understanding of context, co-designing and implementing the package of life-saving MNH interventions for women would reduce the deaths of mothers and their newborns (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Evidence-based effective interventions, delivery models, and tools will be further integrated into the IPHCSD platform.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eStudy design and participants\u003c/h3\u003e\n\u003cp\u003eThe community-based cross-sectional study was conducted among women who gave birth during the previous 12 months in ten agrarian and pastoral woredas of Ethiopia. Villages or kebeles, the lowest administrative units, are far from the woreda capital and with low utilization of health services were selected from agrarian and pastoral contexts. This cross-sectional study is part of a larger community-based quasi-experimental implementation research that served as a baseline for the embedded implementation research(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) of community-based delivery of lifesaving interventions and a participatory learning and action (PLA) approach roach (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). The interventions include promoting facility births, educating communities on birth preparedness and complication readiness, and facilitating the advance distribution of progesterone-only family planning pills (POP). Whereas the PLA approach(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) enhances women\u0026rsquo;s agency to address existing structural barriers to PPFP uptake.\u003c/p\u003e\n\u003ch3\u003eEligibility criteria\u003c/h3\u003e\n\u003cp\u003eEligible women were residents of the 107 kebeles located in 10 selected woredas with low facility-based maternal health service (skilled birth attendance) uptake and communities residing more than two hours walking distance from the woreda hub, and mothers aged 15\u0026ndash;49 years who gave birth during the previous 12 months\u003c/p\u003e\n\u003ch3\u003eSampling methods\u003c/h3\u003e\n\u003cp\u003eThe sample size was calculated using EPI Info StatCalc (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), considering the double population formula for a comparative cross-sectional household study design. The sample size calculation considered a 95% confidence level (Z\u003csub\u003eα/2\u003c/sub\u003e=1.96), a margin of error (d\u0026thinsp;=\u0026thinsp;5%), a design effect of (e\u0026thinsp;=\u0026thinsp;1.5), a power of 80%, and a two-sided significance level of 0.05 to detect 12% points change in the uptake of institutional delivery and women\u0026rsquo;s decision-making autonomy on maternal health services at the end of the project; and stratified by pastoralist and agrarian settings. Accordingly, 3,097 mothers (1,242 from agrarian and 1,855 from pastoral contexts) who gave birth during the previous 12 months at the time of data collection were included in the study. A two-stage cluster sampling technique was used to select the households for in-person interviews. In the first stage, Primary Health Care Units (PHCUs) having a catchment population with a high rate of home birth were purposefully selected. There were 54 Kebeles in the catchments of the selected PHCUs, which were the primary sampling units. Kebele is the smallest functional administrative structural unit in Ethiopia. In each sub-woreda, samples were allocated proportionally to the estimated population size. The updated list of households with mothers of infants 0\u0026ndash;11 months of age with their unique household identifiers(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) was obtained from the family folder of respective health posts, which was used as a sampling frame by the data collectors. In the second stage, a systematic random sample technique was used to identify women for interviews from targeted households.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eData were collected through a house-to-house survey using a structured interview questionnaire that was customized from the Ethiopian demographic and health survey (EDHS). The questionnaire was translated into local dialects (Amharic, Affaan Oromo, and Af-Somali). Experienced data collectors were recruited and trained for two days. The women's interviews yielded data on sociodemographic and previous obstetric history including women\u0026rsquo;s autonomy to seek maternal and newborn health (MNH) services across the continuum of care, men's engagement, and access to and control over financial resources for MNH care. SurveyCTO, a web-based digital platform was used to collect the data among women (15\u0026ndash;49 years) who gave birth during the previous 12 months. The interviews took 45 to 60 minutes.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMeasurements of the outcome and exposures\u003c/h3\u003e\n\u003cp\u003eThe outcome variables of this study are two: current use of PPFP and Intention to use in the future. The women\u0026rsquo;s current use and intention to use modern contraception during their extended postpartum period was the outcome variable and was assessed based on women\u0026rsquo;s self-reported binary responses (yes\u0026thinsp;=\u0026thinsp;1, no\u0026thinsp;=\u0026thinsp;0). The PPFP uptake was assessed by asking a woman whether she or her partner currently doing something or using any modern contraceptive methods to delay or avoid pregnancy during her extended postpartum period. Women\u0026rsquo;s intention to use family planning was assessed by asking whether the woman or partner will use contraceptive methods to delay or avoid pregnancy at any time in the future. The exposure variables included women\u0026rsquo;s autonomy to seek MNH services, men\u0026rsquo;s engagement, gender equitable attitude, and access to and control over financial resources. The gender-related barriers were grouped into women\u0026rsquo;s autonomy in decision-making (\u003cspan additionalcitationids=\"CR22 CR23 CR24 CR25\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), and societal gender norms and attitudes (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan additionalcitationids=\"CR28 CR29 CR30 CR31\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). In addition, the social capital study(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) was indirectly assessed through the social support to the women for maternal health service uptake. So, social support was measured using the Oslo-3 scale (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Gender equitable attitude was measured using a six-item tool rated using a Likert scale ranging from 1(\u0026ldquo;agree\u0026rdquo;), 2(\u0026ldquo;somehow agree\u0026rdquo;), and 3(\u0026ldquo;disagree\u0026rdquo;). The mean values of the response from the six items were used as cut-off points for gender-equitable norms less than the mean value for gender-equitable and above the mean for gender-inequitable norms. Women\u0026rsquo;s experience of disrespect or abuse by healthcare providers during maternal health use was measured using the two-item tool and considered disrespect if a woman has experienced at least one of the disrespectful treatments.\u003c/p\u003e\n\u003ch3\u003eData management and analysis\u003c/h3\u003e\n\u003cp\u003eCollected data were exported from Excel Sheet to Stata v. 18(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e) for cleaning and analysis. Stratified descriptive statistical analysis were used to compute the frequencies and proportions in agrarian and pastoral contexts. The characteristics of women in the two contexts were examined using Pearson\u0026rsquo;s chi-square statistics test. Most of the exposure variables were categorical. Descriptive statistics were carried out to compute the proportion of exposure and outcome variables cross-tabulated with clusters. The primary health care units (PHCUs) were the clustered sampling unit, in which access to PPFP within the PHCUs catchment was similar but women\u0026rsquo;s current and future PPFP use varies across PHCUs. In this paper, women\u0026rsquo;s current and future PPFP use were the two outcome variables fitted independently. Eventually, multilevel mixed-effects logistic regression analysis(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e) was fitted to determine the relationship between explanatory variables and postpartum family planning uptake and future intention stratified by agrarian and pastoral settings. Adjusted odds ratio (AOR) at 95% CI were determined on the final model declaring significant association.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eDemographic and socio-economic profiles of study participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNearly one-half (44.3%) of women included in the study were in the age group of 25-30 years old. The majority (97.8%) of them were ever married. Approximately three-fourths (73.4%) of the women were Muslim. Of these, 99.9% of women in the pastoral setting were Muslim. The women\u0026rsquo;s sociodemographic characteristics from agrarian and pastoral settings are significantly different (\u003cstrong\u003eTable 1\u003c/strong\u003e).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSources of PPFP information\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong 3,097 women who gave birth in the past 12 months, 68.4% (n=2,119) of them gave birth at home and 60% of them received information about modern PPFP methods from either Health Extension Workers (HEWs) or other healthcare providers (HCP). Nearly one-in-five (19.7%, n=609) women discussed with the HEW or other HCPs about PPFP. Of these, 99.7% (607) of them obtained necessary information about birth control methods to be taken within 45 days of the postpartum period. Most of the women were told about injectables (86.5%), implants (71%), and pills (59.9%) to avoid immediate pregnancy during postpartum. Nevertheless, discussion about contraceptives with HCPs was extremely low with significant variation in agrarian (43.5%, n=540) and pastoral (3.7%, n=69) contexts. \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReproductive history\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong women who gave birth for the past 12 months (n=3097), 12.9% of them were primigravida and para. Two-thirds (65.5%) of women attended antenatal care follow up, and 84(2.7%) of women experienced pregnancy within a year of their postpartum period were from the pastoral communities (\u003cstrong\u003eTable 2\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePostpartum FP uptake\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong 3097 women who had given birth in the past 12 months and included in the study, 3013 (97.3%) of them were interviewed about either themselves or their partner currently using any modern family planning methods to delay or prevent pregnancy. Of these, women\u0026rsquo;s current use of postpartum contraceptives was 25.3% (95%CI: 23.8-26.9%) with significant disparity between agrarian and pastoral contexts (\u003cstrong\u003eFig 2\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAdditionally, of those women who used PPFP (n=762), only 2.5% (19) of women used PPFP immediately within 48 hours. Nearly three-quarters (71.3%, n=543) of them started PPFP within six weeks (\u003cstrong\u003eFig 3\u003c/strong\u003e). \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePreferred PPFP methods\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf those women who gave birth in the past 12 months, approximately three-fourths (73.1%, n=557) of them used injectable methods. Although it has low uptake in pastoral contexts, injectables and implants were preferred methods (\u003cstrong\u003eTable 3\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSources of PPFP service\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the studied women, a significant majority used the health centers as main access point to postpartum family planning methods, followed by the health posts (\u003cstrong\u003eFig 4\u003c/strong\u003e). Among women who used postpartum family planning, 96.0% (n=752) of them obtained their preferred method of choice. The remaining 4% (31) of women didn\u0026rsquo;t get the preferred method for various reasons including method stock out, no trained skilled personnel, and absence at the specific facility during women\u0026rsquo;s visits for PPFP. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReasons for not using PPFP\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWomen had several reasons for not using postpartum contraceptives. The major reasons religious prohibition (40%), being lactating (21.1%) and want to have more children (18.1%) (\u003cstrong\u003eTable 4\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWomen\u0026rsquo;s intention to use contraception\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe assessed women\u0026rsquo;s intention to use contraception, overall slightly more than one-third (37.5% 95%CI: 35.8-39.2%) of women expressed intention to use PPFP in the future. Nevertheless, only 5.4% of women who live in pastoral setting had an intention to use PPFP in the future (\u003cstrong\u003eFig\u003c/strong\u003e 5). Injectable (57.1%), implant (34.9%) and pills (3%) were the preferred methods by women for future use.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors determining the women\u0026rsquo;s use of PPFP\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of sixteen explanatory variables were considered in the mixed effect logistic regression analysis. \u0026nbsp;Of these, nine of them have significant associations. being Muslim women \u0026nbsp;(AOR: 0.29; 95%CI: 0.19-0.46); living more than an hour\u0026apos;s walking distance from the health facilities (AOR: 0.70; 95%CI: 0.49-0.99); residing \u0026nbsp;in pastoral contexts (AOR: 0.03; 95%CI: 0.01-0.06); women\u0026rsquo;s previous history of home birth(AOR: 0.53; 95%CI: 0.39-0.72) and women who had autonomy to jointly decide on place of delivery (AOR: 0.38; 95%CI: 0.22-0.66) were significantly associated barriers to PPFP use of women in agrarian and pastoral contexts of Ethiopia. \u0026nbsp;Women who had strong social support (AOR: 1.75; 95%CI: 1.23-2.49); had the autonomy to decide on FP use: 3.25; 95%CI: 1.89-5.59) and had antenatal care follow-up (AOR: 3.46; 95%CI: 2.25-5.32) were significantly associated with women\u0026rsquo;s uptake of PPFP in Ethiopia (\u003cstrong\u003eTable 5\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe null model of the regression analysis considering the inter-cluster variability between PHCUs as cluster (Table 6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors determining women\u0026rsquo;s intention use contraception\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of sixteen explanatory variables were considered in the mixed effect logistic regression analysis to identify independent predictors of women\u0026rsquo;s intention to use postpartum family planning in the future. \u0026nbsp;Of these, six of them positively influence women\u0026rsquo;s postpartum family planning use for the next birth. Women attended secondary school and above (AOR: 1.87; 95% CI:1.14-3.04); \u0026nbsp;women from rich groups (AOR:1,76;\u0026nbsp;95% CI: 1.07-2.89); women lived in families who have favorable attitudes towards equitable gender norms (AOR: 1.64 95% CI:1.19-2.26); women who had antenatal care (AOR: 1.9295% CI:1.35-2.74); women who had strong social support (AOR:\u0026nbsp;2.01 95% CI:1.34-3.02) and women who have the autonomy to use FP (AOR: 2.57 95% CI:1.61-4.10) were the factors significantly associated with positive intention of women to use PPFP in their subsequent births. Nevertheless, women from pastoral context (AOR:0.07; 95% CI: 0.04-0.16);\u0026nbsp;Muslim women (AOR: 0.14; 95% CI: 0.08-0.27); women who gave their previous birth at home (AOR: 0.35; 95% CI: 0.25-0.49); and live far from the health facility (more than an hour walking distance) (AOR: 0.62; 95% CI: (0.61-0.93) were less likely to use the PPFP in the future in Ethiopia\u003cstrong\u003e\u0026nbsp;(Table 7).\u0026nbsp;\u003c/strong\u003eThe null model of the regression analysis considering the inter-cluster variability between PHCUs as cluster (Table 8).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings from this study indicate significant differences in the current and future PPFP use among women in the agrarian and pastoral context in Ethiopia. Women who had previous antenatal care visits, strong social support, autonomy on FP use, live in a community who have a favorable attitude towards equitable gender norms were crucial facilitators for the current and future use of PPFP. Nevertheless, lack of access to health facilities, home birth, being pastoral community, and being Muslim by religion were the barriers to current and future PPFP use in agrarian and pastoral contexts of Ethiopia. This highlights the potential influence of socio-cultural factors on family planning behaviors, where religious and cultural norms could play a role in contraceptive uptake.\u003c/p\u003e \u003cp\u003eThe current study reveals a current PPFP use of 25.3%, which was consistent with global, African, and Ethiopian evidence; 28.5% in Malawi (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e), 28% in Uganda(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e) and 24.6 in Pakistan(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e), and in Ethiopia ranged from 21%(\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e) to 23%(\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). Nevertheless, this study finding was slightly lower than 29.3% in Tigray(\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e) and 31.7% in Aroressa woreda in Southern Ethiopia (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). However, the prevalence of PPFP varies significantly across different regions of Ethiopia. In the Somali Region, low uptake of 12.3% (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e), 31.7%(\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e), 77.9%(\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e) in SNNP, 45.8%(\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e) to 46.7%(\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e) in Amhara Region; 48%(\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) to 68.1%(\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e) in Tigray Region while 80.3%(\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e) in Addis Ababa. These higher rates reflect successful interventions in particular areas but also suggest that efforts should be tailored to address regional disparities in culture, norms, and access to health services.\u003c/p\u003e \u003cp\u003eAlthough the pastoral contexts are extremely low, the overall current use of PPFP is higher than findings from studies conducted in Liberia (11.9%) (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e), the Democratic Republic of Congo (6.9%) (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e), some parts of Ethiopia (10.3%) (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e), that underscores the challenges some countries face in expanding family planning services. Similarly, the method choice, such as injectables and implants by women, is consistent with other studies previously conducted in Ethiopia, implants were most used (57%), followed by injectables (35.5%) (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). These results emphasize the need to promote diverse contraceptive options to address varying family planning preferences.\u003c/p\u003e \u003cp\u003eThis study explored factors influencing PPFP uptake among Ethiopian women, highlighting the impact of sociodemographic and access-related variables. Multilevel analysis revealed key determinants, including religious background, healthcare access, gender-equitable attitudes, social support, and healthcare autonomy have key roles in PPFP uptake and future acceptance. Similarly, research in Liberia found an inverse relationship between distance and PPFP use (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). while a study in Tigray (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) reported higher odds of contraceptive use among women who have access to health facilities (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). These findings underscore the importance of proximity in improving family planning access and utilization. The study highlights that women with gender-equitable attitudes are significantly more likely to adopt PPFP emphasizes the importance of progressive gender norms in reproductive health and aligns with findings from Indonesia (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e). Empowered women in gender-equal societies make autonomous decisions on contraception. Furthermore, a study in pastoralist Somali communities in Kenya (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e) revealed that the low uptake of modern contraceptives among Somali women is influenced by socio-cultural norms, such as polygamy, and a preference for large families. Studies in Ghana (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) and other sub-Saharan Africa(\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e) indicate the common use of covert contraception using birth control without a partner\u0026rsquo;s knowledge indicates differing partner beliefs about family size and contraception.\u003c/p\u003e \u003cp\u003eStrong social support networks play a critical role in increasing the likelihood of PPFP adoption, as evidenced by this study. Community and family support, particularly from spouses, is instrumental in encouraging the use of PPFP. This finding aligns with the existing evidence in Ethiopia (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e), in Indonesia (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e), in Kenya (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e), and in Nigeria(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) which highlights the importance of strong social support as a significant factor influencing PPFP uptake. Similarly, this study shows that women with autonomy to seek family planning (FP) services are significantly more likely to use PPFP, emphasizing the critical role of empowerment in reproductive health decisions. The agreement is found with a sub-Saharan African studies (\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e), Indonesia (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e), in Kenya (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e), that highlighted joint decision-making with partners as a stronger determinant of contraceptive use than women\u0026rsquo;s independent decisions, who noted that limited spousal support often hinders FP participation. Observed covert contraceptive use driven by inadequate spousal support, suggesting that autonomy alone may not address deeply rooted gender dynamics.\u003c/p\u003e \u003cp\u003eThis study examines women\u0026rsquo;s intention to use contraception in Ethiopia, highlighting significant variations influenced by demographic, socioeconomic, and community-level factors. The findings indicate that 37.5% of women expressed an intention to use PPFP, with a notably higher rate of 84.5% in agrarian communities compared to only 5.4% in pastoral communities. These disparities emphasize the influence of context and access to resources on PPFP intentions. Additionally, the intention rate reported in this study aligns closely with the finding of 37% in Benin (\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e), where similar challenges related to healthcare access and cultural factors persist. Other studies conducted in Ethiopia reveal significantly higher intention rates. And 84.3% intention in Northern Ethiopia (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e), showcasing the impact of urban infrastructure, healthcare access, and community-based education on PPFP intentions and A study in the Oromia region found an intention rate of 66.6%(\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e) reinforcing the idea that health education and local acceptance of family planning significantly influence PPFP intentions.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations of this study\u003c/h2\u003e \u003cp\u003eThe study was a community-based and multisite study with a representative sample of women from agrarian and pastoral contexts. Data were collected using computer-assisted personal interviews (CAPI) using a reliable tool adapted from the Ethiopian Demographic and Health survey tool. Nevertheless, the reports depend on the women\u0026rsquo;s self-report data which may have a recall basis. The study is unable to determine the causal impact of these variables on women\u0026rsquo;s PPFP uptake and intention due to the limitation of a cross-sectional study.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eWomen’s current and future PPFP use are extremely low in Ethiopia with significant disparities between agrarian and pastoral communities. Moreover, the current and future PPFP use vary by only 12.2 percentage points implying there is no significant aspiration in the future. Socio-demographic factors such as maternal age, religion, gender-equitable attitudes, women’s autonomy for FP, antenatal care use, and strong social support play pivotal roles in influencing both the uptake and intention to use PPFP. The findings highlight the need for tailored interventions addressing the unique challenges faced by women in pastoral settings, including access to health facilities, socio-cultural barriers, and limited autonomy in decision-making. This finding is critical and informative to design a participatory learning and action (PLA) platform and transform gender equitable norms, promote women’s autonomy, and strengthen social support in agrarian and pastoral contexts of Ethiopia.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eAIC: Akaike’s information criterion; AOR: Adjusted Odds Ratio; CI: Confidence Interval; DIC: Deviance information criterion, HCP: Healthcare providers; HEW: Health Extension Workers; ICC: Intra-class correlation coefficient; PPFP: postpartum family planning; SE: Standard error; WHO: World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance to conduct the study was obtained from the Ethiopian Public Health Association (EPHA) Research Ethical Review Board. The study was conducted by the declaration of Helsinki. Informed verbal and written consent were obtained from each study participant voluntarily to be included in the study. Informed consent from participant/legal guardian and assent from them were obtained from study participants who were younger than 18 years old, and had not attended formal education. The collected data was kept confidential anonymously through the de-identification of names and other personal identifiers from the record/sheet. Parents/guardians in case of minor study participants and legally authorized representatives in case of illiterate participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eAll related data are presented fully within the paper, and available upon reasonable request to the lead author and the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis study was financially supported by the Bill \u0026amp; Melinda Gates Foundation (BMGF) [INV-002643 to MM and INV-037995 to DE]. But the funder has no role on the interpretation of the finding which is the full responsibility of the authors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTA, DE, MM, GTT, NB, AH, NF, and MD, have involved since inception of the study design. GTT, AS, MT, HT, NF, AD, MB, CT, OM, ZF, MY, AM; AG, MA and RD involved in the data acquisition and quality assurance measures. AS*\u0026amp; GTT carried out the data analysis and interpretation of the findings. \u0026nbsp;AS*, GTT, OM, and MDA develop the manuscript, and GTT, MDA, NB, AH, WM, BB, SM, AW, \u0026amp; NF reviewed the manuscript for intellectual contents. AT, MT, SA, SS, LT, DTA, FD, TA\u003csup\u003e,\u0026nbsp;\u003c/sup\u003eDE, ZM, MDM, AW, and MM\u003csup\u003e\u0026nbsp;\u003c/sup\u003egave high-level critical comments and oversee project implementation. All authors have reviewed the manuscript critically for important intellectual contents and approved the final manuscript for submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to acknowledge Bill \u0026amp; Melinda Gates Foundation (BMGF)\u0026nbsp;for financial support, Amref Health Africa and JSI for the overall admirative support, the study participants, data collectors, supervisors for their willingness to give their time and information for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eAmref Health Africa, Addis Ababa Ethiopia; \u003csup\u003e2\u003c/sup\u003eJSI, Addis Ababa, Ethiopia; \u003csup\u003e3\u003c/sup\u003eSchool of Public Health, Addis Ababa, Ethiopia \u003csup\u003e4\u003c/sup\u003eMinistry of Health, Addis Ababa, Ethiopia; and \u003csup\u003e5\u003c/sup\u003eBill \u0026amp;Melinda Gates Foundation (BMGF), Addis Ababa, Ethiopia;\u0026nbsp;\u003csup\u003e6\u003c/sup\u003eMERQ Consultancy P.L.C, Addis Ababa, Ethiopia; and \u003csup\u003e7\u003c/sup\u003eFenot project-Harvard T.H. 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Coverage and determinants of modern contraceptive use in sub-Saharan Africa: further analysis of demographic and health surveys. Reprod Health. 2022;19(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKuug Akolsabilik, Daniels-Donkor SS, Laari TT, Atanuriba GA, Kumbeni MT, Daliri DB et al. Assessment of intention to use modern contraceptives among women of reproductive age in Benin: evidence from a national population-based survey. Contracept Reprod Med. 2024;9(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaba G, Deressa JT, Sinishaw W. Assessment of intention to use postpartum intrauterine contraceptive device and associated factors among pregnant women attending antenatal clinics in ambo town public health institutions, Ethiopia, 2018. Contracept Reprod Med. 2021;6(1).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1: Basic characteristics of women (15-49 years) in 10 woredas from agrarian and pastoral Ethiopia August-October 2023 (n=3,097)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgrarian\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePastoral\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e15-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e446(35.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e378(20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e824(26.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e25-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e604(48.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e768(41.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1372(44.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e31-35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e148(11.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e453(24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e601(19.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e36-49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e44(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e256(13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e300(9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eReligion\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e822(66.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1(0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e823(26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eMuslim\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e419(33.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1853(99.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2272(73.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eMarital status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eEver married\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1229(98.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1,809(97.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e3029(97.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eNever married\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e13(1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e55(2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e68(2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eWomen education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eNot attended formal school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e548(44.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1665(89.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2213(71,5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e346(27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e117(6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e463(15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eSecondary \u0026amp; plus)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e348(28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e73(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e421(13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eHusband education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eNot attended formal school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e355(28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1430(77.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1785(57.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e332(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1148(8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e480(15.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eSecondary \u0026amp; plus)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e555(44,7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e277(14,9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e832(26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eWomen occupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eUnemployed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1146(92.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1672(90.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2818(91.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eEngaged in job\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e94(7.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e177(9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e271(8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eHusband occupation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eUnemployed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e12(0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e191(10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2036.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eEngaged in job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1212(99.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1613(89.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2825(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eDistance from health facilities\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026lt;1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1,033(83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1,353(72.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2386(77.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026ge; 1hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e209(16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e502(25.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e711(27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eFamily size\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026le;5 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e532(42.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e382(20.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e914(29.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026gt;5 Members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e710(57.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1473(79.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2183(70.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eWealth index\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003ePoor\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e65(5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e968(52.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1033(33.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eMiddle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e340(27.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e692(37.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1032(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eRich\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e837(67.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e195(10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1032(33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eSocial support\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003ePoor\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e284(22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e417(22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e701(22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e478(38.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1176(63.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1654(53.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eStrong\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e480(38.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e262(14.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e742(23.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eMembership to VHL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e168(13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e50(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e218(7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eMembership to CBHI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e691(55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e17(0.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e708(22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2: Women\u0026rsquo;s obstetric history in agrarian and pastoral settings in Aug-Oct, 2023 (n=3097)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgrarian\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePastoral\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eGravida q36a\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eprimigravida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e261(21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e137(7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e398(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003emultigravida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e981(78.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1,718(92.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2,699(87.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 120px;\"\u003e\n \u003cp\u003ePara\u0026nbsp;q36b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003ePrimipara\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e261(21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e137(7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e398(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eParity 2-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e650(52.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1,198(64.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1848 (59.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eGrand multipara\u0026gt;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e331(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e520(28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e851(27.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eAntenatal care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eHad follow up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e1093(88.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e934(50.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2,017(65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003ePlace of birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eHome birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e502(40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1617(87.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2119(68.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eFacility birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e740(59.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e238(12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e978(31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003ePregnancy status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3(0.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e81(4.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e84(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e12291(99.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1674(90.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2903(93.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e10(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e100(5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e110(5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3: Women\u0026rsquo;s preferred contraceptive choices for PPFP in agrarian and pastoral Ethiopia (n=762)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily planning methods\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgrarian\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePastoral\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eInjectable\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e557(73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e553(74.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e4(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eImplants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e175 (23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e171(22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e4(26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003ePill\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e17(2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e15(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e2(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eIUD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e3(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e3(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eOthers*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e10(0.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e5(0.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e5(0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eTable 4\u003c/strong\u003e: Women\u0026rsquo;s common reasons for not using PPFP in agrarian and pastoral context of Ethiopia, Aug-Oct, 2023(n=3097)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReason for not using PPFP Variable\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgrarian\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePastoral\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eReligious prohibition\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e905(40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e19(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e886(50.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eBreastfeeding\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e474(21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e147(30.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e327(18.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eWant to get pregnant\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e406(18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e22(4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e384(21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eHusband/partners opposed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e215(9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e42(8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e173(9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003ePostpartum amenorrhoeic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e198(8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e181(37.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e17(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eKnows no method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e113(5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e6(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e107(6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eMethod of choice not available\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e106(4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e8(1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e98(5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eWomen themselves opposed contraceptive\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e94(4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e10(2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e84(4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eNot have sex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e92(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e68(14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e24(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eOther family members opposed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e86(3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e86(4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eFear of Side Effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e75(3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9(1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e66(3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eKnow no source\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e62(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1(0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e61(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eLack of access/far\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e32(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e16(3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e16(0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eHealth concern\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e18(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e4(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e14(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eInfrequent sex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e18(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9(1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e9(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eCost too much\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e16(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e4(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e12(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eInconvenient to use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e7(0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e5(0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5:\u0026nbsp;\u003c/strong\u003eMultilevel mixed-effects logistic regression model of\u0026nbsp;the\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efactors affecting women\u0026rsquo;s uptake of PPFP in Ethiopia\u0026nbsp;in Ethiopia, Aug-Oct 2023\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"612\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e(COR 95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 2: Intercept model\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eAge of women (ref: 15-24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e23-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.84(0.64-1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.01(0.72-1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e31-35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.70(0.47-1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.92(0.57-1.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026ge;36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.69(0.37-1.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.84(0.41-1.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eMaternal education\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(ref: not attended school)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e1.32(0.97-1.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.94(0.68-1.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eSecondary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.28(1.64-3.18)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.43(0.97-2.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eReligion (ref: Christian)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eMuslim\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.10(0.05-0.23)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.29(0.19-0.46)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eHusband education\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(ref: not attended school) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.47(1.05-2.08)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.22(0.85-1.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eSecondary+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.79(1.29-2.49)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.08(0.74-1.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eWealth index (ref: poor)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eMiddle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e1.46(0.87-2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.04(0.60-1.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eRich\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.92(1.16-3.22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.99(0.57-1.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eDistance to HF (ref: \u0026lt;1 hour walking distance)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026ge;1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.72(0.51-1.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.70(0.49-0.99)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eGender-equitable attitude (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e1.62(1.23-2.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.51(1.12-1.71)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eFamily size (ref: \u0026lt;5 family members)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026ge;5 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.63(0.49-0.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.79(0.57-1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eSocial support (ref: poor)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eModerate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e1.29(0.93-0.1.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.35(0.96-1.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eStrong\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.60(1.15-2.23)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003cstrong\u003e.75(1.23-2.49)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eBeing member of VHL (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.58(1.05-2.39)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.29(0.85-1.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eBeing member of CBHI (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e1.31(0.98-1.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.00(0.74-1.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eAutonomy to seek FP (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.51(1.74-3.62)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.25(1.89-5.59)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eANC follow up (ref: No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.07(2.70-6.16)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.46(2.25-5.32)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003ePlace of delivery (ref: Health Facility)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eHome birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.42(0.30-0.57)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.53(0.39-0.72)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eAutonomy to delivery place (ref: Husband)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eJointly or alone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e1.23(0.85-1.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.38(0.22-0.66)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003eResidence/community livelihood (ref: agrarian)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003ePastoral\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.004(0.002-0.007)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03(0.01-0.06)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 612px;\"\u003e\n \u003cp\u003e\u003cem\u003eNB: *significant association at p-values \u0026lt;0.05; HF: health facility; ANC: antenatal care; FP: family planning\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6:\u0026nbsp;\u003c/strong\u003eRandom effects (measures of variations) and model fitness for the\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efactors affecting women\u0026rsquo;s uptake of PPFP in Ethiopia by Multilevel mixed-effects logistic regression modeling, Aug-Oct 2023\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameters\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNull model (empty model)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel-III\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eModel-0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eCommunity-level intercepts (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e-1061.757\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-786.578\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom-effect (measures of variation)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eCluster level variance (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e14.644(3.337)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.231(0.125)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eLoglikelihood (LL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e-928.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-7779.555\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel fit statistics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eICC (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e0.0.817(0.034)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.0658(0.331)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eAIC(BIC)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e1860.534(1872.534)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1607.109(1751.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAIC: Akaike\u0026rsquo;s information criterion, DIC:\u0026nbsp;Deviance information criterion, ICC:\u0026nbsp;Intra-class correlation coefficient, SE:\u0026nbsp;Standard error,\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table 7:\u0026nbsp;\u003c/strong\u003eMultilevel mixed-effects logistic regression model of\u0026nbsp;the\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efactors affecting women\u0026rsquo;s intention to use contraception in Ethiopia, Aug-Oct 2023\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"618\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOR 95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 2:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eIntercept model\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of women (ref: 15-24 year)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e25-30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.71(0.52-0.96)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.65(0.45-0.95)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e31-35 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.49(0.32-0.73)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.49(0.29-0.80)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026ge;36 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.53(0.31-0.94)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.47(0.25-0.89)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMaternal education\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(ref: not attended school)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.82(1.26-2.63)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.19(0.79-1.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eSecondary+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.13(2.02-4.84)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.87(1.14-3.04)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eReligion (ref: Christian)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e0.01(0.004-0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.14(0.08-0.27)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eHusband education\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(ref: not attended school)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.46(1.01-2.11)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.13(0.77-1.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eSecondary+\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.99(1.42-2.81)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.10(0.74-1.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eWealth (ref: Poor)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.02(1.31-3.13)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.40(0.89-2.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eRich\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.84(2.37-6.22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1,76(1.07-2.89)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eDistance to HF (ref: walking hours\u0026lt;1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026ge;1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e0.74(0.48-0.1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.62(0.61-0.93)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eGender-equitable attitude (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.75(1.30-2.36)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.64(1.19-2.26)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eAutonomy to HF delivery (ref: husband)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eAlone or joint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.75(1.25-2.46)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.69(0.41-1.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003ePlace of delivery (ref: HF)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eHome birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.22(0.16-0.31)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.35(0.25-0.49)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eANC follow (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.81(2.03-3.92)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.92(1.35-2.74)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eFamily size (ref: family size \u0026lt;5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026ge;5 members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e0.81(0.61-0.1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.39(0.96-2.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eSocial support (ref: poor)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eModerate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e0.1.36(0.96-1.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.33(0.95-1.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eStrong\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.11(1.44-3.08)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.01(1.34-3.02)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eAutonomy to seek FP (ref: Husband)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eJoint or alone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e261(1.87-3.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.57(1.61-4.10)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMember of VHL (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e1.43(0.81-2.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.26(0.84-1.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eMember of CBHI (ref: No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.73(1.19-2.52)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.99(0.55-1.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eResidence/community livelihood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eAgrarian\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003ePastoral\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e0.005(0.002-0.009)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.07(0.04-0.16*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 618px;\"\u003e\n \u003cp\u003e\u003cem\u003eNB: *significant association at p-values \u0026lt;0.05; HF: health facility; ANC: antenatal care; FP: family planning\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 8:\u0026nbsp;\u003c/strong\u003eRandom effects (measures of variations) and model fitness for the\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003efactors affecting women\u0026rsquo;s intention to use PPFP in Ethiopia by Multilevel mixed-effects logistic regression modeling, Aug-Oct 2023\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameters\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNull model (empty model)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel-III\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003eModel-0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eFinal model\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eCommunity-level intercepts (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e-1063.232\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-741.214\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRandom-effect (measures of variation)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eCluster level variance (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e12.659(2.479)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.555(0.197)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eLoglikelihood (LL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e-913.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.741.214\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel fit statistics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eICC (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e0.794(0.032)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.1444(0.044)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003eAIC(BIC)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e1830.61(1842.138)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1530.429(1675.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAIC: Akaike\u0026rsquo;s information criterion, DIC: Deviance information criterion, ICC: Intra-class correlation coefficient, SE: Standard error,\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Postpartum family planning, intention on contraception, pastoral, agrarian, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-5953712/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5953712/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePostpartum family planning (PPFP) is the initiation of contraceptive methods immediately after childbirth. It is impactful intervention to reduce the risk of maternal and child deaths through spacing pregnancies. However, the magnitude of women\u0026rsquo;s access to and use of modern PPFP methods remains low, context-based evidence is crucial in addressing these gaps to inform policies. Therefore, this study aimed to assess women\u0026rsquo;s current use and intention on contraception in agrarian and pastoral contexts of Ethiopia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA community-based house-to-house survey was conducted as a baseline study to embedded implementation research in 10 selected woredas from the agrarian and pastoral contexts of Ethiopia. Data were collected among randomly selected 3097 women using a structured questionnaire through a SurveyCTO platform and analyzed using Stata 18. A multi-level mixed-effect logistic regression was used to identify the factors associated with women\u0026rsquo;s current of PPFP uses and intention to use contraception it in agrarian and pastoral contexts.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe overall current modern PPFP use was 25.3% (95%CI: 23.8%-26.9%), with significant variations in agrarian (60.6%) and pastoral (0.9%) contexts. Additionally, 37.5% (95%CI: 35.8\u0026ndash;39.2%) of women had the intention to use modern PPFP. Injectable and implant contraceptives were the most preferred PPFP methods. Factors influencing both current and future PPFP use included women\u0026rsquo;s antenatal care visits (AOR:3.46; 95% CI:2.25\u0026ndash;5.32), strong social support (AOR:1.75; 95% CI:1.23\u0026ndash;2.49), autonomy on FP use (AOR:3.25; 95% CI:1.89\u0026ndash;5.59), and favorable attitude towards equitable gender norms (AOR:1.51; 95% CI:1.12\u0026ndash;1.71). Nevertheless, women who have no access to health facilities (AOR:0.70; 95% CI:0.49\u0026ndash;0.99), history of homebirth (AOR:0.53; 95% CI:0.39\u0026ndash;0.72), being from pastoral communities (AOR:0.03; 95% CI:0.01\u0026ndash;0.06), and being Muslim women (AOR:0.29; 95% CI:0.19\u0026ndash;0.46) are less likely to current PPFP use and intention to use contraception.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eWomen\u0026rsquo;s current use of modern PPFP and intentions to use contraception are extremely low in Ethiopia with significant disparities between agrarian and pastoral communities. Improving antenatal care, increasing social support, promoting women's autonomy and transforming gender equitable norms are crucial facilitators for increasing the contraceptive use. Addressing low utilization of PPFP requires culturally tailored interventions for agrarian and pastoral contexts, and promote women's autonomy, and improve service accessibility.\u003c/p\u003e","manuscriptTitle":"Postpartum family planning use and women’s intention on contraception in Ethiopia: Disparities in the agrarian and pastoral contexts from community-based cross- sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-14 13:29:05","doi":"10.21203/rs.3.rs-5953712/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"009a944c-bdb0-4d45-952c-740fc5dc4a69","owner":[],"postedDate":"February 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-04T20:38:19+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-14 13:29:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5953712","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5953712","identity":"rs-5953712","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}