Determinants of an unintended pregnancy among women attending ante natal care at health facilities in Lemi Kura sub city, Addis Ababa, Ethiopia: Institution based case-control study

Résumé

Unintended pregnancy is an unplanned or unwanted at conception. It carries significant social, emotional, and health consequences for women, families and communities. In Ethiopia, approximately one-third of married women report that their pregnancies are an unintended. Despite this burden, evidence on contributing factors remains limited, particularly in Lemi Kura sub city. This study, aimed to identify determinants of an unintended pregnancy among women attending antenatal care services in health facilities in Lemi Kura, Addis Ababa. We conducted a facility-based case-control study in Lemi Kura sub-city, Addis Ababa, Ethiopia, from January 3 to February 18, 2022. Using cluster random sampling, 103 cases (women with an unintended pregnancies) and 197 controls (women with planned pregnancies) attending antenatal care units were selected. Data were collected through interviewer-administered, pretested questionnaires. The sample size was calculated using Epi-Info version 7. Analysis was performed in SPSS version 20, applying multivariable logistic regression. Results were reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI), and statistical significance was declared at p < 0.05. The Muslim women (AOR: 3.33, 95% CI: 1.21-9.15); Protestant women (AOR: 3.06, 95% CI: 1.07-8.75); reduced women's autonomy (AOR: 16.58, 95% CI: 2.40-114.15); residing 4 km or more from the antenatal care facility (AOR: 2.70, 95% CI: 1.07-8.75); having two or more living children(parity) (AOR: 5.37, 95% CI: 1.60-18.15); desiring two or fewer children(Ideal) (AOR: 3.63, 95% CI: 1.50-9.01); and having multiple sexual partners (AOR: 4.25, 95% CI: 1.38-30.38) were significant predictors of unintended pregnancy. Low knowledge of family planning methods, unmarried, religion, low autonomy, multiparous, natural method use, health service inaccessibility and having multiple sexual partners predicted unintended pregnancy. For intervention, engaging religious leaders and focusing on multiparous with empowering women is essential.

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