Journal of Pregnancy and Child Health
Open Access

Despite technological advancements in modern contraception methods, still an unintended pregnancy is a worldwide problem that affects women, their families and the society as a whole. Lack of access and unfavorable attitude towards modern family planning methods contributes to the incidence of unintended pregnancy and mistimed pregnancy [1-3].

The age of the individual has an impact on the utilization of modern contraceptive methods. Accordingly, adolescent women are more likely not to use and to misuse contraceptive than older women [4]. The negative consequences associated with unplanned pregnancy can be prevented by access to contraceptive services [5,6].

Unwanted pregnancies pose a major public health problem in the developed and developing countries including Ethiopia [7,8]. It has a negative impact on the educational progress and future careers development [9,10]. Most of the time due to a concern about the health and side effects of contraceptive methods women do not intend to use contraceptives. Some of them may believe that they are not at risk of getting pregnant [11].

One type of modern contraception is emergency contraceptive that is used after unprotected sexual intercourse, following sexual abuse, misuse of regular contraception or non-use of contraception. Emergency contraceptives includes Emergency Contraceptive Pills (ECPs) and Intrauterine Contraceptive Devices (IUCD) [12,13].

Introduction and promotion of modern contraception in the country would greatly reduce the rate of unwanted pregnancy and thereby decrease the high rate of maternal deaths associated with unsafe abortion. Modern contraception should be available at all levels of the health care system and, where possible [14,15].

Various modern contraceptives inhibit or delay ovulation, interfere with fertilization or tubal transport, prevent an implantation by altering endometrial receptivity and causing regression of the corpus luteum. According to the world Health Organization report, 214 million women of reproductive age in developing countries who want to avoid pregnancy are not using a modern contraceptive method [16].

In Ethiopia, the use modern contraceptive method is 35%. The most commonly used contraceptive method for currently married women in Ethiopia is injectable (23%), followed by implants (8%) [17].

Knowledge and attitude towards the modern family planning methods affect the utilization of the modern contraceptives. Therefore, countries should focus on intervention such as health education on family planning to improve the knowledge, utilization and attitude towards modern family planning method.

The study was conducted in Worabe Town, Silte Zone, Ethiopia which is found 172 km south of Addis Ababa from April 10 to April 25, 2017. The Zonal administration is bounded in the North by Guragae Zone, in the West Hadia Zone, in the South East by Alaba Special Woreda and in the East by Oromia Regional State.

Community based cross-sectional study design was used. All Childbearing age group women in Worabe Town were the source population and all sampled women in reproductive age group were the study population. All selected women of reproductive age group (15- 49) who live in Worabe Town for more than six months, were included in the study.

Single population proportion formula was used to calculate sample size with confidence interval of 95% assuring 5% marginal error. Proportion of sample size determination was used from Ethiopia Demographic and Health survey published in 2016 on prevalence of modern family planning in southern nation nationality and peoples region, Ethiopia 39.6% (17). Since the source population was less than 10,000 which was about 6467 reproductive age women in worabe Town, population correction formula was used. Considering 10% non-response rate, the total sample size was 382. Systematic random sampling technique was used. In Worabe Town, 6467 reproductive age group women at household level were present. By using systematic sampling, reproductive age group women (N) and dividing it by sample size (n), the selected study participants (K) was determined (K=N/ n=6467/382=16). Therefore, eligible woman was interviewed by going in every sixteenth households. For households with more than one eligible woman, interview was done by selecting a woman using lottery method.

The structured questionnaire was adapted from various literatures. Three data collectors who were a fluent speaker of Amharic and Siltie language were used for data collection. The data collectors were oriented about the questioners to avoid the misunderstanding of the questioners. The data quality was assured by pretest, checking for completeness and validity of prepared questionnaire.

Ethical approval was obtained from Wolaita Sodo University, College of health science and medicine. The data was entered into Epidata version 3.1. The generated data was transferred to Statistical Package for Social Sciences (SPSS) version 20. Finally, the result was summarized in tables and graphs.

Socio-demographic characteristics

In the study, 376 were involved in the study giving a response rate of 98.4%. Majority 181 (48.1%) were in the age group 25-34 and 192 (51.1%) were married (Table 1).

Table 1: Socio demographic characteristics of the respondents of reproductive age women in worabe town, Ethiopia, May 2017.

Obstetrics and sexual history

Of the respondents 196 (52.1%) were pregnant and majority (53.5%) had sexual partner (Table 2).

Table 2: Obstetrics and sexual history of the respondents of reproductive age women in worabe town, Ethiopia, May 2017.

Knowledge towards modern family planning methods

Of the respondents, 352 (93.6%) heard about modern family planning method. Majority (63.4%), 121(34.3%), 138 (39.2%), 102 (29%), 27 (7.7%), 21(6%) and 3 (0.9%) have heard about injectable, implants, pills, condom, IUCD, Post-pill and surgical methods, respectively (Table 3).

Table 3: Knowledge towards modern family planning among reproductive age women in worabe town, Ethiopia, May 2017.

Attitude towards modern family planning methods

From mothers who heard about the modern family planning methods, more than two third 312 (88.6%), 342 (97.2%), 212 (60.2%),193 (54.8%) agreed that family planning makes life easy and regarding discussion about family planning is good and helps mothers to regain strength, respectively (Table 4).

Table 4: Attitude towards modern family planning among reproductive age women in worabe town, Ethiopia, May 2017.

Use of modern family planning methods

One hundred seven (28.5%) used modern family planning method. Majority (72.9%) used injectable (Table 5).

Table 5: Use of modern family planning among reproductive age women in worabe town, Ethiopia, May 2017.

In this study, only a small proportion (28.5%) of the women used modern family planning method. This is much lower than a report from a study conducted in 65.3% in Cameroon, 61% in Rohtak district, Haryan, 62.5% in Mumbai, 96.9% in Rwanda, 68.7% in India, 68% in Osun state, 60.4% used modern family planning method and in Eastern Nepal 45.7% used modern contraceptive method [18-25]. The decreased utilization might be related to the individual, organizational and environmental factors. Therefore, great emphasis is required to improve the utilization. Community mobilization and health education should be provided focusing on the different types of modern contraceptives and their detail description.

In Udupi District, Karnataka 19.85% of the women were using the oral contraceptive pills, according to a study done in the rural southern region of Jordan, the most common contraceptive methods ever used was oral contraceptive pills (31.1%), in Dharan Sub-Metropolitan City, majority (35.6%) were using the injectable, Depo-Provera, in Eastern Nepal majority were using injectable [25-28]. The difference might be due to a variation in the information provided regarding each modern family planning method. It might be associated with the difference in the availability of each method in the study areas.

Among the mothers who used modern contraceptives, 86% have changed method. This is higher than a finding from a study done in Mizan-Aman Town where 61.1% of the mothers have changed the method used [29]. The difference could be related to the variation in the presence of the mothers in relation to the availability of information or a change in the reproductive health pattern.

In this study, (93.6%) of the women have heard about the modern contraceptive methods from Media. This finding is supported by a study conducted in Karnataka [30]. Contrariwise, according to a study conducted in Rohtak district, Haryana the main source of information was the health professionals, in Nigeria, the main source of information was health education during antenatal care visit, in Rwanda, women were aware of family planning through different trainings at health centers levels, in Mumbai, majority of the women had procured the information from family and friends [12,19,21,31]. The difference might be related to a difference in the socio-economic background of the women and the study areas and period’s difference. Communication and health education should be delivered by Medias n collaboration to the health professionals. The information transmitted need to focus on the advantage and disadvantage of the use of modern contraceptive methods. The information gap can be filled by the collaborative effort of various sectors working on the information dissemination.

In this study, 72.4% of the husband feeling towards family planning method use is positive. This is lower than finding from a study conducted in Ethiopia in which 93% husbands supported their wives to use the family planning [32]. On the contrary, the finding is higher than a finding from a study conducted in Meghalaya, in which 44.5% of the husbands supported their wives [33]. The difference might be related to the difference in the study periods and the study areas.

The study assessed the knowledge, attitude and practice of modern family planning among the reproductive age group women in Worabe Town, Ethiopia. The study revealed that less than half of the reproductive age group women used modern family planning methods. Therefore, Health education and increasing the accessibility of the reproductive health service is recommended.