Modern contraceptive use and associated factors among reproductive-age women in Ethiopia: multilevel analysis evidence from 2019 Ethiopia mini demographic and health survey

Background Despite the high fertility and population growth rates, the use of modern contraceptives remains low in low- and middle-income countries. Different pocket-sized studies on the use of modern contraceptive methods conducted in various parts of Ethiopia have been extremely varied and ambiguous. Therefore, this study aimed to assess modern contraceptive use and its associated factors in women of reproductive age in Ethiopia. Methods Cross-sectional data from the Ethiopia Interim Demographic Health Survey (EMDHS) 2019 in a stratified, two-stage, and cluster sampling study. Multilevel binary logistic regression analysis was used to fit the associated factors. The interclass correlation (ICC), median odds ratio (MOR), proportional change variance (PVC), and deviance were used for model comparison and fitness. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the significant factors of modern contraceptive use. Result The multilevel analysis demonstrated that Orthodox religion [AOR = 1.7; 95%CI: 1.4-2.10] protestant religion [AOR = 1.2; 95%CI: 0.93-1.62], married [AOR = 4.2; 95%CI: 1.93-9.07], primary education [AOR = 1.5; 95%CI: 1.26-1.76], secondary education [AOR = 1.36; 95%CI: 1.04-1.77 [AOR = 1.89; 95%CI: 1.37-2.61], middle [AOR = 1.4; 95%CI: 1.14-1.73], rich [AOR = 1.3; 95%CI: 1.06-2.68] were positively associated with modern contraceptive utilization, while the age group of 40-49 [AOR = 0.45, 95% CI: 0.34-0.58], and high community poverty [AOR = 0.62; 95%CI: 0.46-0.83] were negatively associated with modern contraceptive utilization. Conclusion The prevalence of modern contraception in Ethiopia remains low. Maternal age, religion, maternal education, marital status, wealth index, region, and community poverty were significant predictors of modern contraceptive utilization in Ethiopia. Governments and non-governmental organizations should expand their public health programs to poorer communities to increase the use of modern contraception in the country.