Abstract
BACKGROUND: Despite progress in national reproductive health, pastoralist regions, including the Fentale District in Eastern Ethiopia, face challenges with limited contraceptive coverage due to gaps in understanding and adoption among couples. METHODS: This cross-sectional study of 1496 couples in Fentale District, Eastern Ethiopia, from October 1 to December 25, 2021, utilized multistage sampling. Data entered into EPI Data underwent analysis with SPSS (v23.0) and STATA (v14.0), employing descriptive statistics, bivariate analysis, and binary logistic regression to identify predictors of contraceptive knowledge. RESULTS: Of the 1496 couples, 93.8% (1404) participated in the survey. Significant educational disparities were observed, with 53.8% having no formal education, particularly among women (65.2%). Despite this, 80.2% of couples were aware of at least one family planning (FP) method, and 78.6% knew modern methods. The median knowledge of contraception methods was 3 for both genders. Men showed higher awareness of male (43.2%) and female condoms (17.4%) compared to women (31.8% and 6.0%). Overall, 27.4% of couples used contraception, with a significant gender difference: 41.2% of women and 13.5% of men. Modern contraceptives were used by 18.2% of couples, predominantly by women (34.8%). Binary logistic regression analysis indicated positive associations between contraceptive knowledge and education, bank account ownership, occupation, proximity to healthcare, and media exposure, while a nomadic-pastoralist lifestyle and specific treatment preferences showed negative associations. CONCLUSION: The limited knowledge and utilization of family planning in the Fentale District stem from gaps in comprehension and disparities among couples. Factors influencing this situation include socio-demographic considerations, such as variations based on education, occupation, media exposure, bank account ownership, treatment preferences, and distance from healthcare facilities. This ensures that the interventions are having the desired effect and allows for adjustments as needed to promote family planning uptake.