Hierarchical Analysis of Contraceptive Compliance Among Rural Reproductive Age Group Women in Awi Zone, Northwest Ethiopia

Background: Contraceptive compliance has become a major health concern around the globe, particularly in rural parts of Ethiopia. Therefore, this study aimed to assess contraceptive compliance among rural women of the reproductive age group in the Awi zone, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted on 2341sampled rural women's reproductive age group from Jan to April 30; 2021G.C. Multistage random sampling was employed. A multilevel logistic regression model was used to identify the predictors of contraceptive compliance, which allows us to account for the random component. Intra-cluster correlation coefficient (ICC) statistics were also computed to measure the variation between clusters. Results: Results showed that prevalence of contraceptive compliance in the selected districts of Awi zone was 17.1%. At individual level, women's aged 35-49 (AOR = 0.50, 95% CI 0.28, 0.90), married women's (AOR = 8.81, 95% CI 4.62, 16.66), had 1 to 2 living children (AOR = 1.15, 95% CI 1.06, 1.40), women's work status hard (AOR = 5.80, 95% CI 2.85, 11.82) and moderate (AOR = 4.71, 95% CI 2.39, 9.28), long-acting (AOR = 1.84, 95% CI1.28, 2.64) and positive attitude (AOR = 2.71, 95% CI1.16, 6.33) and at hierarchical level (group level), mass media exposure (AOR = 1.78, 95% CI 1.32, 2.41) and enforcement exposure (AOR = 1.77, 95% CI 1.19, 2.65) were significant factors of contraceptive compliance. Moreover, results for the intra-class correlation coefficient show that variation exists between clusters. Conclusion: Individual-level (women's age, married women's, number of living children, women's work status, type of contraceptive method and attitude) and community-level (mass media exposure and enforcement exposure) were found to be significant factors associated with compliance in Awi zone.