Modern Contraceptive Utilization Among Reproductive Aged Women in Ethiopia: Mixed Effect Multi‐Level, Regression, Health Analysis With Health Survey of Mini‐EDHS 2019

ABSTRACT Background The use of contraceptives is key to reducing unsafe abortions from unintended pregnancies and helping to improve maternal health and socioeconomic outcomes. It allows individuals to achieve their desired family size and timing effectively. Therefore, this study aimed to identify multi‐level factors for Modern Contraceptive use among Reproductive‐Age Women in Ethiopia. Methods Data for this study were extracted from the nationally representative 2019 Ethiopian Mini Health Analysis with Health Survey of Mini‐EDHS 2019. The survey employed a two‐stage cluster sampling design: enumeration areas (EAs) were selected in the first stage, followed by household selection in the second stage. Data collection took place from March 21 to June 28, 2019. A mixed‐effects multilevel analysis was used to identify factors associated with modern contraceptive use. Result A total of 8885 (Wt = 100) participants were included in the study, with a mean age of participants 27.5 years (SD ± 10.3). In Ethiopia, modern contraceptive utilization among reproductive‐age women was 23.8%. The prevalence was 90.79% for married women and 3.74% for never‐in‐union women. The most common methods were injectable 13.6% and implants 5.8%. In the final multi‐level logistic regression being woman aged 15–25 years (AOR = 4.91; 95% CI: 2.70–11.38), having children 13–24 months (AOR = 2.40; 95% CI: 2.50–25.6), married women (AOR = 7.90; 95% CI: 2.47–25.60), Completed high school (AOR = 1.65; 95% CI: 1.20–2.60), middle wealth index (AOR = 1.55; 95% CI: 1.15–1.98), urban resident (AOR = 1.69; 95% CI: 1.20–2.40), living in Amhara region (AOR = 2.74; 95% CI: 1.24–3.50), and mass media exposures (AOR = 1.69; 95% CI: 1.21–2.93) were associated with modern contraceptives usages. In contrast, residing in the Somali region decreased the likelihood by 88% (AOR = 0.22; 95% CI: 0.11–0.45) of using contraceptives. Conclusion Modern contraceptive use among women of reproductive age in Ethiopia remains critically low, falling short of the target set for 2030. The variation in usage is significantly influenced by both individual and community‐level factors. To address this gap, the government should prioritize investments in education and financial empowerment to strengthen women's autonomy in family planning decision‐making.