ArticleTherapeutic advances in reproductive health
The effect of contraceptive empowerment during pregnancy on postpartum family planning use in Ethiopia: evidence from a longitudinal panel study.
Article in Therapeutic advances in reproductive health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Women's empowerment significantly influences maternal and child health by enhancing access to healthcare and enabling autonomous reproductive decisions, including timely family planning during postpartum. However, in Ethiopia, the specific role of contraceptive empowerment in postpartum family planning (PPFP) use remains insufficiently studied despite the low level of women's empowerment. Objective: To assess the effect of contraceptive empowerment on PPFP use in Ethiopia. Design: A community-based panel study design. Methods: We used the panel data from Performance Monitoring for Action Ethiopia (2021-2023), which followed 1759 pregnant women aged 15-49 years from four regions of Ethiopia. The analytic sample is restricted to non-pregnant women who completed the interview at 1 year postpartum. Contraceptive empowerment was assessed using five items on a 5‑point Likert scale, whereas PPFP use was measured through yes/no question regarding modern contraceptive use at 1 year postpartum. A mixed-effect multilevel multivariable logistic regression model was employed, and Result: PPFP use at 12 months of postpartum is significantly higher among women reporting high and medium contraceptive empowerment during pregnancy, compared to low contraceptive empowerment (AOR: 1.8, 95% CI: 1.3-2.6) and (AOR: 1.7, 95% CI: 1.2-2.3) respectively. In addition, women whose birth was attended by a skilled birth attendant (AOR: 1.7, 95% CI: 1.3-2.4), lower parity (1: AOR: 4.5, 95% CI: 2.5-8.1, 2-4: AOR: 2.1, 95% CI: 1.3-3.3 compared to ⩾5), and those who previously used contraception (AOR: 3.8, 95% CI: 2.8-5.4) were more likely to use PPFP; women residing in Amhara (AOR: 0.4, 95% CI: 0.1-0.8) and Oromia regions (AOR: 0.4, 95% CI: 0.1-0.8) had significantly lower use of PPFP. Conclusion: Contraceptive empowerment during pregnancy predicted PPFP use at 12 months of postpartum. Higher contraceptive empowerment at pregnancy significantly increases the use of PPFP at 1 year postpartum in Ethiopia. The findings highlight the need for targeted interventions to enhance contraceptive empowerment prior to, during, and after pregnancy; strengthen skilled birth attendance and address regional disparities for equitable and sustained PPFP use.
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