Spatial distribution and determinants of contraceptive non-use due to others’ influence in Ethiopia: a spatial, multilevel regression analysis, EDHS 2016

Contraceptive non-use results in unintended (mistimed or unwanted) pregnancy, and unintended pregnancy mostly ends up with abortion, which is one of the direct causes of maternal mortality. Contraceptive non-use influenced by others is often shaped by cultural norms, beliefs, and specific settings. However, there is a lack of evidence regarding the spatial distribution of contraceptive non-use driven by such external influences. This study aimed to demonstrate the spatial distribution and determinants of contraceptive non-use due to others influence in Ethiopia. A cross-sectional study design was utilized, drawing on data from the 2016 Ethiopian Demographic and Health Survey (EDHS), and included a total of 5,754 women of reproductive age. ArcGIS version 10.7 and SaTScan version 9.6 software were used to perform the spatial analysis. Mixed effects analysis was done by STATA version 14 software. Bivariate analysis was done, and variables with a p-value < 0.2 were taken as candidates for multilevel multivariable logistic regression. Intraclass Correlation Coefficient (ICC), Proportion Change in Variance (PCV), and Median Odds Ratio (MOR) were used for model comparison, and AOR concerning a 95% confidence interval was used for declaring statistical significance. In the multivariable analysis, a p-value less than, or equal 0.05 was considered a cut point of statistical significance with the outcome variable. The prevalence of contraceptive non-use due to other influences was 69.52%. The cluster spatial distribution was not random. Women with age group of ≥ 35 years (Adjusted Odds Ratio (AOR = 0.60; 95% CI O.43, 0.83), Being Muslim by religion (AOR = 1.73; 95% CI 1.38, 2.16), history of pregnancy termination (AOR = 0.69; 0.56,0.83) and fertility preference no more (AOR = 0.66; 95% CI 0.56, 0.78) were statistically significant variables. The prevalence of contraceptive non-use due to other influences was high, and its spatial distribution was not random. Great attention should be given to the age of women, religion, history of pregnancy termination, and fertility preference to avert the high prevalence of contraceptive non-use due to others influence. It is better to addressing both individual and community-level factors, and tailoring interventions to the specific needs and characteristics of the clustered areas, contraceptive non-use can be effectively reduced, improving reproductive health outcomes.