BMC Womens Health. 2026 Jan 24. doi: 10.1186/s12905-026-04283-8. Online ahead of print.
ABSTRACT
This study aimed to identify the spatial distribution and its associated factors of unmet need for family planning among women of reproductive age in administrative woredas of Ethiopia, using data from 8,716 married or in-union women in the 2016 Ethiopian Demographic and Health Survey. Spatial analyses, including autocorrelation, hotspot identification, and interpolation, were employed to examine geographical patterns, while a multilevel multinomial logistic regression model identified associated factors. The overall prevalence of unmet need was 21.04% (12.84% for spacing, 8.2% for limiting). Spatial analysis revealed that unmet need for limiting was dispersed, while spacing needs were randomly distributed. Key determinants included knowledge of family planning (spacing: aOR = 1.76, 95% CI:1.21-2.57; limiting: aOR = 2.45, 95% CI:1.41-4.23), having more than four living children (spacing: aOR = 1.40, 95% CI:1.05-1.86; limiting: aOR = 10.04, 95% CI:5.45-18.50), husband’s employment (spacing: aOR = 0.44, 95% CI:0.28-0.71; limiting: aOR = 0.35, 95% CI:0.20-0.61), and the interaction of rural residency with husband’s employment (spacing: aOR = 1.98, 95% CI:1.17-3.36; limiting: aOR = 2.42, 95% CI:1.28-4.55). The findings indicate that the prevalence of unmet need for family planning in Ethiopia’s administrative woredas remains high, greater the acceptable standard defined by global benchmarks. Key factors include women’s knowledge of family planning, the number of living children, the husband’s occupation, and the contextual influence of rural residency. The spatial heterogeneity, particularly for limiting births, underscores the need for geographically targeted interventions. Therefore, national strategies and woreda-specific programs aimed at reducing unmet need must move beyond uniform approaches. They should prioritize enhancing comprehensive family planning education, addressing high-parity concerns, engaging male partners, and tailoring service delivery to mitigate the specific socio-contextual barriers prevalent in rural settings to ensure equitable access to family planning services across all administrative woredas.
PMID:41580755 | DOI:10.1186/s12905-026-04283-8
