Determinants of Long Acting Family Planning Utilization Among Reproductive Age Women in Ethiopia Based on Ethiopian Demographic and Health Survey Data 2019: Generalized Estimated Equation (GEE) Modeling

Background: Obstetric morbidity and mortality is reduced by universal access of reproductive health services including family planning. Long acting family planning is highly effective with low failure rate while the utilization and its determinants is not well studied in the recent EDHS data. Identifying the determinants of long acting family planning is important to design appropriate interventions and programs that address for the specific population. Objective: To identify the determinants of long acting family planning utilization among reproductive age women in Ethiopia based on Ethiopian demographic and health survey-2019. Method: A secondary data analysis was done from 2019 EDHS data. A data were extracted from kid record file by STATA version 15. A total of, 4,782 reproductive age women were selected for the study. After weighting the data, generalized estimated equation modeling was analyzed by xtgee STATA command. The model selection was done by quasi likelihood criteria (QIC) and fitting the model was done by two proposed working correlation structure (exchangeable and independent). Generalized estimated equation modeling of the study parameter was assessed accordingly. Result: The magnitude of long acting family planning utilization in this study was 8.6[95% CI: 7.8, 9.4]. Determinants of long acting family planning utilization was age of women 40-49 year (OR=1.87 [95%CI: 1.7, 4.7]), rural residence (OR= 0.47[95%CI: 0.19, 0.89]), female household head (OR=1.67[95%CI:1.5,2.2]), family size ≥13 (OR=0.04[95CI:0.003,0.68]) and number of under five children ≥4 (OR=0.26[95%CI:0.09,0.68]). Conclusion: The magnitude of long acting family planning utilization in Ethiopian women is relatively low. Age, residence, household head, family size, and number of under five children was the identified determinants of long acting family planning utilization. The finding imply that the country need scaling up the use of long acting family planning through improving young and adolescent FP use, empowering women and working on large family size households. RH interventions including family planning could address the rural male headed young aged women who had more than four under five children in the house to increase the utilization of long acting family planning utilization. Funding Information: The authors did not receive any fund for this research Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: The dataset used in this study was obtained from demographic and health survey (DHS) database at http://dhsprogram.com/data/ after getting the approval letter from DHS program office. The Institution Review Board approved procedures for DHS public use datasets do not in any way allow respondents, households or sample communities to be identified.