Abstract
BACKGROUND: Women's decision-making power on contraceptive use is crucial for increasing modern contraceptive uptake. However, evidence in Ethiopia regarding this topic is limited and inconclusive. OBJECTIVE: To assess the prevalence and factors associated with women's decision-making power on modern contraceptive use in Girawa district, Eastern Ethiopia, January 1-30, 2024. METHOD: A community-based cross-sectional study was conducted among 510 married contraceptive users in Girawa district selected through multistage sampling. Descriptive statistics and logistic regression analyses were employed. The questionnaire was developed reviewing different literature, and pretested before actual data collection. Trained data collectors were collected the data. Face-to-face interview was conducted to collect data from study participants. Data cleaned and entered to Epidata, transferred to SPSS version 20 for analysis. Descriptive statistics were computed for all variables and the results were presented using frequency, tables and percentages. Using binary logistic regression, bivariate analysis was conducted to recruit variables for multivariable analysis at p-value of less than 0.25. Then multivariable analysis was conducted to control confounding variables. The strength of associations of variables was reported using odds ratio, with its 95% confidence interval, and p-value less than 0.05 used to declare significant association of explanatory with outcome variable. RESULTS: The prevalence of women's decision-making power on modern contraceptive use was 78% (95%CI: 74.4, 81.6). Factors significantly associated with increased decision-making power included: women's education (primary: AOR = 10.51[5.37, 20.56]; secondary and above: AOR = 2.58[1.35, 4.93]), husband's education (primary: AOR = 2.53[1.33, 4.81]; secondary and above: AOR = 2.25[1.08, 4.68]), government employment (AOR = 5.29[1.44, 19.57]), ANC visits (1-3: AOR = 2.16[1.18, 3.95]; ≥4: AOR = 1.86[1.85, 4.05]), positive attitude (AOR = 2.83[1.28, 6.25]), and good knowledge about modern contraceptives (AOR = 3.67[1.78, 7.56]). CONCLUSION: Three in four married women in Girawa district have decision-making power on modern contraceptive use. Education, employment, Antenatal care (ANC) utilization, positive attitudes, and good knowledge about contraceptives were associated with increased decision-making power. Interventions targeting these factors could further empower women in contraceptive decision-making.