Magnitude and determinants of unmet need for family planning in Ethiopia from 2013- March 2020: Meta-analysis and systematic review

Abstract Unmet need for family planning is a major problem in developing countries. Millions of women want to delay or avoid pregnancy but are not using Contraception. Addressing the unmet need for family planning provides an opportunity for policymakers to respond to existing choice problems. Simultaneously improving maternal and child health, slowing the rate of population growth, and contributing to the achievement of national goals. This study aimed to determine the pooled Magnitude and determinants of unmet need for family planning in Ethiopia. Ten articles with 19312 study participants were identified through electronic search of reputable databases: Google Scholar, PubMed, Cochrane library, MIDLINE, EMBASE, and Ovid Maternity and Infant Care Databases. 10 studies were selected based on a comprehensive list of inclusion and exclusion criteria. The analysis was done by using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used and a random effect model was also used to estimate the pooled prevalence of perinatal mortality rate. The pooled prevalence of the unmet need of modern family planning among reproductive-age women in Ethiopia was 19.99,95% CI(16.53,23.45).Age at first marriage less than 18, OR = 1.37, 95 CI :( 1.04–1.18),discussion with husbands, OR = 0.24, 95%CI :( 0.12–0.49), having two and less children OR = 0.49,95CI:(0.35–0.67), illiterate partner OR = 3.61, 95 %( 2.63–4.95), good attitude of partner OR = 0.11,95% CI:(0.05–0.26), history of discussion with health care worker OR = 0.31,95%CI: (0.14–0.68), a poor knowledge OR = 3.15,95% CI:(1.75–5.69) were significantly associated with unmet need for family planning. Unmet need for planning in Ethiopia is high as compared to world unmet need according to the United Nations World family planning report of 2017 which states one in ten reproductive age women have an unmet need for family planning but this study revealed one in five the same age group women had an unmet need for it. Early marriage, women’s discussion with husbands and health care workers about family planning, having children greater than two, education status and attitudes of husband, and knowledge of women about family planning were significantly associated with unmet need for family planning. So great effort is needed from all stakeholders to involve males in family planning decisions, alleviate early marriages, and structured health education interventions for both husbands and women to reduce the unmet need for family planning.