View metadata, citation and similar papers at core.ac.

uk brought to you by CORE

provided by National Academic Repository of Ethiopia

INSTIUTE OF PUBLIC HEALTH

COLLEGE OF MEDICINE AND HEALTH SCIENCES
UNIVERSITY OF GONDAR

EXTENT AND ASSOCIATED FACTORS OF UNMET NEED FOR

MODERN CONTRACEPTIVES AMONG CURRENTLY MARRIED
WOMEN IN JIGJIGA TOWN MAY 2012.

BY BEZA TAMIRAT

Advisors
1. Mr. Takele Tadesse (BSc,MPH,Phd student)
2. Mr. Zelalem Birhanu (BSc,MPHil)
June, 2012
Jigjiga, Ethiopia

i
 UNIVERSITY OF GONDAR
COLLEGE OF MEDICINE AND HEALTH SCIENCE
INSTITUTE OF PUBLIC HEALTH

EXTENT AND ASSOCIATED FACTORS OF UNMET NEED

FOR MODERN CONTRACEPTIVES AMONG CURRENTLY
MARRIED WOMEN IN JIGJIGA TOWN MAY 2012.

By: BEZA TAMIRAT

Tel: +251921695252
Email: bezatamirat@yahoo.com

Approved by the Examining Board

--------------------------------------------------- ---------------------------------
Director, Institute of public Health

Advisors

1. --------------------------------------------- -----------------------------

2. ----------------------------------------------- ------------------------------

---------------------------------------------- ------------------------------
Examiner

ii
ACKNOWLEDGEMENT

My special thanks goes to my advisors Mr. Takele Tadesse and Mr. Zelalem Birhanu

for their unreserved and continuous guidance, constructive comments, valuable

suggestions and support in all directions they provided me since the start of this work.

I want to extend my thanks to university of Gondar for letting me conduct my research

and Jigjiga University for giving me the chance to pursue my education.

My appreciation also goes to data collectors and participants who spent their valuable

time in responding to the questions.

At last but not least my deepest gratitude goes to my family without whom this was

impossible (EBISHO and YESH), Mr. Assefa Tola and his family and my friends for

their all rounded encouragement and support during the hard days.

iii
Table of content
Acknowledgement ….................................................................................................... i
Acronyms …………………………………………………………………………………….. ii
Table of content ……………………………………………………………………………… iii
List of table …………………………………………………………………………………… iv
List of figures …………………………………………………………………………………. v
Abstract ……………………………………………………………………………………….. vi
1. Introduction………………………………………………………………………………… 1
1.1 Statement of the problem……………………………………………………………. 1
1.2 Literature review……………………………………………………………………….3
1.3 Rationale of the study ………………………………………………………………...9
2. Objective……………………………………………………………………………………10
2.1 General objective……………………………………………………………………..10
2.2 specific objectives………………………………………………………………….....10
3. Methods…………………………………………………………………………………….11
3.1 Study design and period……………………………………………………………..11
3.2 Study area and population…………………………………………………………..11
3.3 Source population……………………………………………………………………12
3.4 Study population……………………………………………………………………..12
3.5 sample size…………………………………………………………………………...12
3.6 Sampling procedure…………………………………………………………………13
3.7 Variables of the study……………………………………………………………….15
3.8 Operational definition……………………………………………………………….16
3.9 Inclusion and exclusion criteria……………………………………………………16
3.10 Data collection procedure………………………………………………………...17
3.11 Data processing and analysis……………………………………………………17
3.12 Data quality control………………………………………………………………..17

iv
 3.13 Ethical consideration………………………………………………………………18
3.14 Dissemination of result…………………………………………………………….18
4. Result……………………………………………………………………………………….19
5. Discussion………………………………………………………………………………….30
6. Conclusion …………………………………………………………………………………33
7. Recommendation…………………………………………………………………………..34
8. Reference ………………………………………………………………………………….35
9. Annexes ……………………………………………………………………………………38

v
LIST OF TABLES

Table 1 The socio demographic characteristics of currently married women in

Jigjiga, Ethiopia, 2012………………………………………………………….21

Table 2 The Reproductive characteristics of currently married women with unmet

need in Jigjiga,Ethiopia,2012………………………………………………….22

Table 3 Knowledge characteristics of married women in Jigjiga, Ethiopia,

2012……………………………………………………………………………..24

Table 4 Attitude of currently married women towards modern contraceptive in

Jigjiga , Ethiopia, 2012...............................................................................25

Table 5 Practice of modern contraceptive among currently married women in

Jigjiga , Ethiopia, 2012……………………………………………………………………………………26

Table 6 Impact of selected socio-demographic characteristics on un met need

among married women in Jigjiga, May 2012………………………………..28

List of figures
Figure 1 Conceptual frame work developed to assess the extent and associated factors
of unmet need for modern contraceptive…………………………………………...9

Figure 2 Schematic presentation of sampling procedure ………..………………..…........15

Figure 3 Distribution of married women with unmet by spacing and limiting. Jigjiga,
Ethiopia ,2012………………………………………………………………………..27

Figure 4 Distribution of married women with unmet need by their reason for non
use……………………………………………………………………………….……27

vi
 List of Acronyms
BSC Bachelor of Science

CSA Central Statistical Agency

CPR Contraceptive Prevalence Rate

DHS Demographic Health Survey

DALYS Disability Adjusted Life Year

FGAE Family Guidance Association of Ethiopia

HH House Hold

IUD Intra Uterine Device

OR Odds Ratio

PMTCT Prevention of Mother to Child Transmission

SNNPR Southern Nation Nationalities and Peoples Region

USAID United States Agency for International Development

UNFPA United Nation Population Find Agency

WHO World Health Organization

vii
Abstract

Back Ground

In all three demographic surveys of Ethiopia despite the increased level of contraceptive
utilization some proportion of women still report that they want to postpone child bearing or
want no more children in the absence of any preventive measure against pregnancy. Thus this
study will help policy makers and concerned bodies to understand the magnitude and factors
associated with to act accordingly.

Objective: To assess the extent and associated factors of unmet need for modern
contraceptives.

Methods
Community based cross sectional study was conducted from April 13-23, 2012 among 963
currently married women using multi stage sampling. Data was collected via face to face
interview by trained data collectors using pretested and structured questionnaire. Data analysis
was done using SPSS version 16 software package and logistic regression was done to
identify factors associated with unmet need for modern contraceptives.
Result:
A total of 924 currently married women were interviewed. The extent of unmet need was found
to be 33.3% and age greater than or equal to 35 [AOR=3.27:95%CI,(1.79,5.95)], less exposure
to media [AOR=3.1;95%CI, (1.69,5.68)], perceived husband disapproval of contraceptive
[AOR=16.73;95%CI,(10.8,26.0)], lack of discussion with husband [AOR=2.76;95%CI,
(1.7,4.49), respondent decision on contraceptive use [AOR= .29; 95%CI(.16 , .55)] and number
of living children [AOR=.51;95%CI, (.29,.87)], were found significant after controlling
cofounders.

Conclusion: - The magnitude of unmet need for modern contraceptive found to be high
compared to the national as well as the regional level. Perceived husband disapproval, lack of
spousal discussion, less exposure to media, older age of women, decision making on
contraceptive use and number of living children were found significantly associated with unmet
need. We that recommend all stake holders need to work strongly to enable mothers through
Information, Education and Communication to be decision maker on their own health, to be
committed to use the services and to persuade their partner and family members for the
opposition.

viii
1. Introduction
1.1. Statement of the problem

The definition of unmet need for family planning has been under continuous revision
and development since the 1960s, unmet need is defined as the percentage of
currently married women who want to post pone childbearing for at least two years
or want no more children but are not using contraception plus married women who
are currently pregnant and whose pregnancy is either mistimed or unwanted
(1).Even though there is a dramatic increase in the use of modern contraceptive
over the past 30 years(2)Yet there are still significant levels of demand for family
planning that are unmet(3).

Different data’s on unmet need shows that there is significant difference in the level
of unmet need in different regions of the world. Globally the level of unmet need is
11.2% and in developed nations it is 11.4% but it is still high in the sub Saharan
African regions being 24% (4) and according to recent data’s 25% in Ethiopia (5).

In 2008, More than half reproductive age group women in developing countries 818
million—wanted to avoid a pregnancy and therefore required effective, continuing
contraception supply but Of these 818 million women who want to avoid a
pregnancy 215 million were not using any method and Women with unmet need
make up 26% of those who want to avoid a pregnancy but account for 82% of
unintended pregnancies (6).

Pregnancy and childbirth are a major source of ill health for women in developing
countries and this countries accounted for 99% of maternal deaths that occurred in
2005—533,000 out of 536,000 and of which 270,000 deaths occur in sub Saharan
Africa (6) Every year, about 19–20 million abortions unsafe abortion occurred and
nearly all (97%) are in developing countries. An estimated 68 000 women die as a
result, and millions more have complications, many permanent (7).

9
The annual number of induced abortions in Africa rose between 2003 and 2008,
from 5.6 million to 6.4 million. In 2008, the most abortions occurred in Eastern Africa
(2.5 million)(8).
Ethiopia has one of the highest numbers of maternal deaths in the world 673 death
per 100000 One in 27 women die from complications of pregnancy or childbirth
annually .In 2008, 101 unintended pregnancies occurred per 1,000 women aged 15–
44, and 42% of all pregnancies were unintended and an estimated 382,500 induced
abortions were performed in the same year (9).

Fulfilling unmet contraceptive need can prevent an additional 150,000 maternal

deaths annually and bring a wide range of benefits for women, their families and
society. in addition to that It slow the spread of HIV/AIDS by preventing 29% more
births of children with HIV than spending the same amount on PMTCT programs that
offer antiretroviral drugs to pregnant women with HIV (10).

In order to reduce and prevent the effect of unintended pregnancy and its terrible
outcomes it is necessary to identify the factors that hinder the use of modern
contraceptive. Thus, the study was aimed to assess the magnitude and factors
associated with unmet need for modern contraception.

10
1.2 Literature review
1.2.1 Extent of unmet need

Despite the rise in modern family planning use evidenced in surveys, more than one
quarter of the births worldwide are unplanned; with 16% wanted later and 11% not
wanted at all (UN,2004). (11) and large and growing need for family Planning
remains in many developing nations. While the world population continues to grow
by 79 million people annually, 215 million women in developing countries seek to
postpone childbearing, space births, or stop having children, but are not using a
modern method of contraception (12).

Unmet need is higher for limiting than spacing in all regions except Sub Saharan
Africa, where unmet need for spacing is almost twice as high as for limiting Across
regions, unmet need ranges from 11% (Middle East and North Africa) to 26 % (Sub-
Saharan Africa); met need (Contraceptive Prevalence Rate) ranges from 25 % (Sub-
Saharan Africa) to 63 % (Latin America and the Caribbean The total demand for
family planning across regions ranges from 51 % (Sub-Saharan Africa) to 80 %
(Latin America and the Caribbean). In Africa, only 45 % of demand is satisfied,
contrasting to 70–84 percent in the other regions (13).

In Sub-Saharan African countries, unmet need is very high ranging from 41% in
Uganda to 13% in Zimbabwe. Unmet need for limiting in this region is also very low
being below 5% in Chad, Congo, and Niger and 5% in Zimbabwe, Nigeria and
Congo democratic republic. Different levels of unmet need and total potential
demand for family planning in Sub-Saharan African countries reflect the non-linear
pattern of unmet need over the fertility transition, pointing (13).

By using DHS 2000-2005, in the Sub-Saharan African countries, 24% of married

women had an unmet need for contraception. Unmet need was lower on average in
South and Southeast Asia (11%), North Africa and West Asia (10%) and the Latin
America region (12%) (14).

11
A community based cross sectional study done in Butagira district showed that, the
proportion of unmet need was 52.4% of which 74.8% was attributed to spacing and
the rest one is for limiting (15). A cross sectional study done in West Belessa
Woreda show that, 40 percent of women had unmet need for contraception (16).
Similarly a study by using data from the 2002 Eritrea Demographic and Health
Survey (EDHS) showed that, 27 percent of women had unmet need for
contraception (17).

A study done by using data from three consecutive rounds of the UDHS showed
that 37% of women had unmet need for contraception (18). A study done by using
data from 2000 and 2005 EDHS showed that, in SNNPRS unmet need for
contraception increased from 35.1% in 2000 to 37.4% in 2005. Unmet need for
spacing remained constant at about 25%, while unmet need for limiting increased by
20% between 2000 and 2005 (19).

In six African countries Benin, Burkina Faso, Cameroon, Cote divoire, Guinea and
Mali 20 to 30 percent of married women of reproductive age report unmet need for
family planning. Unmet need was 17% in both Nigeria and Niger (20). Similarly a
study done in Lungwena, Malawi showed that 32% of married women had unmet
need for contraception (21).

In Ethiopia the level of unmet need has a decreasing trend over the last three
DHSs ranging from 37% in 2000 to 25% in 2011 but in Somali region there is an
increasing trend in the level of unmet need from 14.3% in 2000 to 24 in 2011(22).
1.2.2 Factors Affecting Unmet Need
1.2.2.1 Socio demographic

Educational status

Education is among the variables with most pervasive impact on fertility preference
and behavior of women. Educated women are more likely to have information about
contraceptive and to be more confident in approaching service providers than
women with no education

12
A study conducted in Mosule city in Iraq found highly significant association between
causes of unmet need and education level of women with various degree of
significance depending on the level of education. Low perceived risk of pregnancy is
the most frequent stated reason among illiterate women (34.3%). On the other hand
health concerns and side effects are the reasons number one among educated
women with various fractions varied from 60.1% among women with secondary
education to 41.2% among those with higher degree of education(23).

A study conducted in Kenya revealed that unmet need tends to decline as women
are better educated. Women with incomplete primary education have the greatest
unmet need (33%), even more so than women with no education (26%). This may
reflect the fact that women with at least some education want to have somewhat
fewer children than those with no education. Better educated women – secondary
level or higher – have considerably less unmet need (17%) than women with little or
no education (24).

According to EDHS 2011 unmet need decrease as the educational level of women
increase being 26.3%, 26.7%, 12.7% and 7% among women with no education,
primary education, secondary education and higher education respectively (5).

Age of Respondent

Study conducted in different parts of the world showed that age was significantly
associated with unmet need study in Indonesia, South Asia and India have revealed
this association (25-27) According to Ugandan DHS total unmet need is highest
among married women age 30-44(18).To the contrary in Ethiopia Unmet need is
highest among women 15-19 (33%) and lowest among women age 45-49 (15%).
Unmet need for spacing is highest in the early age group where 30% of women have
an unmet need for spacing birth and Unmet need for limiting is highest among
women age 40-44, with 20 percent of women wanting no more children (5)

13
Number of living children

Number of living children is one of the factors that influence couples demand for
contraceptive. Large number of living children encourages couple to space or limit
child bearing (20). Study conducted in Malaysia and India showed that number of
living children had significant association with unmet need for contraceptive (27, 28)

According to a report by USAID on Benin For women with an unmet need for
spacing, unmet need is highest among women who already have one to five
children. About 23 percent of married women with one or two children and 20 % of
women with three to five children have a demonstrated unmet need for services. For
those with an unmet need for limiting, the greatest need is, as one would expect,
among women who already have a higher number of children. About 23 percent of
women with six or more children have an unmet need for limiting(20).

Study in Kenya indicated that couples who have more children are more likely to
have unmet need than those who have fewer children or none at all (29).

A study conducted in Eritrea revealed that the likelihood of having total unmet need
and unmet need for spacing and limiting rise significantly as the number of living
children increases. Specially need is stronger after the fourth child(17).

A study done in West Belessa Woreda showed that, among the variables, number of
living children was found to be significantly affecting couples unmet need for
contraception. Thus, couples who have no child and have one to four children were
53% and 69% less likely to have unmet need for contraception respectively than the
grand multi parous(16). Similarly a study by using UDHS showed that Women who
have 3 or 4 living children are about twice as likely as women with 0-2 children to
have an unmet need (OR: 1.95, 95% CI: 1.61-2.36), and those with 5 or more
children are more than three times as likely to have an unmet need (OR: 3.37, 95%
CI: 2.72-4.18)(18).

14
1.2.2.2 Family planning factor

Attitude about modern method

Most studies found that women who discuss family planning issue with their spouse
and having a partner who support use of family planning are more likely to use
contraceptive or to have lower risk for unmet need than their counter parts.
A longitudinal study conducted in Nepal on spousal communication and
contraceptive use found that spousal communication play an important role in the
transition to use of contraception play an important role and that it consistently
predict the use of family planning even after controlling other known predictor
variables Nepal(30).
A study conducted in Rwanda and Egypt shows that attitudes toward family
planning were associated with unmet need. It shows that unmet is higher among
women who disapprove or whose partner disapprove the use of modern method and
who have lower level of discussion with partner this study shows that women whose
partner disapprove the use of contraceptive who don’t discuss with partner and who
disapprove use are 4 times, 3 times and 2.89 times more likely to have unmet need
(31, 32).
According to Ethiopian EDHs 2005 women whose partner approve are 38% less
likely to have unmet need than those whose husband disapprove (33).

A cross sectional study done in West Belessa Woreda showed that, spousal
communication about family planning methods was found to be significantly affecting
couples unmet need for contraception. Couples who discussed with their spouse
about family planning at least once were less likely to have unmet need than those
who did not (16)

Study conducted Gwalior district India showed that those who are not exposed to
media have two times more odds to have unmet need than those exposed(34). This
finding is also supported by different studies in Africa study conducted in Uganda
and Egypt revealed that exposure to media is associated with low unmet need.(18,
32)

15
 Demographic
Variables
 Age
 Religion
 Ethnicity
 Age at first
marriage
 Ideal number Proximate Factors
of children  Women’s approval
of Family planning
 Exposure to media Unmet
 Perceived husband need for
Approval of modern
contraception
contrace
 Couples’ discussion
ptive
about family
Socio economic planning
factors  Decision making
 Educational about FP
level of women
 husband
education
 Exposure to
media
 Occupation
Source; -Ethiopia 2000

Figure 1: Conceptual frame work developed to assess the extent and associated
factors of unmet need for modern contraceptives (33)

16
1.4 The Rationale for Study

Despite the high fertility use of modern methods is still low in Somali region and little
information is available on the magnitude and associated factors of unmet need.
Data from demographic health survey 2011 shows that the proportion of women
currently using modern contraceptive in the region is much lower than other regions
being 3.8% but level of un met need is 24% similar with that of other regions, So if
family planning programs serve women with unmet need the CPR will rise and the
demographic effect will be substantial reducing fertility and slowing population
growth. Thus this study aimed to assess magnitude and associated factors of unmet
need in the area and help stake holders in planning and implementing appropriate
strategy to increase utilization of modern method.

17
2. Objective

2.1 General objective

 To assess the extent of unmet need for modern contraceptive and associated
factors among currently married women in Jigjiga town, Somali region,
Ethiopia.

2.2 Specific objective

 To determine the extent of unmet need for modern contraceptives.

 To identify factors associated with unmet need for modern contraceptives.

18
 3. Methods
3.1 Study design and period
A community-based cross sectional study was conducted among currently married
women from April 13 – 23, 2012.

3.2 Study area and population

Somali Region is one of the nine Regional States that make the Federal Republic of
Ethiopia and located in the eastern part of the country, it lies over an area of about
375, 000Km2.
It is bordered by Oromiya National Regional State in the west and southwest & Afar
National Regional State in the Northeast. Internationally it is bordered with Kenya in
the south, Somalia in the east and Djibouti in the north. According to the population
projections of the Central Statistical Authority (CSA) based on the 2007 Population
and Housing Census, the total population of Somali Region was estimated
4,439,147 million among this, 44.39 % and 55.61% were females and males
respectively. The average house hold size is 6.6 the total urban population of the
region is estimated to be only 13.9%(35) .The majority (about 84%) of the population
are pastoralist and agro-pastoralist. The age structure of the population is typical as
other Regional States of the country, with 44.5% of the population under the age of
15 years; children under the age of one year and five years are 3.31% and 17.45%
respectively. Large proportion of women (23.1%) is in the reproductive age group. It
has one referral hospital (Karamara Hospital), one health center, 7 health stations,
one MCH clinic, two health posts, and one Family Guidance Association clinic.

19
3.3 Source population
All reproductive age women (15-49Years) who were married and those who lived in
the area for more than six month.

3.4 Study population

All reproductive age married women who are currently married and who are living in
the randomly selected kebeles of Jigjiga town.

3.5 Sample size and sampling procedures

Single population proportion formula was used with the following
assumptions.

N= (z α/2)2 * p (1-p)

W2

Using the assumption

 level of confidence 95%  1.96

 Margin of error  4%
 prevalence of unmet need  24% (5)
 design effect  2
 10% non response is also added
Using the above formula

N=1.962 * 0.24 * 0.76 = 438

0.042

Design effect = 438*2 = 876

Adding 10% non response rate it become 963

Table for sample size by factors

Proportion Sample size

Spousal communication 20.6 398

Education 22.2 412

Regional prevalence 24 438

20
3.6. Sampling procedure
A two–stage sampling technique was employed. From the ten kebeles five
were selected randomly using lottery method. Individual households in the
chosen kebeles were selected using a systematic sampling technique and
the numbers of households included among the selected kebeles were
determined using proportional to household size.

One married woman aged 15-49 years in the selected household was further
selected and interviewed. In the case of more than one eligible participant in the
household, lottery method was used to select only one. For households in which
married woman were not found at home, but if it is known that there were eligible
woman for the study, the interviewers revisited the HH three times at different time
intervals and when interviewers failed to get the woman the household was excluded
from the survey and replaced by the next HH in clockwise direction.

21
 JIGJIGA TOWN

Simple random sampling

01 03 04 06 10

1527 1959 HH 1671 HH 2538 HH 1404 HH

HH

Systematic sampling

161HH 207HH 177HH 269HH 149HH

963 HH

Figure 2 Schematic sampling procedure Jigjiga Town

22
 3.7. Variables of the study
3.7.1 Dependent variable
 Unmet need for modern contraceptives

3.7.2 Independent
Socio demographic factor

 Educational status of respondent

 Educational status of husband
 Age of respondent
 Age at marriage
 Exposure to mass media
 Occupation
 Income
 Number of living children

Family planning factor

 Discussion with husband within the last six months

 Responsibility of decision making
 Perceived Husband attitude
 Self opposition to family planning

23
3.8. Operational definitions
 Unmet need: - the percentage of currently married women who want
to post pone Child bearing for at least two years or want no more
children but are not using contraception plus pregnant women whose
pregnancy is mistimed or unwanted(36).
 Fecundity: - physiological ability of a woman to conceive.
 Women in union:- women who are married or living with a partner at
least for three months.
 Unintended pregnancy; - includes both unwanted and mistimed
pregnancies.
 Mistimed pregnancy; - is pregnancy, which has occurred without
intention of the woman or the couples at specific time, but wants to be
pregnant and have a child sometime in the future.
 Intended pregnancy; - is a pregnancy that is wanted and planned.
 Met need: - percentage of currently married women who are currently
using contraceptive.
 Total potential demand: - The addition of percentage of women
whose need is met and the percentage of women with unmet need.

3.9. Exclusion and inclusion criteria

3.9.1 Inclusion criteria

All women in reproductive age group who are married and permanent residents of
the area.

3.9.2 Exclusion criteria

Women who were seriously ill during the data collection were excluded.

24
3.10. Data collection procedures
Data were collected via face to face interview using a structured and pre-tested
questionnaire prepared in English and translated to local language (somali), and
then back translated to English. For data collection eight data collectors from statics
office of Jigjiga and three supervisors (BSC Nurses) were participated in the data
collection process. Two days Training was given to the data collectors and
supervisors on the objective, relevance of the study, confidentiality of information,
respondent’s right, about pre-test, informed consent and techniques of interview the
data collection was conducted from April 13 --.23,2012.

3.11. Data processing and analysis

All filled questionnaires were checked for completeness, cleaned manually, coded
and entered in to EPI info version 6 statistical software and then exported to SPSS
windows version 16 for further analysis. Frequencies, proportion and summary
statistics were used to describe the study population in relation to relevant variables
and were presented by using tables and figures. Bivariate analysis was used
primarily to check which variables have association with the dependent variable.
Then variables found to have p-value of less than 0.2 were entered in to Multiple
Logistic regression for controlling the possible effect of confounders. Finally the
variables which have significant association were identified on the basis of OR with
95%CI.

3.12. Data Quality control

The quality of data was assured by pre-testing of the questionnaires in one of the
kebele other than the selected one on 48(5%) of the participants, and by giving
training for the data collectors and supervisors before the actual data collection.
Every day after data collection, questionnaires were reviewed and checked for
completeness and consistency by the supervisors and principal investigator and the
necessary feedback was offered to data collectors in the next morning.

25
3.13. Ethical consideration
Ethical clearance was obtained from the Institutional Review Board (IRB) of institute
of public health. Official letter was submitted to the Regional Health Bureau and
every selected kebeles were informed about the study objective and relevance
through letter. Verbal informed consent was obtained from all respondents before
participation after explaining the purpose of the study. The participants were
informed that they can with draw from the interview at any point if they feel any
discomfort.

In order to keep any information provided by study subjects confidential, the data
collection procedure was maintained by excluding their names as identification in the
questionnaire and keeping their privacy during interview period by interviewing them
alone.

3.14. Dissemination of result

High priority was given to the timely dissemination of the study findings to the
relevant organizations and stakeholders. The plan of diffusion of the project result
includes presentation at University of Gondar and Ethiopian Public Health
Association Annual Conference. The report paper will also be disseminated to
Somali Region Health Bureau and other interested governmental and
nongovernmental organizations. Publication in peer reviewed journal will also be
considered.

26
4. Results
4.1 socio demographic characteristics
A total of 924 married women in reproductive age group living in the area were
interviewed yielding 95.9% response rate. More than half (56.5%) of the
respondents were Muslims and the rest refers to Christianity. The median age of
respondents was 28 years with inter quartile range of 9. More than one third (37.6%)
of the respondents were Somalis followed by Amhara (25.2%). Concerning
occupation around two third (67.7%) of them were house wives (Table1).

27
Table1. Selected socio demographic characteristics of married women in
Jigjiga, Ethiopia, 2012 (n = 924).

characteristics Frequency %
Respondents' age
≤ 24 250 27.1
25-34 467 50.5
≥35 207 22.4
Religion
Muslim 522 56.5
Christian 402 43.5
Ethnicity
Somali 347 37.6
Amhara 233 25.2
Oromo 188 20.3
Guragie 114 12.3
Other 42 4.6
Occupation
Employee 115 12.5
House wife 626 67.7
Merchant 131 14.2
Other 52 5.6
Edu. Of respondent
No formal education 271 29.3
Elementary 219 23.7
Junior high 284 30.7
Preparatory 73 8
Higher education 77 8.3
Edu. Of husband
No formal education 119 12.9
Elementary 125 13.5
Junior high 335 36.2
Preparatory 190 20.6
Higher education 155 16.8
Eco. perception
Very poor 17 1.8
Poor 190 20.6
Medium 551 59.6
Good 149 16.2
Very good 17 1.8
Possession of TV &radio
Radio only 39 4.2
TV only 265 28.7
Both 511 55.3
None 109 11.8

28
4.2 Reproductive characteristics
The median age of marriage was 19. The minimum and maximum age of marriage
was 11 and 36 respectively. The mean age of first pregnancy was 20(SD±3.6).

Table2.The reproductive characteristics of married women with unmet need in

Jigjiga, Ethiopia, 2012 (n = 924)

Reproductive factors Unmet need

Yes % No % Total %
Age of marriage
≤ 24 254 82.5 546 88.6 800 86.6
25-34 36 11.7 50 8.1 86 9.3
≥ 35 1 0.3 2 0.3 3 0.3
Don’t remember 17 5.5 18 3 35 3.8
№ of pregnancy
1-4 192 65.8 491 90 683 81.5
≥5 100 34.2 55 10 155 18.6
Age at first pregnancy
≤ 24 242 82.9 473 86.6 715 85.3
25-34 45 15.4 65 11.9 110 13.1
≥ 35 1 0.3 2 0.4 3 0.4
Don’t remember 4 1.4 6 1.1 10 1.2
№ of living children
1-4 204 70 491 90 695 83
≥5 79 27 45 8.2 124 14.8
No child 9 3 10 1.8 19 2.2
Age at first birth
≤ 24 239 81.8 463 84.8 702 83.8
25-34 49 16.8 77 14.1 126 15
≥ 35 1 0.3 2 0.37 3 0.36
Don’t remember 3 1.1 4 0.73 7 0.84

29
From all respondents 838(90.7%) had ever been pregnant. Currently 101 of the
women were pregnant among all the pregnant, 93(92.1%) reported it was intended,
seven reported it was mistimed and one woman report it was unwanted. About
23(22.7%) of the currently pregnant women reported that they do not want to have
another child in the future and 68(67.3%) of them want to use contraceptive in the
future Injectable being the most preferred method 44(43.6%).

Regarding the reason for the unwanted and mistimed pregnancy two mentioned little
perceived risk of pregnancy the other two mentioned religious prohibition to use
contraceptive and the rest mentioned lack of awareness and husband prohibition to
use contraceptive as a reason. Among the pregnant, four of them planned to use
contraceptive in the future with the preference of injectables selected by the three.

4.3 Knowledge of family planning

From all respondent, 896 (97%) of them had ever heard about family planning.
Injectable is the most widely mentioned method (91.7%) and the least mentioned
method was male sterilization (5.6%). The commonly mentioned source of
information was health institution783 (84.7%) and the least mentioned was school
73(8.1%).

Regarding knowledge of place where to obtain a method among all respondents

96.7% had known a place and the widely mentioned sources were Family Guidance
Association Ethiopia (FGAE) and Hospital as they were mentioned by 613(70%) and
585(67.3%) of respondents respectively.

Pertaining the advantage of family planning most of the respondents mentioned

spacing705 (76.8%) and the least known advantage was to prevent STI 216(24%)
(Table 3) .

30
Table3.Knoweledge characteristics of married women with unmet need jigjiga,
Ethiopia, 2012 (n = 924).

Characteristics Unmet need Total %

Yes % No %
Hear about FP
No 25 8.1 3 0.5 28 3
Yes 283 91.9 613 100 896 97
Method known
Pill 231 81.6 517 83.9 748 83.2
IUCD 84 29.7 360 58.4 444 49.4
Injectable 243 85.7 581 94.3 824 91.7
Norplant 113 39.9 391 63.5 504 56
Male condom 84 29.7 315 51 399 44.4
Female condom 15 5.3 75 12.2 90 10
Female sterilization 20 7.1 66 10.7 86 9.6
Male sterilization 10 3.5 40 6.5 50 5.6
Emergency 19 6.7 95 15.4 114 12.7
Natural 32 11.3 176 28.6 208 22.5
Source
Health institution 212 68.8 571 61.8 783 84.7
Radio 114 40.3 275 44.6 389 43.2
Television 157 55.5 417 67.8 574 63.8
Friend 93 32.9 206 33.4 299 33.3
News paper 19 6.7 61 9.9 80 8.9
Husband 22 7.8 87 14 109 12.1
School 15 5.3 60 9.7 75 8.11
Know place
No 30 10.6 3 0.5 30 3.3
Yes 253 89.4 613 100 869 96.7
Known places
Hospital 180 71.2 405 65.7 585 67.3
Health center 22 8.7 82 13.3 104 12.0
Health post 7 2.8 38 45
FGAE 125 49.4 488 79.2 613 70.5
Pharmacy 106 41.9 311 50.5 417 48.0
Advantage of FP
Avoid unwanted pregnancy 187 66 465 75.5 652 70.6
Spacing 183 64.7 527 85.5 710 76.8
Limiting 90 31.8 302 49.0 392 42.4
Prevent STI 32 11.3 189 30.6 221 24.0
* The percent may not add to 100 as multiple answers are possible.

31
4.4 Attitude towards family planning
From all respondents 699 of them (75.6%) said they need additional information
about family planning. Nearly half of women with unmet need approve (49.4%) use
of contraceptive. Pertaining discussion with husband about contraceptive within the
last 6 months 299(32.4%) of them mention that they did so. (Table 4)

Table4.Attitude of currently married women in Jigjiga, Ethiopia, 2012 (N = 924).

Characteristics Frequency %

Need more information

No 225 24.4
Yes 699 75.6
Approve use
No 156 17
Yes 768 83
Reason for disapproval
Fear of side effect 20 12.8
Desire more child 35 22.4
Fear of infertility 10 6.4
Religion 112 71.8
Other 4 2.6
Discus about FP with husband
in the last 6 month
No 625 67.6
Yes 299 32.4
№ of discussion with husband
≥ three 75 25.1
≤ two 152 50.8
Don’t remember 72 24.1
Husband know use or non use
No 33 3.6
Yes 891 96.4
Perceived Husband attitude
Approve 659 71.3
Disapprove 237 25.7
Am Not sure 28 3

32
4.5 Practice of family planning

Around half (52%) of the respondents had ever used modern contraceptive and the
widely used method was Injectable (54%). Three hundred thirty four respondents
(36%) were currently using contraceptives and the widely used method was
Injectable (62.2%) and the least used method was condom (0.9%). (Table 5).

Table5.Practice of modern contraceptive among currently married women in

Jigjiga town, Ethiopia, 2012 (n = 924).

Characteristics Frequency %

Ever use No 444 48

Yes 480 52

Pill 172 36
Method used IUCD 13 2.7
Injectable 259 54
Norplant 31 6.4
Male condom 5 0.1

Current use No 590 63.9

Yes 334 36%

Total potential demand

Met need 334 36
Unmet need 308 33.3

Mainly respondent 86 9.3

Decision on FP use Mainly husband 34 3.7
Joint decision 804 87

33
 Extent of unmet need
33.3
35
30 25.8
25
20
15
10 7.6
5
0

Total
spacing
limiting

Figure3. Distribution of married women with unmet need by spacing and

limiting,Jigjiga, Ethiopia, 2012.

45
40
35
30
25
20
15
10
5
0

Figure4. Distribution of married women with unmet need by their reason for
non use of modern contraceptive, Jigjiga, Ethiopia, 2012.

34
4.6 Factors associated with unmet need
The impact of selected socio-demographic and other characteristics on unmet need
for modern contraceptive was investigated using both bivariate and multivariate
logistic regression technique. Variables found to be significant at p value of 0.2 were
included in the multivariate analysis. Finally, age of respondent, № of living children,
discussion with husband within the last six month, husband attitude, possession of
TV and Radio and decision making about contraceptive use were found to be
significantly associated with unmet need.

Table6 - Impact of selected socio-demographic and other characteristics on

unmet need among married women in jigjiga, May 2012.
Variable Yes No Crude OR(95% Adjusted
CI) OR(95%CI)
Age
≤24 61(19.8) 189(30.7) 1 1
25-34 136(44.2) 331(53.7) 1.27(.89, 1.81) 1.18(.72,1.95)
35 111(36) 96(15.6) 3.58(2.41, 5.33) 3.27 (1.79 , 5.95)*
Occupation
Employee 17(5.5) 98(16) 1

House wife 247(80.2) 413(67) 3.45(2.01,5.91)

Merchant 44(14.3) 105(17) 2.42(1.29,4.51)

Education of the
respondent
No formal education 153(49.7) 118(19.2) 5.2(3.25 , 8.27)
≤ 10 125(40.6) 378(61.4) 1.32(.85 , 2.07)
≥ 11 30(9.7) 120(19.4) 1

Husband education
No formal education 75(24.4) 44(7.14) 4.42( 2.85, 6.87)
≤ 10 137(44.5) 323(52.4) 1.1(0.81 ,1.49)
≥ 11 96(15.6) 249(40.4) 1

Economic perception
very poor 8(2.6) 9(1.5) 1.27(1.33,4.93)
poor 79(25.6) 111(18) 1.02(0.37,2.79)
Medium 171 (55.5) 380(61.7) 0.64(0.24,1.72)
good 43(14.0) 106(17.2) 0.58(0.21,1.62)
Very good 7(2.3) 10(1.6) 1

35
Possession of TV/Radio
Both 139(45.1) 372(60.4) 1 1
TV 87(28.2) 178(28.9) 1.31(0.95 , 1.81) 1.09(.43 , 2.78)
Radio 11(3.6) 28(4.5) 1.05(0.51 , 2.17) 1.42(.93 , 2.15)
None 71(23.1) 38(6.2) 5.00(3.22 , 7.76) 3.10(1.69, 5.68)*
№ living children
No child 9(3) 10(1.8) 0.51(0.19 , 1.36) .54(.23 , 1.25)
1-4 204(70) 491(90) o.24(0.16,0.353) .51(.29 , .87)*
5 79(27) 45(8.2) 1 1
Decision making on FP
Respondent 32(10.4) 54(8.8) 1.32(.83, 2.09) .29(.16 , .55)*
Husband 27(8.8) 7(1.2) 8.59(3.69, 20.01) 2.12(.73 , 6.15)
Joint decision 249(80.8) 555(90) 1 1
Discussion with husband
Yes 30(9.7) 269(43.7) 1 1
No 278(90.3) 347(56.3) 7.18(4.77, 10.81) 2.76(1.7 , 4.49)*
Husband attitude
Approve 102(33.1) 557(90.4) 1 1
Disapprove 206(66.9) 59(9.6) 19.07 (13.33, 27.3) 16.73(10.8 , 26.0)*
*significant
After controlling for confounders the result revealed that women age 35 and above
were three times more likely to have unmet need than women in the early
ages[AOR=3.27;95%CI(1.79,5.95)],respondents who have neither Radio nor TV
were three times more likely to have unmet need than those who own both [AOR=3;
95%CI(1.69,5.68)].

Women who perceive their husband do not approve the use of modern contraceptive
were more than sixteen times more likely to have unmet need than women who
perceive their husband attitude positively [AOR=16.7; 95% CI (10.8, 26.0)].

women who don’t discuss about contraceptive with their partner in the last six month
were more than two times more likely to have unmet need than those who discuss
[AOR=2.76; 95% CI (1.7, 4.49)].

36
Women who alone decide about the use of contraceptive were 71% less likely to
have unmet need than those who made a joint decision. [AOR=0.29; 95% CI (0.16,
0.55)].

According to the current study women with fewer number of children have lower risk
for unmet need than women with more children. It is found that women who have 1-4
child were 49% less likely to have unmet need than those who have five or more
children [AOR=0.51; 95% CI (0.29, 0.87)].

37
5. Discussion
This study revealed that the extent of unmet need is higher than studies
conducted in South and Southeast Asia which was, North Africa and west
Asia, Latin America region, Nigeria and Niger which was ranging from 10% -
17% (14, 20). The difference might be, in those countries there is good
access to family planning service as compared to this study.

Our study found that, unmet need for modern contraceptives among married
women was 33.3%. This finding was in line with studies done in Malawi,
Uganda, Eretria, SNNPRS and West belesa which ranges from (32–
40%)(16-19, 21) This finding was Also in line with the national estimate
according to EDHS 2011 which was 25% and Somali region (24%) (5, 22) .

But this finding was lower than a study conducted in Butagira which was
52.4%(15). This might be due to the Butagira study involves large sample
size and involves rural areas which have low access to information about
FP and modern contraceptives.

women aged 35 and above were three times more likely to have unmet need than
those women in the early ages .This finding is in line with a study conducted in
Indonesia that women who were in the age between 33 and 49 were less likely to
use contraceptive even if they want to stop child bearing (25). Study conducted in
four south Asian countries (Bangladesh, Nepal, Pakistan and India)also showed
that age has a negative relationship with unmet need for spacing and positive
relationship with unmet need for limiting (26).Also study conducted in India showed
that age was significantly associated with unmet need.

Most studies found that women who discuss family planning issue with their spouse
and whose partner support the use of family planning are more likely to use
contraceptive or to have lower risk for unmet need relatively to their counter parts.
In this study women who don’t discuss family planning issue with their partner were
more than two times more likely to have unmet need than those who discuss.
Similarly different researches in other areas also support this finding a study in

38
Rwanda and Egypt showed that women who don’t discuss with partner are three
times more likely to have unmet need (31, 32) but to the contrary a study done in
Eritrea revealed that women who discuss family planning with partner are 1.5 times
more likely to have unmet need this difference might be due to little accessibility to
family planning service in the area despite a need to limit or postpone child bearing.

The other most predictor of unmet need in this study was perceived husband
disapproval to contraceptive use this study revealed that perceived husband
disapproval was strong predictor of unmet need. In the study area those women who
perceived their husband disapprove use of contraceptive were more than sixteen
times more likely to have unmet need This result is in line with a study conducted in
Egypt and Rwanda but the odds of unmet need in this studies is lower than this
study being 3 and 4 respectively(31, 32). This might be due to the cultural, socio
demographic and modernization differences between the study populations. This
Result is also in line with other studies. According to Ethiopian EDHs 2005 women
whose partner approve were 38% less likely to have unmet need than those whose
husband disapprove (36).

Women who were responsible to decide for themselves about contraceptive

utilization were 71% less likely to have unmet need than those whose made a joint
decision.
Those who don’t have either of the two (TV and Radio) were three times more likely
to have unmet need for modern contraceptive than those who own both. This result
is in line with a study conducted in Gwalior district as the study showed those who
were not exposed to media had two times more odds to have unmet need than
those exposed. This might be due to it is a fact that those who have TV and Radio
are more likely to have information about contraceptive(34).

In this study women with 1-4 children were 49% less likely to have unmet need than
those women with 5 or more number of children this result is in line with study
conducted in Malaysia and five Asian countries which also found number of living
children significantly associated with unmet need(26, 28)also study conducted in

39
kenya indicated that couples who have more children were more likely to have
unmet need than the ones who have fewer children or none at all(29).

Strength of the study

 Community based study and can be generalized to similar settings..

Limitation of the study

 There could be social desirability bias because some women purposively may
not disclose status of current use.

40
6. Conclusions

 The extent of unmet need was found to be high.

 Age, husband attitude, discussion with husband within the last six months,
media exposure, number of living children and decision making about
contraceptive use were found to be associated with unmet need. This study
showed that not only family planning accessibility and socio demographic
factors are responsible for high unmet need but also women empowerment is
a salient point to be considered in the effort to meet the unmet need.

41
7. Recommendations

1. Woreda Health Office

 Enable women through Information, Education and Communication to
be decision maker utilize the services and persuade their partner and
family members for the opposition.
2. The regional health bureau
 To consider induction of urban health extension workers program.
 Need to Develop and implement programs that encourage the
involvement of men in family planning to persuade men to support
their partners and use the services
3. There is a need to establish net working among regional health bureaus,
regional offices of population, regional women’s associations and
nongovernmental organization
4. Medias
 Need to reinforce messages that Encouraging spousal
Communication which is crucial to enhance joint decision making.
Messages about the benefit of family planning need to be reinforced
by using different communication channels, including the media that
are available and accessible to most women and men.
5. Researchers
 Further research is needed to identify the more about unmet need.

42
8. Reference
1. Bradley SEK, Croft TN, Fishel JD, Westoff CF. Revising Unmet Need for
Family Planning. Calverton, Maryland, USA: ICF International, 2012 Contract No.:
25.
2. Tsui AO, McDonald-Mosley R, Burke AE. Family Planning and the Burden of
Unintended Pregnancies. Oxford University Press journal. 2010;32:152-74.
3. Moreland S, Smith E, Sharma S. World Population Prospects and Unmet
Need for Family Planning Washington, DC,United States of America: 2010.
4. WHO. Access to Reproductive Health among Least Developed Countries
Levels, Disparities and Trends. 2010.
5. CSA, ICF M. Ethiopia Demographic Health Survey 2010. Addis Ababa,
Ethiopia and Calverton, Maryland, USA: 2011.
6. Singh S, Darroch JE, Ashford LS, Vlassoff M. The Costs and Benefits of
Investing in Family Planning and Maternal and Newborn Health. 2010.
7. David AG, Jaine B, susheela S, et al. unsafe abortion the preventable
pandemic. lancet. 2006(368):1908-19.
8. Guttamacher, Institute. Facts on abortion in Africa. 2012.
9. Guttamacher, Institute. Facts on un intended pregnancy and abortion in
Ethiopia 2012.
10. UNFPA, PATH. Reducing unmet need for family planning: Evidencebased
strategies and approaches. Out look. 2008;25(1).
11. S.Singh, Darroch E, Jacquiline, Vlassoff M, e t al. The Costs and Benefit s of
Investi ng in Fa mily Planning and Mat ernal and Newborn Health. 2003.
12. Population, action, international. Meeting the Development and Health Needs
of 215 Million Women: U.S. International Family Planning Goals. 2008.
13. Mills S, Bos E, Suzuki E. Unmet need for contraception. 2010.
14. Gilda Sedgh RH, Akinrinola Bankole,Suhsela Singh. Women with unmwt
need in developing country and their reason for not using a method. 2007 37.
15. Wubegzier Mekonnen AW. determinants of low family planning use and high
unmet need in butajira district south centeral Ethiopia. Reproductive Health Journal.
2011;8(37).

43
16. Mihiret N. Determinants of unmet need for Contraception Among Currently
Barried Coupls in West Bellessa Woreda North Gondar of Amhara Ethiopia. Adiss
Ababa: AAU; 2008.
17. woldemicael g. currently married women with an unmet need for
contraception in Eritrea;profil and determinants. canadian studies in population.
2011;38(1-2):61-81.
18. Shane Khan SEKB, Joy Fishel,Vinod Mishera. unmet need and the demand
for family planning in Uganda,further analyisis of the ugandan demographic and
health survey 1995-2006. Calverton,Mary land,USA;Macro International Inc.: 2008.
19. Assefa Haile mariam FH. Factores Affecting unmet need for family planning in
southern nation, nationalties and people region,Ethiopia. Ethioian journal health
science. 2011;21(2):77-89.
20. USAID. perspectives on unmet need for Family planning in west Africa;Benin.
2005.
21. Kamvazina G. factors contributing to high unmet need for modern family
planning in Lungwena: university of Malawi; 2007.
22. CSA IM. Ethiopia demographic and health survey 2000 Addis Ababa. Ethiopia
and Calverton,Mary land,USA: 2001.
23. AL-JAWADI AA, AL-BAKRY DH. Family Planning Unmet Need Profile In
Mosule City, North Of IRAQ: A Cross-Sectional Study. Duhok medical journal.
2010;4(1):40-50.
24. NCAPD. fullfilling unmet need for family planning can help kenya achieve
vision 2030. 2010 13.
25. Mellissa Withers Mk, GDE Ngurah,Indraguna pinatih. desire for more children
contraceptive use and unmet need for family planning in a remote area of Bali
Indonesia. Cambrige university 2010;42:549-62.
26. Chandhury RH. unmet need for contraception in south asia;level,trends and
determinants. Asian pacific journal. 2001;16(3).
27. Supriya Satish Patil MD, SR Patil. epidimeological correlates of unmet need
for contraception in urban slum population. Al Ameen journal medical science.
2010;3(4):312-6.

44
28. Sapina S. patil ARK, KA Narayan. unmet need for contraception in married
women in triabal area of india. Malesian journal of public health medicine
2010;10(2):44-51.
29. Moses Otieno Omwago AAK. factors influencing couples unmet need for
contraception in kenya.
30. F. C. Spousal communication and contraceptive use in rural nepal.event
history analysis. studies in family planning. 2011;42(2):83-92.
31. Dieudonne Muhoza N, Annelet Broekhuis Pieter Hoomeijer. demand and
unmet need for means of family limitation,Rwanda. international perspectives on
sexual and reproductive health. 2009;35(3):122-30.
32. M.KoTB sultan .I.Baker N, Ahmed Ismaeli,N Arafa. prevalence of unmet
contraceptive need among egyptian women ; a community based study journal of
prevMEdHyg. 2010;51:62-6.
33. korra A. Attitudes to ward family planning and reasons for non use among
women with unmet need for family planing in Ethiopia Claverton,Maryland USA;ORC
Macro.: 2002.
34. Srivastava Dhiraj Kumar GP, Gautam Roli,Gour Neeraj Bansal,Manoj. study
to assess the unmet need of family planning in Gwalior District and to study the
factors that helps in determining it. national journal of community medicin. 2011;2(1).
35. CSA. Summary and statistical report of the 2007 population and housing
census. Addis Ababa,Ethiopia: 2008.
36. Samuel Mills EB, Emi Suzuki. Unmet need for contraception. 2010.

45
ANNEXES
Annex I
Information Sheet and Consent Form

Title of the Research Project

Determinants of Unmet Need for Modern Contraceptives among Currently Married Women
in Somali Regional State, Jigjiga town,2012GC.
Name of Principal Investigator: Beza Tamirat
Name of the Organization: University of Gondar, Gondar College of Medicine and
Health Sciences, Institute of Public Health
Name of the Sponsor: University of Gondar
Information Sheet and Consent Form Prepared For women who are married and are going
to participate in a research project entitled as “determinants of unmet need for modern
contraceptive among currently married women in jigjiga town,2012.”
Introduction
This information sheet and consent form is prepared with the aim of determining the
predicting factors of unmet need for modern contraceptive. The research group includes the
principal investigator ten trained data collectors, two Supervisors, and two advisors from
University of Gondar.
Purpose of the Research Project
The aim of this study is to determine the predicting factors of unmet need for modern
contraceptive. Understanding the predicting factors for unmet need is very important to
reduce unintended pregnancy and its terrible outcomes including maternal mortality ratio
and help to achieve millennium development goals. The results of this study will be used to
design appropriate intervention programs to address the low utilization of modern
contraceptive through providing the service for married women with unmet need in jigjiga
town.
Procedure
The study involves married women who are permanent resident of the area. You are
selected to be one of the study participants. If you are willing to take part in this study, we
are so happy and we need you to clearly understand the aim of this study and show your
agreement .Finally you are kindly requested to give your genuine response in the interview.

46
Benefits, Risk and /or Discomfort
By participating in this research project you may feel some discomfort in wasting your time
(a maximum of 45minute). However, your participation is definitely important to identify
determinant factors of unmet need for modern contraceptive to design appropriate strategy
to increase the utilization of modern contraceptive. There is no risk or direct benefit in
participating in this research project.
Incentives/Payments for Participating
You will not be provided any incentives or payment to take part in this project.
Confidentiality
The information collected from you will be kept confidential and stored in a file, without your
name by assigning a code number to it and hence no report of the study ever identifies you.
Right to Refusal or Withdraw
You have the full right to refuse from participating in this research. You have also the full
right to withdraw from this study at any time you wish.
Person to contact
This research project will be reviewed and approved by the ethical committee of the
University of Gondar. If you have any question you can contact any of the following
individuals and you may ask at any time you want.
 Name: Beza Tamirat
Tele: +251_921_69_52_52
E-mail:bezatamirat@yahoo.com
 Name: Takele Tadesse
Tele: +251_918_77_33_17
E-mail: takele_tadesse@yahoo.com
 Name: Zelalem Birhanu
Tele: +251_912_03_86_54
E-mail: zelalem78@gmail.com

47
Annex II
The data collection instrument

University of Gondar institute of public health Survey questionnaire on the Magnitude and
Determinants of Unmet need for family planning among currently married Women in
childbearing age [15-49] In Jigjiga town Somali Regional State.
Consent form
Introduction

Good Morning/Good Afternoon

My name is --------------------------------- I am working on a research team which is conducted

as partial fulfillment for the requirement of Master of Public Health (RH) at Gondar
University.
We are interviewing currently married women in child bearing age to know the determinants
of unmet need for family planning. I am going to ask you some questions that are not difficult
to answer. Your name will not be written in this form and will never be used in connection
with any of the information you tell me. You do not have to answer any question that you do
not want to answer and you may end this interview at any time you want to. However, your
honest answers to these questions will help as in identifying the magnitude and
determinants of unmet need for family planning and improve the family planning services in
the future to meet the unmet need of the community. We would appreciate your help in
responding to this survey questions .The interview will take about 30 minutes. Would you be
willing to participate [indicate by ticking the appropriate responses]?
Yes-------, no-----------
Signature of the interviewer certifying that the informed consent has been verbally given by
Respondents -----------------------------------------
Date
Interviewers’ name
Result 1 completed, Result 2 respondents not available Result 3 respondent refused
001 –interviewer code -------------------/---------------------/name----------------
002 –Household number--------------------
003 – Date of interview in Ethiopian calendar---------/---------/------time
004 – Checked by supervisor.
Signature-------------------- day-------------month-------------year.

48
Annex II

The data collection instrument

University of Gondar institute of public health Survey questionnaire on the Magnitude and
Determinants of Unmet need for family planning among currently married Women in
childbearing age [15-49] In Jigjiga town Somali Regional State.
Consent form
Introduction

Good Morning/Good Afternoon

My name is --------------------------------- I am working on a research team which is conducted
as partial fulfillment for the requirement of Master of Public Health (RH) at Gondar
University.
We are interviewing currently married women in child bearing age to know the determinants
of unmet need for family planning. I am going to ask you some questions that are not difficult
to answer. Your name will not be written in this form and will never be used in connection
with any of the information you tell me. You do not have to answer any question that you do
not want to answer and you may end this interview at any time you want to. However, your
honest answers to these questions will help as in identifying the magnitude and
determinants of unmet need for family planning and improve the family planning services in
the future to meet the unmet need of the community. We would appreciate your help in
responding to this survey questions .The interview will take about 30 minutes. Would you be
willing to participate [indicate by ticking the appropriate responses]?
Yes-------, no-----------
Signature of the interviewer certifying that the informed consent has been verbally given by
Respondents -----------------------------------------
Date
Interviewers’ name
Result 1 completed, Result 2 respondents not available Result 3 respondent refused
001 –interviewer code -------------------/---------------------/name----------------
002 –Household number--------------------
003 – Date of interview in Ethiopian calendar---------/---------/------time
004 – Checked by supervisor.
Signature-------------------- day-------------month-------------year.

49
Part I Demographic and socioeconomic characteristics

No Questions Choice of answer Skip to

question Code
101 How old are you at your last ------- years (in complete
Birth day? years)

102 What is your religion? 1.Muslim 1

2.orthodox 2
3. protestant 3
4. catholic 4
5. Other (specify)…..
103 What is your ethnicity? 1. Somali 1
2. Amhara 2
3.Oromo 3
4.Gurage 4
5.. Others (specify)
104 What is your Educational 1. Do not write and read 1
status? [illiterate]
2. Read and write 2
3. Elementary school [1- 3
6] 4
4. Junior high school 7- 5
10]
5. Preparatory school 6
[11-12]
6. Higher education
105 What is the educational status 1. Do not write and read 1
of your husband [illiterate]
2. Read and write 2
3. Elementary school [1- 3
6] 4
4. Junior high school 7- 5
10]
5. Preparatory school 6
[11-12]
6. Higher education
106 What type of occupation you 1. house wife 1
are currently engaged in? 2. merchant 2
3. daily laborer 3
4. house maid 4
5. government 5
employee 6
6. farmer 7
7. others (specify)

50
107 What is your monthly income? 1. …… birr 1
2. I don’t know exactly 2
99. Refusal 99

108 If you compare your monthly 1. Very poor 1

income with your
2 .Poor
neighborhood, where you put 2
your economic status? 3 .Medium
3
4 .Sufficient
4
5 .Rich 5
109 Do you have functional radio 1. Radio only 1
or TV in your house? 2. TV only 2
3. Both radio and TV 3
4. None 4
Part II Reproductive History
Question Answer Skip to code
201 At what age did you first got 1. At the age of ……..
married? 2. I do not remember

202 Have you ever been 1. Yes If no go 1

pregnant? 2. No to 2
208
203 How many pregnancies have Enter number….
you ever had?
204 How old were you when you 1. ----- years
first got pregnant?

205 How many live children do Enter the number….

you have?
206 How old were you when your
first child was born Enter number
207 How many children would you 1. Enter no……..
like to have in your life?
208 Are you currently pregnant? 1. Yes If no 220 1
2. No 2

51
 Question Answer code
209 If the answer is yes is the 1. Intended If intended 1
pregnancy 2 .Mistimed go to 213 2
3. Unwanted 3
4. No response 4
210 If you have been 1. Lack of awareness of 1
pregnant when you do Contraception method?
not want to, what was the
reason you could not 2. Poor access to 2
avoid becoming contraception method
pregnant?
3. Husband or partner
Disapproval 3

4. Contraceptive failure 4

5. Little perceived risk of 5

pregnancy
6. Religion prohibition 6
7. Culture prohibition 7
8. Other specify… 8
211 After the child you are 1.Yes 1
expecting now, would you 2. No If no 216 2
like to have another 3. Not yet decided 3
child?
212 Do you intend to use 1. Yes If no go to 1
family 2. No 219 2
Planning in the future to 3 .Not decided 3
delay or avoid
pregnancy?
213 Which method do you 1. Pill 1
prefer to 2. IUCD 2
Use? 3. inject able 3
4. implant [Norplant] 4
5. condom 5
6. Female sterilization 6
7. Male sterilization 7
8. Spermicidal 8
9. Natural method 9
10. Other specify 10

52
214 If, you are not going to Yes No
use any method to delay 1 Not aware of contraception
or avoid pregnancy at 2. Fear of side effect 1 2
any time in the 3. Fear of infertility 1 2
Future would you tell me 4. Unacceptable in my culture 1 2
the main reason?
5. Medical problem 1 2
6. Preferred method is 1 2
not available
7. Desire to have more 1 2
children
8. Husband or partner 1 2
disapproval
9. Religion prohibition 1 2
10. Little perceived risk 1 2
of pregnancy
11. Other specify 1 2
215 If you are not pregnant or 1. Have child 1
amenorrhric would you 2. No more child 2
like to have another child 3. Undecided 3
or not to have another
child?
216 If you like to have a child 1. > 2 years 1
how long would you like 2. < 2 years 2
to wait from now before 3. Not decided 3
the birth of another child?

Part III Knowledge about contraception

Question Answer Skip to Code

301 Have you ever heard of family 1. Yes If no skip to 1
planning methods that women 2. No 401 2
or men can use to avoid
pregnancy?
302 Which of the following methods Yes No
do you know about? 1. Pill 1 2
2. IUCD 1 2
3. Inject able 1 2
4. Implant (Norplant) 1 2
5. Male Condom 1 2
6.Female condom 1 2
7.Female sterilization 1 2
8. Male sterilization 1 2
9. Emergency 1 2
contraceptive

53
 10. Natural method 1 2
11. Others (specify) 1 2
303 What is your source of Yes No
information about family 1. Health Institution 1 2
planning? 2. Health Extension 1 2
Workers
3. Radio 1 2
4. TV 1 2
5. Friends 1 2
6. News papers 1 2
7. Husband 1 2
8. School 1 2
9.Other, specify 1 2

304 Do you know the place where 1. Yes If no skip to 1

modern contraceptive methods 2. No 306 2
Could be obtained?
305 If you know where the methods 1. hospital 1
are obtained, where is the main 2. health center 2
place that you or others are able3. health post 3
to get modern contraceptive? 4. FGAE
5. pharmacy/drug 4
vendor 5
306 Which advantage of contraceptive 1. Avoid unwanted Yes No
methods do you know pregnancy 1 2

2. To space child 1 2
bearing
3. To limit family size 1 2
4. To prevent STI 1 2
5. Other specify 1 2

54
Part IV Practice of modern contraceptive

Question Answer Skip to Code

401 Have you ever used modern 1.Yes If NO 406 1
Contraceptive? 2 .No 2
402 If the answer to 401 is yes, 1.pill 1
what was the method you 2.Norplant 2
used? 3.Inject ables 3
4.IUCD 4
5.condom 5
6 .Female sterilization 6
7.Male sterilization 7
8.LAM 8
9.Natural method(rhythm ,with 9
drawal) 10
10.Others (specify
403 Are you currently using any 1.yes If No 406 1
contraceptive? 2.no 2
404 If the answer to ques 403 is 1.pill 1
yes, which method are you 2.Norplant 2
using? 3.Inject ables 3
4.IUCD 4
5.condom 5
6 .Female sterilization 6
7.Male sterilization 7
8.LAM 8
9.Natural method(rhythm ,with 9
drawal) 10
10.Others (specify
405 If the answer to question to 1.Spacing 1
403 is yes, for what purpose 2.Limiting 2
are you using the methods?
406 what is the main reason that Yes No
you are not using 1.Fear of side effect 1 2
contraceptive 2.Medical problem 1 2
Method? 3.preferred method is not 1 2
available
4.Desire to have more children 1 2
5.Little risk of pregnancy 1 2
6.using natural method 1 2
7.Unacceptable in my culture 1 2
8.Religion prohibition 1 2
9.Others (specify)

55
 Question Answer Skip to Code
407 Would you say that 1.Mainly respondent’s 1
using contraception is 2.Mainly husband’s 2
mainly your decision or 3.Joint decision 3
you husband’s decision 4.Other 4
or did you both decide
together?

Part V Attitude towards modern contraceptive use

Question Answer Skip to Code

501 Would you like to know 1.Yes 1
more about contraceptive 2.No 2
methods?
502 Do you approve using a 1. Yes 1
method of family planning? 2. No 2

503 If the answer to question № Yes No

5o2 is to disapprove, Why? 1.Religion prohibition 1 2
2.Fear of side effect 1 2
3.Medical problem 1 2
4.Desire for more children 1 2
5.Believe it is immoral 1 2
6.Others, specify 1 2
504 Have you discussed about 1.Yes If no go to 506 1
contraception with your 2.No 2
husband within the last six 3
Months?
505 If the answer to question 1.Once 1
504 is yes, how many times 2.Twice 2
have you discussed? 3.Three times 3
4.Greater than 3 times 4
5.Don’t remember exact no 5

506 What is your husband’s 1.Approve 1

attitude towards 2.Disapprove 2
contraceptive methods? 3.Do not know 3
507 Does your husband know 1.Yes he does know 1
whether you are Using or 2.No he doesn’t know 2
not using any 3.I am not sure 3
contraceptive?

56
Annex III

Agabka Xog Ururinta

Su’aalaha daraasaadka Macadka jaamacada caafimaadka bulshada ee goonder ee lagusoo

saarayo xadiga baahida aan ladarsin ee ay qaar kamid ah haweenka haatan guusaday oo
ah da’da caruur dhasha (15 – 49) ee kunool Jigjiga deeganka Soomaalida u qabaan
qorsheynta qoyiska.

Foomka Li’isku Waafaqay

Hordhac.

Aniga oo Magacgu yahay --------------------------------- waxaan kamid ahay tiimka sigaar ah ugu
hawlan dhamaystirka daraasaadka looga baahan yahay Masterka caafimaadka bulshada
ee jaamacada Gonder.

Waxaan xog wareeysanaynaa dumarka haatan guusaday oo ah da’da caruur dhasha si aan
u ogaano xadiga ay dhan tahay baahida dhabta ah ee loo qabo qorshenta qoyiska. Waxaan
kuweydiin dhawr su’aalood oo aan kugu adkaan doonin inaad kajawaabtid. Magacaaga
foomkan laguma qori doono, sidoo kale marnaba lalama xidhiidhin doono warbixinta aad
iisheegtid. Su’aalaha aadan rabin kuma qasbanid in aad ka jawaabtid, xogwaraysigana
xiligaad rabtid ayaad soo afjari kartaa. Hasa yeeshee su’aalahan oo si daacadnimo ah uga
jawaatid waxay naga caawinaysaa in aan ogaano xadiga baahida loo qabo qorshanta
qoyiska si mustaqbalka kor loogu soo qaado adeegyada qorshanta qoyiska oo la daboolo
baahida bulshada.

Waxaan kaaga mahan naqaynaa taageerada aad naga siisid jawaabaha su’aalahan
daraasaadka. Wareysiga aan kula yeelanaynaa wuxuu qaadan karaa 30 daqiiqo, markaa
managala qeyb qaadan kartaa? ( Sax jawaabta ku haboon) ?

Haa………………, Maya……………………..

Saxeexa xog wareystaha cadeeyey in warbixinta laga helay ……………………… oo ah

qofka la waraystay

Taariikh……………………

Magaca xog wareystaha…………………………….

Natiijada 1aad waraysigii oo ladhameys tiray, Natiijada 2aad qofkii lawaraysan lahaa oo
lawaayay, Natiijada 3aad qofkii oo waraysiga iska diiday.

01. Koodhka waraystaha…………………./Magaca………………….

02. Tirsiga Guriga
03. Taariikhda warasiga oo ah midda Etoobiya ………./………./……….waqtiga
04. Waxaa hubiyay Kormeeraha
Saxeexa………………….malinta……………bisha…….sanadka

57
Qeybta Iaad Xogta Qofka u Gaarka Ah Iyo Dhaqaalaha Bulshada

Tiro Su’aal Jawaabta La doortay Uga Koo

gudub dhka
Su’aasha
101 Da’adaada -------------sanad guud ahaan
102 Waa maxay diinta aad 1. Mulim 1
haysatid ? 2. Orthodox 2
3. Protestant 3
4. Kotalik 4
5. Qaar kale (Qeex) 5
103 Waa maxay qoomiyada 1. Soomaali 1
aad u dhalatay? 2. Axmaaro 2
3. Oromo 3
4. Guragee 4
5. Qaarkale (Qeex) 5
104 Waa maxay Xadiga 1. Wax aan qori Karin akhrina 1
waxbarashadaada ama Karin (jaahil)
aqoontaada? 2. Wax qori Kara akhrina Kara 2
3. Dugsi hoose (1- 6) 3
4. Dugsi dhaxe (7 – 10) 4
5. Dugsi sare (11 – 12) 5
6. Aqoon kale oo kasareysa 6
105 Heerka aqoonta 1. Wax aan qori Karin akhrina 1
/waxbarashada ninka ku Karin (jaahil)
qaba ( iayga) waa 2. Wax qori Kara akhrina Kara 2
mahay/ 3. Dugsi hoose (1- 6) 3
4. Dugsi dhaxe (7 – 10) 4
5. Dugsi sare (11 – 12) 5
6. Aqoon kale oo kasareysa 6
106 Maxaad waqtigan 1. Guri joog 1
xaadirka ah 2. Baayac-mushtar 2
kashaqeysaa? 3. Xoogsato 3
4. Jaariyad guri 4
5. Shaqaale dawladeed 5
6. Beeraley 6
7. Qaarkale (Qeex) 7
107 Dakhliga bishii kusoo
gala waa intee? 1. -------------birr
2. Xaqiiqdii magaran karo 1
3. Marabou inaan sheegayo 99
108 Haddi aad dakhliga 1. Aad uga hooseeya 1
barbar dhigtid midka 2. Ka yara hooseeya 2
jaarkaaga maxaad ku 3. Dhaxdhaxaad ah 3
qiimeyn lahayd? 4. Iska fiican 4
5. Maal qabeen ah 5

58
109 Gurigaaga miyaad ku 1. Waxaan haystaa reediyoo 1
haysataa TV, Rediyo kaliya
shaqeynaya? 2. Waxaan haystaa TV kaliya 2
3. Waxaan haystaa labadaba 3
reediyoo iyo TV 4
4. Midnaba mahayst
Qeybta IIaad Xogta Qofka u Gaarka Ah Iyo Dhaqaalaha Bulshada

Tir Su’aal Jawaabta La doortay Uga Koo

o gudub dhka
Su’aasha
201 Da’adaada markii ugu
horeysay ee aad 1. Da’adeydu markay ahayd------
guursatay? --
2. Ma xasuusan karo
202 Waligaa uur ma yeelatay? 1. Haa 1
2. Maya 2
203 Imisa jeer ayaad uur Qor tirada……….
yeelatay?
204 Imisa jir ayaad ahayd uurii ………. jir
kuugu horeeyay?
205 Imisa caruur ah ayaad Qor tirada…………….
leedahay?
206 Imisa jir ayaad ahayd Qor tirada…………….
markii aad ilmiha kuugu
horeeyad aad dhashid?
207 Imisa caruura ayaad Qor tirada…………….
jeceshay in aad dhashid
inta aad nooshahay?
208 Hadda ma uurbaad 1. Haa 1
leedahay? 2. Maya 2
209 Haddi ay jawaatu tahay 1. Waa Mid kutala gal ah 1
haa? 2. Waa mid waqtigii loogu tala 2
galay ahayn 3
3. Mid aan kutalagal ahayn 4
4. Jawaab looma hayo

59
Tir Su’aal Jawaabta La doortay Uga Koo
o gudub dhka
Su’aasha
210 Haddii uusan uurkaagu 1. Aqoon daro kahaysata 1
ahayn mid kutala gal ah isticmaalka qalabka iska
waa maxay sababta aad ilaalinta uurka 2
isaga ilaalin weyday?
2. Helitaanka qalabka oo aad u
liita awgeed
3
3. Odayga ama wehelka oo aan
ogolayn 4

4. Daawada ama qalabaka oo 5

shaqeyn waayay

5. Aragtida aan ka qabo halista 6

uurka oo aad u yar

6. Diinta oo aan ogalayn

isticmaalka wax yaaba 7
qaarkood ee la iskaga ilaaliyo
uurka

7. Dhaqanka oo aan ogalayn 8

isticmaalka wax yaaba
qaarkood ee la iskaga ilaaliyo
uurka
8 Qeex sababa kale
211 Hadda wixii kadanbeeya 1. Haa inaan ilma kale dhlaan 1
makuraja weyn tahay in rabaa 2
aad ilma kale dhashid 2. Maya inaan joojiyaan rabaa 3
mise waxaad rabtaa in 3. Wali ma’aanan go’aansan
aad joojisid dhalmada?
212 Mustaqbalka ma ku raja 1. Haa 1
weyntahay in aad 2. Maya 2
isticmaashid qaabka kala 3. Wali mago’aansan 3
fogenta dhalmada?

60
213 Mikee ayaad jeceshahay Haa M
in aad isticmaashid? ay
1. Kiniinka laliqo a
1 2
2. 2.Qalabka ladhexdhigo 1 2
makaanka
3. 3.Daawada irbada 1 2
4. 4.Midka garabka la dhex 1 2
dhigo

5. Koondham 1 2
6. Makaanka oo la gunto 1 2

7. Ninka oo xididka biyaha 1 2

gudbiya oo la gunto
8. Ninka oo qaata daawo wiiqda 1 2
taranka (Kareem)
9. Mid dabiici ah 1 2
10. Qeex qaar kale 1 2

214 Haddii aadan rabin in aad Haa M

mustaqbalka isticmaashid 1. Aqoon igu filan oo aanan u ay
daawada ama qalabka lahayn awgeed a
dhalmada la isga ilaaliyo 1 2
waa wamaxay sababtu?
1 2
2. Maadama aan kacabsanayo
in uu cilad ii keesado
3. Maadaama aan kabaqayo in 1 2
uu madhasley iga dhigo
4. Dhaqanka oo aan ii fasaxayn 1 2
awgeed
5. Maadama xanuun aan qabaa 1 2
ii ogolaanayn
6. Maadama qaabka aan rabo 1 2
aanan heleyn
7. Maadam aan rabo in aan 1 2
caruur badan yeesho
8. Ninkeyga ama qaraabada oo 1 2
aan ii ogalayn awgeed
9. Diinta oo aan ii fasaxayn 1 2
10. Khatarta ay leedahay uurku 1 2
oo aanan fahasaneyn
11. Qeex qaar kale 1 2

61
215 Haddiii aadan uur lahayn 1. Haa waan rabaa 1
ma rabtaa in aad ilma kale 2. Caruur kale marabou 2
dhashid? 3. Mago’aansan 3
216 Haddii aad rabtid in aad 1. < 2 sano 1
midkale dhashid mudo 2. > 2 sano 2
intee le’eg aayaad u 3. Maan go’aasan 3
dhaxaysiin kahor ilmaha?

Qeybta IIIaad Aqoon kusaabsan Daawada iyo Qalabka Kala Fogeynta

Dhalmada

Tiro Su’aal Jawaabta La doortay Uga gudub Koodhka

Su’aasha
301 Waligaa mamaqashay 1. Haa Haday 1
daawada iyo qalabka raga 2. Maya jawaatu 2
tahay maya u
ama dumarku u gudub
isticmaalaan qorshaynta su’aasha 401
qoyiska ee kahortaga uur
qaadista?
302 Kuwan soo socda kuwee Ha May
ayaad ka taqaan? 1. Kiniinka laliqo a a
1 2
2. Qalabka ladhexdhigo 1 2
makaanka
3. Daawada irbada 1 2
4. Midka garabka la 1 2
dhex dhigo
5. Koondham 1 2
6. Makaanka oo la gunto 1 2
7. Ninka oo xididka 1 2
biyaha gudbiya oo la
gunto
8. Ninka oo qaata daawo 1 2
wiiqda taranka
(Kareem)
9. Midka dag daga ah 1 2
10. Mid dabiici ah 1 2
11. Qeex qaar kale 1 2

62
303 Xagee ayaad ka heshaa Ha May
macluumaadka kusaabsan a a
qorshaynta qoyiska? 1. Macadka 1 2
caafimaadka
2. Shaqaalaha fidinta 1 2
caafimaadka
3. Raadiyaha 1 2
4. Tiiviiga 1 2
5. Saaxiibaday 1 2
6. Wargeysyada 1 2
7. Ninkeyga 1 2
8. Schoolka 1 2
9. Qaar kale 1 2
304 Mataqaana goobta laga 1. Haa Haday 1
qaato daawada ama jawaatu
qalabka dhalmada lagu 2. Maya tahay maya 2
kala fogeeyo? u gudub
su’aasha
306
305 Hadhi aad ogtahay a. Haa May
meelaha adeega habka 2. Isbitaalka a
laga helo waa halka goobta 1 2
aad iskaaga ama dadka 3. Xarun caafiimaad 1 2
kale fursad uyeelan karan 4. Dukaanka 1 2
adeega casriga la xidhida
ka hortagida uur qaadidda 5. Xafiiska hogaaminta 1 2
qoyska (FGAE)
6. Farmasiga 1 2
306 Maxaad kataqaanaa Haa May
muhiimada ayleeyihiin a
waxyaabaha loo isticmaalo 1. In lagaga hortago 1 2
kalafogeynta dhalmada ? uurka aan loo
baahnayn
2. Kala fogeynta 1 2
dhalmad
3. Yaraynta dhalmada 1 2
4. Kahortaga cudurada 1 2
lagu kala qaado
galmada
5. Waxaaba kale 1 2

63
Qeybta IVaad Isticmaalka Daawada iyo Qalabka Kala Fogeynta Dhalmada

Tiro Su’aal Jawaabta La doortay Uga Kood

gudub hka
Su’aasha
401 Waligaa ma isticmaashay 1. Haa Haday 1
daawada ama qalabka 2. Maya jawaatu 2
tahay maya
casriga ah ee kala u gudub
3
fogeynta dhalmada? su’aasha 4
407

402 Haday jawaata su’aasha 1. Kiniinka laliqo 1

401 tahay haa kuwee 2. Qalabka ladhexdhigo 2
ayaad isticmaashay? makaanka 3
3. Daawada irbada 4
4. Midka garabka la dhex 5
dhigo 6
5. Koondham 7
6. Makaanka oo la gunto 8
7. Ninka oo xididka biyaha 9
gudbiya oo la gunto
8. Ninka oo qaata daawo 10
wiiqda taranka (Kareem)
9. Mid dabiici ah
10. Qeex qaar kale
403 Waqtigan xadirkah (1) haa 1
maisticmaasha hab kale (2) maya 2
404 Hadhi jawaabtada la 1. Kiinina uur qaadidda lagu 1
xidhido suaasha 403 xakameyo 2
tahay “ Haa” nooca 2. Daawada gacanta korkeeda 3
habka aad isticmaasha lagu dhax geliyo 4
waa uwe 3. Iirbad 5
4. Daawada makaanka
dhaxdisa la geliyo 6
5. Koondomka 7
6. Habka makaanka lagu xirto 8
7. Habka raga ma dhalays 9
laga dhigo 10
8. LAM
9. Hab dabiici ah
10. Iyo kuwo kale

64
405 Haday jawaata su’aasha 1. Kala fageynta dhalmada 1
403 tahay haa kuwee
ayaad u isticmaashay? 2. Xadidida dhamada 2

3. Magaranayo 3
406 Waa maxay sababta 1. Maadama aan kacabsanayo Ha Ma
aadan u isticmaalayn in uu cilad ii keesado a ya
daawada ama qalabka 1 2
kala fogeynta dhalmada?
2. Maadaama aan kabaqayo in 1 2
uu madhasley iga dhigo
3. Dhaqanka oo aan ii 1 2
fasaxayn awgeed
4. Maadama xanuun aan 1 2
qabaa ii ogolaanayn
5. Maadam aan rabo in aan 1 2
caruur badan yeesho
6. Ninkeyga ama qaraabada 1 2
oo aan ii ogalayn awgeed
7. Diinta oo aan ii fasaxayn 1 2
8. Khatarta ay leedahay uurku 1 2
oo aanan fahasaneyn
9. Qeex qaar kale 1 2
407 Isticmaalka daawada ama 1. Waa go’aankeyga 1
qalabka dhalmada lagu kala 2. Waa go’aanka ninkeyga 2
fogeeyo ama lagu yareeyo 3. Waa go’aan labada yada 3
Maga’aan kaaga mise waa
go’aanka ninkaaga mise
waad mid labadiiniba aad
go’aansateen ?

65
Qeybta Vaad Fikirka ama Aragtida Laga Qabo Isticmaalka Daawada iyo
Qalabka Casriga ah ee Loo Isticmaalo Kala fogenta ama Xadidida Dhalmada

Tiro Su’aal Jawaabta La doortay Uga gudub Kood

Su’aasha hka
501 Marabtaa in aad ogaatid 1. Haa 1
waxbadan oo kusaabsan 2. Maya 2
Daawada iyo Qalabka ah
ee Loo Isticmaalo Kala
fogenta ama Xadidida
Dhalmada ?
502 Mataageersan tahay mise 1. Haa 1
waad kasoo hor jeedaa 2. Maya 2
isticmaalka qorshnta
qoyiska?
503 Haddii jawaabta su’aasha Haa May
502 tahay waan kasoo 1. Maadama aan kacabsanayo a
horjeedaa waa maxay in uu cilad ii keesado 1 2
sababtu 2. Maadaama aan kabaqayo in 1 2
uu madhasley iga dhigo
3. Maadama xanuun aan 1 2
qabaa ii ogolaanayn
4. Maadam aan rabo in aan 1 2
caruur badan yeesho
5. Diinta oo aan ii fasaxayn 1 2
6. Qeex qaar kale 1 2
504 Ninkaaga makala 1. Haa Haddii
tashatay isticmaalka 2. Maya jawaabtu
tahay maya u
daawada ama qalabka 3. Kamajawaabi karo gudub
lixdii bilood ee u su’aasha 506
danbeysay
505 Haddii jawabta su’aasha 1. Hal mar ah 1
504 tahay haa imisa jeer 2. Laba jeer 2
ayaad kala tashatay? 3. Saddex jeer 3
4. In kabadan saddex jeer 4
5. Maxasuusan karo 5
506 Waa maxay aragtida 1. Waa mid raali uu kayahay 1
ninkaagu kaqabo 2. Waa mid uu kasoo hor jeedo 2
xidhiidhka adiga iyo 3. Kama jawaabi karo 3
shaqaalaha fidinta
caafimaadka idin
kadhaxeeya?
507 Ninkaagu ma og yahay in 1. Haa wuu og yahay 1
aad isticmaashid 2. Maya ma oga 2
daawada ama qalabka? 3. Kama jawaabi karo 3

66
Annex-IV
Declaration

I, the undersigned, senior MPH student declare that this thesis is my original work in
partial fulfillment of the requirement for the degree of Master of Public Health.

Name: Beza Tamirat

Signature: ______________

Place of submission: Institute of public Health, College of Medicine and Health

Sciences, University of Gondar.

Date of Submission: ____________________________

This thesis work has been submitted for examination with my/ our approval as
university advisor(s).
Advisors

Name Signature

1. ________________________ __________________

2. ________________________ __________________

67
68