Differentials and determinants of men’s sexual behavior in Ethiopia

Introduction: Males’ involvement in sexual and reproductive health can bring greater impacts on the health of family members although it is an intricate issue and few explored in Ethiopia.Objective: The objective of this study was to investigate the sexual behaviour of Ethiopian men’s timing of entry into sexual activity, tendency to have multiple sexual partners in their life time and their motivation to take a VCT.Methods: The study was conducted based on the socio-economic and demographic data obtained from randomly selected 14,110 men in the age group 15 to 59 using multi-stage sampling of the 2011 Ethiopian DHS. The data were analysed using descriptive statistics, the Cox proportional hazards and binary logistic regression models.Results: Given the socio-cultural factors motivating men to experiment sex and prove sexual competence and capacity, 27.2% of the sampled respondents had premarital sex, 38.1% of them had multiple (i.e. two and more) sexual partners in their life time while only 42.5% have ever had voluntary counselling and testing. Multivariate analysis results show that the likelihood of having multiple sexual partners increased among older men; while the tendency to take VCT was significantly higher among men of marriageable age group (AOR = 1.18, P<0.05). Late entry into sexual activity (AHR= 0.90, P< 0.05) but higher likelihood of having multiple sexual partners (AOR = 1.40, P< 0.001) and taking VCT services (AOR = 3.01, P<0.001) were observed among men who attended secondary and higher education. Men with frequent access to media were also observed to indulge in sex early (AOR = 1.08, P<0.05) and have multiple life-time sexual partners (AOR = 1.35, P<0.001) with higher chances of taking VCT services (AOR =2.28, P<0.001).Conclusions: The study revealed that Ethiopian males have diversified sexual behaviour mainly governed by the socio-cultural and institutional settings of their living environment. Hence, there is a strong need to make use of formal and informal institutions in mediating male’s sexual behaviour in the country. [Ethiop. J. Health Dev. 2017;31(1):36-43]Key words: Male sexual behaviour, age at first sex, multiple sexual partners, VCT, Ethiopi

Correlates of High Risk Fertility Behaviour in Ethiopia: A Multilevel Analysis of the 2011 Ethiopian Demographic and Health Survey Data

High risk fertility is one of the main public health concerns in Ethiopia.  This study examines factors affecting high risk fertility (i.e. child birth at early (less than 18 years) and late (greater than 35 years), birth taking place within shorter birth interval (less than 24 months) and too many births (greater than four children)) based on last births taking place in the five years preceding the 2011 demographic and health survey data of Ethiopia collected among women in the age group 15–49 years. Percentage distribution was used to describe the data while a multilevel logistic regression model was fitted to identify the predictors of high risk fertility behaviour. The result shows that 58.7% of Ethiopian women were experiencing high risk fertility with considerable variation among the rural (62.1%) and urban (39.5%) residents. The likelihood of exposure to high risk fertility was significantly lower among educated women and those having high perception of HIV risk assessment but higher among that experiencing child loss and living in Somali region. The results generally indicate that high risk fertility behaviour in Ethiopia is partly explained by respondents’ educational attainment, survival status of children born to a woman, region of residence and neighbourhood factors that shape the perception of women about their exposure to risky situations. Awareness raising efforts should thus consider the socio-cultural contexts in which behavioural change occurs to tackle exposure to high risk fertility in addition to promoting the status of women to reduce their dependency on offspring at later ages. Keywords: High risk, fertility, child loss, Ethiopi

Age at First Marriage and First Birth Interval in Ethiopia: Analysis of the Roles of Social and Demographic Factors

The ages at which females establish marital union and give first birth depend on and result in varying demographic features. Utilizing the Ethiopian Demographic and Health Survey Data, this study examined determinants of first birth interval. The analysis was made using Cox proportional hazard model and Kaplan Meier plot based on data collected from 10,240 ever-married women in the age group 15 to 49. The result shows that first marriage at early age, lower level of education, older marriage cohort, and residence in Amhara region significantly elongated first birth interval. It reveals that timings of marriage and first birth are partly governed by social factors and marriage practices of the society although modernization factors have roles to play. The findings indicate the importance of considering the context within which marriage and first birth take place to address reproductive health problems of women and speed-up the achievement of the targets set in the National Population Policy of Ethiopia

Trend and correlates of contraceptive use in rural and urban Ethiopia: is there a link to the health extension programme?

When international funders shifted funding priorities from family planning to HIV/AIDS in themid-1990s, most family planning programmes in Africa faced serious challenges. The government of Ethiopia took a creative route of establishing the Health Extension Programme (HEP) in 2004 that provides health care services including family planning and integrated population issues into the school curricula besides promulgating contraceptive use as a right for any women of reproductive age. This study aims at analysing the correlates of contraceptive use in rural and urban Ethiopia using the Demographic and Health Survey data of 2000, 2005 and 2011. Data were analysed using tabular and graphical methods, and a binary logistic regression model was fitted to identify factors associated with contraceptive use. Findings of the study reveal that contraceptive uptake, particularly injectable, has increased markedly in the rural areas as a result of the implementation of the HEP despite regional variations in the level of commitment to the family planning package. Other African countries need to emulate such an initiative but ensuring equal commitment throughout the nation to overcome any possible outrages

Measuring Hidden Support for Physical Intimate Partner Violence: A List Randomization Experiment in South-Central Ethiopia

Understanding how and why physical intimate partner violence (IPV) persists in high-risk communities has proven difficult. As IPV is both sensitive and illegal, people may be inclined to misreport their views and experiences. By embedding a list randomization experiment (LRE), which increases respondent privacy, in a survey of 809 adult Arsi Oromo men and women in rural south-central Ethiopia, we test the reliability of direct questioning survey methods (e.g., used in the Demographic and Health Surveys) for measuring attitudes that underpin the acceptability of IPV. Participants were randomly assigned versions of the survey in which they were asked either directly or indirectly about the acceptability of wife-beating. By comparing responses across these surveys, we identify the extent to which views are being misreported using direct questioning methods, as well as identifying the "true" predictors of continued support for wife-beating. Indirect questioning reveals that almost one third of the sample believe that wife-beating is acceptable. Adults (particularly men) who are less educated (50% endorsement). These individuals, however, are also more inclined to hide their approval when asked directly by an interviewer. That we find high but underreported support for wife-beating among some members of the community demonstrates a clear need to encourage a more open dialogue, to prevent violence toward women remaining undetected and thus unchanged. This finding also raises questions about the accuracy of traditional direct questioning for capturing information on IPV attitudes and norms. Of relevance to policy, we find that wife-beating is entirely absent only among adults with higher levels of education, living in households where decision making is shared between couples.Wellcome Trust Seed AwardMinisterio de Educación, Cultura y Deport

Social Transmission and the Spread of Modern Contraception in Rural Ethiopia

Socio-economic development has proven to be insufficient to explain the time and pace of the human demographic transition. Shifts to low fertility norms have thus been thought to result from social diffusion, yet to date, micro-level studies are limited and are often unable to disentangle the effect of social transmission from that of extrinsic factors. We used data which included the first ever use of modern contraception among a population of over 900 women in four villages in rural Ethiopia, where contraceptive prevalence is still low (<20%). We investigated whether the time of adoption of modern contraception is predicted by (i) the proportion of ever-users/non ever-users within both women and their husbands' friendships networks and (ii) the geographic distance to contraceptive ever-users. Using a model comparison approach, we found that individual socio-demographic characteristics (e.g. parity, education) and a religious norm are the most likely explanatory factors of temporal and spatial patterns of contraceptive uptake, while the role of person-to-person contact through either friendship or spatial networks remains marginal. Our study has broad implications for understanding the processes that initiate transitions to low fertility and the uptake of birth control technologies in the developing world

Fertility transition driven by poverty : the case of Addis Ababa (Ethiopia)

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Trends and Differentials of Adolescent Motherhood in Ethiopia: Evidences from 2005 Demographic and Health Survey

Adolescent childbearing has undesirable consequences. Dropping out of school, high rates of abortion, maternal mortality and morbidity are noted consequences of adolescent pregnancy and childbearing. The objective of this study, which is based on the 2005 Ethiopian Demographic and Health Survey data, is to analyze the levels, trends and differentials of adolescent motherhood in Ethiopia. A multilevel logistic regression was fitted to analyze the determinants of adolescent childbearing. Adolescent motherhood in Ethiopia has shown a generally declining trend over time. The decline was more marked in the periods following the adoption of the national population policy in the country. Further, it was lower in urban areas and among women who have secondary and above level of education, but higher among women not working and those engaged in agricultural activities. Housewives and women working in the agricultural sector should be given attention to reduce the risks and consequences of adolescent motherhood.La grossesse chez les adolescentes a des conséquences indésirables. L’abandon des études, les taux élevés d&apos;avortement, la mortalité maternelle et la morbidité maternelle sont des conséquences bien connues de la grossesse et de la procréation chez les adolescentes. L&apos;objectif de cette étude, qui est basée sur les données tirées de l’Enquête Démographique et de Santé de 2005 en Ethiopie, est d&apos;analyser les niveaux, les tendances et les différentielles de la maternité chez les adolescentes en Ethiopie. Une régression logistique a été mise en place à plusieurs niveaux pour analyser les déterminants de la grossesse chez les adolescentes. La maternité chez les adolescentes en Ethiopie a montré une tendance générale à la baisse au fil du temps. La baisse a été plus marquée dans les périodes qui suivent l&apos;adoption de la politique nationale démographique dans le pays. En outre, il a été plus faible dans les milieux urbains et chez les femmes qui ont un niveau d’étude secondaire ou supérieur, mais plus élevé chez les femmes qui ne travaillent pas et chez celles qui sont engagées dans des activités agricoles. Il faut accorder l’attention aux femmes au foyer et aux femmes qui travaillent dans le secteur agricole afin de réduire les risques et les conséquences de la maternité chez les adolescente

Exploring reproductive trajectories of youths of Oromia, Ethiopia: A life course approach.

In the context of continuous cultural, social, and economic changes happening around the globe, the predictable patterns of the life course of the past observed over successive birth cohorts will not remain stable across generations. In this study, three reproductive role indicators-first sexual encounter, first marriage, and first birth-for three synthetic birth cohorts were used to identify and characterize the reproductive trajectories of youths. In our analysis, for the sake of comparison with global literature, we considered youths to be between ages 15 and 24. The analysis was conducted using data extracted from the 2005, 2011, and 2016 Ethiopian Demographic Health Survey for Oromia National Regional State. Three synthetic birth cohorts of youths of birth years between 1975 and 1989 were constructed for the analysis. A sequence analysis based on dynamic hamming distance with partition around medoids technique was employed to extract the typologies of reproductive trajectories of youths. In addition, discrepancy analysis and a sequence regression tree analysis were employed to characterize the identified typologies of trajectories. Data management was done using STATA 14 and all analyses were carried out using R software. The study identified four different typologies of reproductive trajectories among the youth. The sex of respondents was the primary discriminating factor of the typologies of reproductive trajectories. The findings support the notion of changing norms in reproductive behavior among the less educated youth irrespective of sex. The discriminating power of education was stronger for female youth in urban areas than rural females. It implies that the postponement of reproductive role assumption was stronger among educated female youths residing in urban than their rural counterparts. Normative reproductive practices such as early marriage and adolescent fertility are still common practices that require efforts of communities and local government bodies to ameliorate these practices. Results of the study indicate that less educated youth should be targeted in programs that aim at improving youth empowerment (i.e., training and employment opportunities) as well as their sexual and reproductive health