Background

In Ethiopia, young women’s pregnancy is a serious public health issue that hurts the health outcomes of both the mother and child. However, no research has been done on the use of contraceptives to delay first birth and associated factors among married young women aged 15-24 in Ethiopia.

Objectives

This study aimed to assess the contraceptive use to delay first birth and its associated factors among married young women in rural parts of central Oromia, Ethiopia, in 2024.

Design

A community-based cross-sectional study design was employed.

Methods

The sample size for the study was 422 married young women. A census was conducted to obtain a sample frame, and a simple random sampling method was used to select the study participants. Data were collected using interviewer-administered structured questionnaires. The collected data were entered into EpiData version 4.6 and exported to SPSS version 23 for further analysis. Binary logistic regression analyses were performed to identify variables associated with contraceptive use to delay first birth, with a p-value of less than 0.05 considered significant.

Results

The overall contraceptive use to delay first birth among married young women was 16.3%, with a 95% CI (12.8, 20.3). The following were found to be factors associated with the use of contraceptives to delay first birth among married young women: exposure to contraceptive information. [AOR=4.36; [95% CI: (2.14, 8.86)], p=0.001], a favorable attitude toward contraceptive methods (95% CI: (1.72, 7.31)), and p=0.001]; intention to use contraceptives [AOR=4.16; (95% CI: (1.96, 8.84); p < 0.001)]; perceived social approval [AOR=3.48; (95% CI: (1.65, 7.35)); p=0.001]; beliefs about contraceptive myths at the community level) [AOR=3.74; 95% CI: (1.82, 7.66); p < 0.001); and family planning counseling [AOR=5.19; 95% CI: (2.43, 11.08); p < 0.001) were among the significant variables associated with contraceptive use to delay first birth among young married women.

Conclusions

The contraceptive use to delay first birth among married young women was low. Healthcare providers, policymakers, and program designers should intensify their efforts to create awareness about the importance of contraceptive utilization among young married women to delay their first birth.

Plain language summary

Why was this study needed? Young women’s pregnancy is a serious public health issue that negatively impacts the health outcomes of both the mother and child. Therefore, this focuses on the use of contraceptives to delay first birth and associated factors among married young women aged 15-24 in rural parts of central Oromia, Ethiopia. Understanding the prevalence of contraceptives to delay first birth and associated factors among married young women in rural parts can help to create more pregnancy delay strategies.

What did the researcher aim for? This study aimed to investigate the contraceptive use to delay first birth and its associated factors among married young women in rural parts of central Oromia, Ethiopia, in 2024.

What did the researcher do? A community-based one-time data collection was used as a design for the study. We included 422 married young women aged 15-24 years from nine kebeles of rural central Oromia, Ethiopia, for the study. On starting a mass registration of all young married women in the selected rural kebeles to obtain a sample frame, multistage sampling was used for proportional allocation of the sample. A simple random sampling method was used to select the study participants. Data were collected using interviewer-administered structured questionnaires on sociodemographic and economic factors; knowledge, attitude, and intention to use contraceptive methods; perceived social approval; and community-level beliefs and enhance about modern contraceptive use and counseling services. Then, the collected data were entered into EpiData version 4.6 and exported to SPSS version 23 for further analysis. Binary logistic regression analyses were performed to identify variables associated with contraceptive use to delay first birth, with a p-value of less than 0.05 considered to declare the statistical significant association between the exposure and outcome variables.

What did the study find? Out of 405 study participants, the overall contraceptive use to delay first birth among married young women was only 66 (16.3%). 162 (40%) of the women were married at ages younger than 18 years, and 340 (84%) study participants were housewives by occupation. Nearly 160 (39.5%) of the respondents’ spouses had completed secondary school. 221 (54.6%) had a monthly income of 10-30 USD.

Young married people with exposure to contraceptive information were four times more likely to be contraceptive users than those with no exposure to contraceptive information. Furthermore, having a favorable attitude toward contraceptive methods, intention to use contraceptives, perceived social approval, good beliefs about contraceptive myths at the community level, and family planning counseling by healthcare providers were among factors that enhanced contraceptive use to delay first birth among young married women.

What do the findings mean? The contraceptive use to delay first birth among married young women was low. Thus, this study highlights the need for targeted interventions to enhance contraceptive use to delay birth among young married women in rural Ethiopia. These interventions should focus on information, a favorableattitude, social behavioral change, and counseling on modern contraceptive methods for the better health of young married women. Healthcare providers, policymakers, and program designers should intensify their efforts on modern contraceptive methods and services for young married women to delay their first birth.