Trends in Modern Contraceptive Use in Ethiopia: Empirical Evidence from a decade-long Family Planning Program Implementation
Background: Changes in modern contraceptive prevalence rate are among the determinants of a country‘s efforts to improve its reproductive health but limited longitudinal data and variability in data sources create difficulties in monitoring progress for family planning outcomes. The objective of this study is to be presenting empirical evidence from pathfinder monitoring and documentation experience, and lessons learned from a decade of family planning program implementation in Ethiopia from 2011 to 2019.
Method: We accessed records of 24,621 women of reproductive age from Pathfinder International‘s annual Follow-up survey database. The descriptive statistics (table and figure) used to estimate the changes in modern contraceptive prevalence rate and method mix from 2011 to 2019 where the organization implemented family planning services. The statistical stability of survey estimates across the nine-year period using variance estimate and coefficient of variation less than 30%. The ascertained plausible interpretation of the observed trends by referring to other national surveys and program documents of the organization. All analyses were done using SPSS version 20.
Results: Findings indicated that there was a 17-percentage point (95% CI: 4.8 – 22.1) increase in modern contraceptive prevalence rate between 2011 and 2019. Long-acting reversible contraceptives accounted for a significant share of this increase, particularly implants (mean difference =18%, 95% CI, 15-20%, p-value< 0.001). Among short-acting methods, use of injectables accounted for a significant portion of the increase (mean difference =4%, 95% CI= 2-7%, P<0.001).
Conclusion: Findings indicated that the observed changes were correlated with integration of family planning into primary health care services, improved service availability and access, and expanded method choice in the intervention areas. This analysis provided empirical evidence that aligning a program‘s monitoring system with national priorities can provide information to foster timely subnational decision making, document contributions of organizations to national programs, and generate scalable lessons. [Ethiop. J. Health Dev. 2021;35(SI-5):63-69]
Keywords: Contraceptives, Modern Contraceptive Prevalence Rate, Method Mix, Performance Monitoring, Ethiopia