A multivariate decomposition analysis of modern contraceptive utilization among married women in the emerging region of Ethiopia (2000–2019)

AbstractEnsuring universal access to family planning services is a proven strategy to improve reproductive health as well as economic development. Assessing the trend and identifying the factors for the change in modern contraceptive utilization is crucial to design effective measures, but trend analysis was not conducted previously. Thus, this study aimed to assess the trend and determinants of modern contraceptive utilization change among married women in emerging regions of Ethiopia. This study used the 2000 Ethiopia Demographic and Health Survey and the 2019 Ethiopia Min Demographic and Health Survey datasets for analysis. A total of 2555 and 1916 married women in the 2000 and 2019 surveys were included in the analysis, respectively. The data were analyzed using Stata version 17.0. Logit-based decomposition analysis was executed to identify factors for modern contraceptive utilization change. Statistical significance was declared at a P value of less than 0.05. The trend of contraceptive utilization change increased from 6.26% in 2000 to 21.97% in 2019. About  − 65.87% and 165.87% of the change in contraceptive utilization was due to changes in composition and behavior, respectively. The change in composition was due to the change in the composition of women according to religion, educational status, region, and the number of living children. The change in behaviors of not educated women, rural women, Muslim women, and those who resided in the afar region was the source of change in modern contraceptive utilization. Modern contraceptive utilization has increased in the last two decades. The change in modern contraceptive utilization is due to changes in population composition and behavior. Interventions targeting uneducated and rural women are vital to increasing contraceptive utilization. Strategic interventions are also required for the Somali regions of Ethiopia.