Prevalence of Family Planning Utilization and Its Determinants among Women of Reproductive Age in Oromia and Gambella Regions, Ethiopia

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Abstract Background Family planning (FP) is essential for improving maternal and child health. Despite Ethiopia’s national progress, regional disparities persist in underserved areas. This study assesses FP utilization and its determinants among women of reproductive age in the Oromia and Gambella regions. Methods A community-based cross-sectional study was conducted from October 15–25, 2023, among 840 women of reproductive age selected from five districts in Oromia and Gambella Regions. Data were collected using a structured, interviewer-administered questionnaire adapted from the Demographic and Health Survey and implemented through SurveyCTO. Multivariable logistic regression analysis was performed to identify factors associated with FP utilization, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. Results FP utilization was 60.9%, with injectables (48.2%) and implants (30.4%) being most common. Utilization was significantly lower among women lacking transport access (AOR=0.49, 95% CI: 0.36–0.67) and those in the poorest (AOR=0.48, 95% CI: 0.29–0.77) and poor (AOR=0.47, 95% CI: 0.29–0.74) wealth quintiles. Women whose partners had no formal education (AOR=0.46, 95% CI: 0.30–0.70) or only primary education (AOR=0.64, 95% CI: 0.44–0.92) were less likely to use FP compared to those with more educated partners. Additionally, farming women were more likely to use FP (AOR=1.64, 95% CI: 1.11–2.42), while those reporting unwanted pregnancies had lower utilization (AOR=0.54, 95% CI: 0.32–0.92). Conclusion FP utilization in these regions exceeds national averages, yet reliance on short-acting methods remains high. Limited transport, low household wealth, low partner education, and pregnancy unintendedness are critical barriers. Strengthening community-based services, addressing economic disparities, and promoting male involvement are essential for improving equitable FP access.

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