Ris 3

METTU UNIVERSITY
FACALITY OF PUBLIC HEALTH AND MEDICAL SCIENCE
DEPARTMENT OF MIDWFERY
Assessment of the prevalence of unwanted pregnancy and associated factors among pregnant
women attending antenatal care at Mettu health center, in Mettu town, south west , Ethiopia.
A research proposal to be submitted to Mettu University, faculty of public health and

medical sciences, Department of midwifery in the partial fulfillment of the requirements
for the Bachelor of Science degree in Midwifery
By
ALAMIYA ABDO
Advisor: Lensa Gari (BSC Midwifery)
APRI 2017
Mettu town
Mettu University
Summary
Background
Reducing the number of unwanted pregnancy promotes reproductive health mainly by reducing
the number of times a women is exposed to the risk of pregnancy and child bearing unwanted
pregnancy is among the major public health problems that predispose women to maternal death
and illness mainly through unsafe abortion and poor maternity care. The level of unwanted
pregnancy is high in developing countries(1).Hence, the purpose of this study is to assess the
prevalence of unwanted pregnancy and the associated factors among pregnant woman attending
antenatal care at Mettu health center, in Mettu town, south west Ethiopia.
Objective
The objective of this research is to assess the prevalence of unwanted pregnancy and associated
factors among pregnant mothers attending antenatal care at Mettu health center in Mettu town
Illuababora zone in Ethiopia 2017.
Methods
A Cross sectional study design will be conducted among pregnant mothers visiting antenatal
care follow up from April 2017, to May 2017 at health center. The study participants will be
selected using convenient sampling method, and the data will be collected using pre tested
structured questionnaire by two trained data collectors who will be selected from ANC clinic
midwifery staffs. Then, the data will be analyzed using tally sheet and /or SPSS software. For the
existence of association, chi square test will be used.
WORK PLAN
The overall research activity will be conducted from October 2016 to june 2017.
Budget
The total budget need for completion of the research is 3956 Ethiopian birr will be used.
Key words: unwanted pregnancy,
i
Acknowledgement
First and for most I would like to express my deepest gratitude and respect to my advisor Miss.
LENSA GARI for her necessary guidance and moral support in the process of preparing this
research proposal.
I would like to acknowledge Mettu University, faculty of Public Health and medical sciences for
giving me this opportunity in processing this research proposal.
ii
Table of Contents
Summary...........................................................................................................................................i
Acknowledgement...........................................................................................................................ii
Table of Contents...........................................................................................................................iii
List of Tables...................................................................................................................................v
Acronyms........................................................................................................................................vi
1. INTRODUCTION....................................................................................................................1
1.1. Background................................................................................................................................................ 1
1.2. Statement of the problem.................................................................................................................... 3
1.3. Significance of the study....................................................................................................................... 4
2. LITERATURE REVIEW.........................................................................................................5
3. OBJECTIVE.............................................................................................................................9
3.1. General objective..................................................................................................................................... 9
3.2. Specific objectives................................................................................................................................... 9
4. METHODS AND MATEERIALS.........................................................................................10
4.1. Study area and period.........................................................................................................................10
4.2. Study Design............................................................................................................................................ 10
4.3. Population................................................................................................................................................ 10
4.3.1. Source population....................................................................................................10
4.3.2. Study population......................................................................................................10
4.4. Selection criteria................................................................................................................................... 10
4.4.1 Inclusion criteria......................................................................................................10
4.4.2. Exclusion Criteria....................................................................................................10
4.5. Sample size and sampling techniques.........................................................................................11
4.5.1. Sample size..............................................................................................................11
4.5.2. Sampling technique.................................................................................................11
4.6. Data collection method and instrument.....................................................................................11
4.6.1. Data Collection Procedure.......................................................................................12
4.7. Study Variables...................................................................................................................................... 12
iii
4.7.1. Dependent Variables................................................................................................12
4.7.2. Independent Variables.............................................................................................12
4.8. Operational Definition........................................................................................................................ 12
4.9. Ethical Consideration.......................................................................................................................... 13
4.10. Quality Control measures..................................................................................................................13
4.11. Data processing and analysis...........................................................................................................13
4.12. Data presentation and dissemination of the result................................................................14
5. WORK PLAN........................................................................................................................15
6. Budget breakdown..................................................................................................................16
7. Dummy tables.........................................................................................................................18
References......................................................................................................................................22
Annexes.........................................................................................................................................25
Annex- I፡ English Version Questioners......................................................................................................25
Annex- I I: Amharic Version Questioners................................................................................................ 31
iv
List of Tables
Table 1: Work plan........................................................................................................................15
Table 2: Stationary and personal cost............................................................................................16
Table 3: Socio demographic characteristics of pregnant women attending ANC at Mettu health
center, Mettu town, central zone Oromia regional State, May 2017.............................................18
Table 4: Reproductive history of pregnant women among ANC attendants of Mettu health center,
Mettu town, central zone Oromia regional State, May 2017.........................................................19
Table 5: Awareness and source of information about modern FP methods among ANC attending
women at Mettu health center, Mettu town, central zone Oromia regional State, May 2017.......21
v
Acronyms
KDHS Kenya demographic health survey

ANC Antenatal Care
MEUFHS METTU University Faculty of Health Science
RH Reproductive Health
DHS Demographic health survey
WHO World Health Organization
FP Family planning
SPSS Statistical Package for the Social Sciences
vi
women attending antenatal care at mettu health center, in Mettu town, south west , Ethiopia
1. INTRODUCTION
1.1. Background
Unwanted pregnancy is a pregnancy that is either unplanned or unwanted at the time of

conception, and it is a significant public health concern in the world nowadays .unwanted
pregnancy is an important public health problem that predisposes women to maternal deaths and
illnesses mainly through unsafe abortion s and poor maternity care. It is associated with late
initiation and inadequate utilization of antenatal care services, maternal depression and anxiety
and smoking and drinking behaviors during pregnancy Even if family planning services are
available free of charge, unwanted pregnancy is still one of the remaining challenges in reducing
maternal mortality in Ethiopia (1, 3). For any of health care access and usage, reducing the
number of pregnancies will lower maternal death rate, unplanned pregnancy complicate maternal
health and it also affects children health through many ways because of most of these
pregnancies occur among women in high risk categories, including very young or old women
(2).
unwanted pregnancies are a pregnancy that is mistimed, unplanned or unwanted at the time of
conception . Mistimed pregnancies are defined as pregnancies that the women reports occurred
sooner than desired. In general pregnancies ending in abortion are defined as unintended ( 1,3).
unwanted pregnancies and unplanned births can have serious health, economic and social
consequences for women, their children and families (Gipson 2008). The millennium
development goals of reducing child mortality and improving maternal health (United Nations
2006) are to be achieved, the incidence of unintended pregnancy and its consequences must be
dramatically reduced. Period estimates of the incidence of unintended pregnancy can be used to
monitor progress toward that goal. Moreover, this information can be used to estimate the costs
and benefits of investing in family planning programs (Singh et al., 2009).
Estimates of the global incidence of unintended pregnancy and pregnancy outcomes have been
developed for 1995 and 2008. During that interval the proportion of pregnancies that were
unintended increased slightly, from 38% to 41%. However, the unintended pregnancy rate
declined from 69 per 1,000 women 15-44 in 1995 to 55 in 2008, a 20% drop that is reflective of
the worldwide trend towards increased use of contraception. More than half of all unintended
pregnancies ended in abortion in 1995 and slightly under half did so in 2008, indicative of the
strength of motivation behind preferences for increasingly smaller families, worldwide.
MEU, FPHMS, Department of Midwifery Page 1

Estimates of the incidence of abortion, a key component of unintended pregnancy, are available
for all regions and sub regions. New estimates for 2012 of the numbers, rates and distribution of
all pregnancies by their planning status and outcomes: planned births, induced abortion,
Literatures of various studies describe the concepts of unintended or unplanned pregnancy

in different ways. It refers to the sum of mistimed and unwanted pregnancies. A woman is
assumed to have a mistimed pregnancy, if she became pregnant at the time when she did
not want to. On the other hand, a woman is assumed to have an unwanted pregnancy if the
woman did not want to become pregnant at all, or in other words, the pregnancy
occurred when she wanted to have no more children (Central Statistical Agency of Nigeria,
2008) (4,9).
unwanted pregnancy is an important public health issue in developed and developing countries
because of its negative association with the social and health outcomes for both mothers and
children .of the estimated 210 million pregnancies that occur throughout the world. Each year
about 38% are unplanned. Out of which 22% end in abortion (5).
An estimated 80 million unwanted pregnancies occur each year worldwide, resulting in 42

million induced abortions. Twenty millions of these induced abortion performed in unsafe
circumstances or by un-trained providers and 34 million unintended births. These Unintended
pregnancies have grave consequences for the health and well-being of women and their families,
particularly in low and middle income countries where maternal mortality is high and abortions
often unsafe (6,11).
The 2008–09 KDHS showed that 43% (26% mistimed and 17% unwanted) of married women in
Kenya reported their current pregnancies as unintended (7). Unintended pregnancy is one of the
most critical factors contributing to schoolgirl drop out in Kenya. Up to 13,000 Kenyan girls
drop out of school every year as a result of unintended pregnancy (8). In addition, unsafe
pregnancy termination contributes immensely to maternal mortality which currently estimated at
488 deaths per 100 000 live births (7). .
Unlike other developing countries, Ethiopia is facing a population crisis. This is more evident
when we look at the estimation on the annual population growth rate of 3.3 %, similarly, the total
fertility rate for each women is an average of 6.6, more over it was also estimated that 48.5% of
the total population of Ethiopia were children age 0-14 years from total population (8).

1.2. Statement of the problem
Unwanted pregnancies and unplanned births can have serious health, economic, and social
consequences for Women and their families. One immediate outcome of some unwanted
pregnancies induced abortion is unsafe in many countries that have highly restrictive abortion
Laws. In these countries, abortion often damages women’s Health and sometimes results in their
death.
The United Nations Millennium Development Goals of reducing child mortality and improving
maternal Health (United Nations 2006) are to be achieved, the Incidence of unwanted pregnancy
and its consequences must be dramatically reduced. Information concerning unwanted pregnancy
levels can also point to gaps in access to and use of contraceptives. Moreover, this information
can be used to estimate the costs and benefits of investing in family planning programs (10).
unwanted pregnancy is one of the most critical factors contributing to schoolgirl drop out in
Kenya. Up to 13,000 Kenyan girls drop out of school every year because of unwanted
pregnancy. Unsafe pregnancy termination contributes immensely to maternal mortality which
currently estimated at 488 deaths per 100 000 live births (12).
In Ethiopia, the situation is not different from developing countries; women suffer from problem
of repeated pregnancy and child bearing. Maternal mortality rate from pregnancy and pregnancy
related condition was still as high as or more than 10/100 pregnancies, while 1-2/1000 in
developed countries (9). Therefore, the purpose of this study is to assess the prevalence of
unwanted pregnancies and the associated factors among pregnant mothers attending at health
institution ANC unit to provide because data for possible intervention.

1.3. Significance of the study
The study will help to give recent prevalence of nuwanted pregnancy in Mettu town for policy
makers and health planners to design strategy to improve reproductive health status of
reproductive age women.
The study result also serve as a base line data for further investigations on the same topic in
future.
The study also will help to identify the reasons of unwanted pregnancies and will be used to
make recommendations based on the study findings for possible solutions.
Additionally, the study result will help as a source of information to update the knowledge of
midwifery profession.

2. LITERATURE REVIEW
The global rate of unintended pregnancy was 55 per 1,000 women aged 15–44 in 2008, of which
26 per 1,000 ended in abortion(13). The rate of intended pregnancy was 79 per 1,000(13).The
estimated 208 million pregnancies in 2008 resulted in 102 million intended births, 41 million
induced abortions, 33 million unintended births, and 31 million miscarriages(13).
Globally, from 210 million pregnancies that occur each year, 38% were unplanned and out of
this unplanned pregnancy, 22% end with abortion. From this abortion, 40% of them were done
on women aged less than 25 years, and about 68 000 women die every year from complications
of unsafe abortion. From the total eighty - five million pregnancies occur globally, 40% of all
them were unintended in 2012. From these unintended pregnancies, 50%, 13% and 38% them
ended in abortion, miscarriage and unplanned birth respectively. An estimated 50 million
induced abortion were performed each year as result of unplanned pregnancies of which 95% of
them were in developing countries . In most developing countries, about 20% - 60% of married
women or about 120 million women that need to avoid pregnancy become pregnant(30).
The United States rate of unintended pregnancies is higher than the world average, and much
higher than that in other industrialized nations(15).Almost half (49%) of U.S. pregnancies are
unintended, more than 3 million unintended pregnancies per year(16,17).
A 2011 study by the Guttmacher Institute based on data from the Centers for Disease Control
and Prevention and other sources determined that the average U.S. rate of unintended
pregnancies was 51 per 1,000 women ages 15 to 44 in 2006. Most states' rates were between 40
and 65 unintended pregnancies per 1,000 women. The state with the highest rate of unintended
pregnancies was Mississippi, 69 per 1,000 women, followed by California, Delaware, the
District of Columbia, Hawaii and Nevada (66 to 67 per 1,000). New Hampshire had the lowest
rate, 36 per 1,000 women, followed by Maine, North Dakota, Vermont and West Virginia (37 to
39 per 1,000 women)(18,19).
Over 92% of abortions are the result of unintended pregnancy(15). unintended pregnancies result
in about 1.3 million abortions/year(15).In 2001, 44% of unintended pregnancies resulted in
births, and 42% resulted in induced abortion and the rest in miscarriage(16). It is estimated that
more than half of US women have had an unintended pregnancy by age 45 (22). The U.S. states
with the highest levels of abortions performed were Delaware, New York and New Jersey, with
rates of 40, 38 and 31 per 1,000 women, respectively. High rates were also seen in the states of
Maryland, California, Florida, Nevada and Connecticut (25 to 29 per 1,000 women). The state
with the lowest abortion rate was Wyoming, which had less than 1 per 1,000 women, followed
by Mississippi, Kentucky, South Dakota, Idaho and Missouri (5 to 6 abortions per 1,000
womenThe teenage birth rate in United States was 53 births per 1,000 women aged 15–19 in
2002, the highest in (22,23).

One of the negative consequences of unintended pregnancy in developing countries is abortion
that can result serious long-term negative health effects including infertility maternal death, and
other complications. Women living in every country irrespective of development status have
been facing the problem of unintended pregnancy . Unintended pregnancy is the most common
cause of maternal mortality in developing countries. In Africa, the very high rate of unintended
pregnancy in 1995 which was 92 per 1000 women declined only slightly by 2008, to 86 per
1,000 noted that unwanted, (31, 34).
Currently, 38% of pregnancies globally are either unwanted or unplanned (Kaye, 2006). Un -
wanted pregnancy poses a major and continuing social and health challenge in Africa,
accounting for more than a quarter of the 40 mil-lion pregnancies that occur annually in the
region. It is a key risk factor for adverse pregnancy and maternal out-comes, including mortality
and morbidity associated with unsafe induced abortions. The research described in this brief
focused on Nairobi city. Rapid urban growth under enormous economic constraints has led to
rural-urban migration. Poor urban settlement contexts set limits on the ability of women and men
to safeguard their sexual and reproductive health, control their fertility, and implement their
fertility aspirations. These settlements are characterized by extreme poverty and poor livelihood
conditions, limited access to family planning services, illiteracy, sexual violence, and lack of
access to quality health care. They present particularly interesting and fertile locations for
unwanted pregnancy and abortion(35).
The prevalence of unintended pregnancy Kenya continues to be high. The 2003 Kenya
Demographic and Health Survey (KDHS) showed that nearly 50% of unmarried women aged
15–19 and 45% of the married women reported their current pregnancies as mistimed or
unwanted (12).
Similarly, a survey conducted in Ethiopia showed that 30% of all pregnancies were unwanted
(20). This indicated an enormous unmet need for F/P will be about 800,000 “unwanted
pregnancies another study done in the Kechene community of Addis Ababa an desired number of
children and number of children obtained showed that 57% of the respondent already gave birth
to more than the number of children they need (2,20).
In Ethiopia, the few surveys conducted on issues related to unintended pregnancy

suggested that unintended pregnancy is among the main causes of maternal mortality
(Solomon and Mesganaw, 2006). Even if fertility declined steadily from 6.8 live births per
women in 1981 to 5.4 in 2005 and there is increase in contraceptive prevalence, many
women in Ethiopia are experiencing unintended pregnancy. For example, Ethiopian
Demographic and Health Survey of 2005 reported that 35% pregnancies among women in
reproductive age were unintended (CSA and ORC Macro, 2006). As a result, significant
proportion of married women turned to induced abortion to avoid unintended pregnancy.
According to Ministry of Health 2006 report, approximately half a million pregnancies

annually end in induced abortion among 3.7 million pregnancies, which is a reflection of
the high rate of unintended pregnancy (33).
According to in 2008 study in Ethiopia by Hailemicheal G/Selassie Ahmed Abdel an estimated

382,000 induced abortion were performed and 52,600 women were treated for complication of
such abortion. There were an estimated 103,000 legal procedure in health facilities nationwide
27% of all abortions .nationally the annual abortion rate was 23 per 1000 women aged 15-44,
and the abortion ratio was 13 per 100 live births. The abortion rate in Addis Ababa (49 per 1000
women) was twice the national level. Over all about 42% of pregnancies unplanned and the
unplanned pregnancy rate was 101 per 1000 women (27)
According to in 2011study in Hosanna town southern part of Ethiopia by Belayneh Homedale,

Abebe G/Miriam and Tizta Tilahun out of the total pregnancies, 34% were unintended and 66%
were reported to be intended. A history of previous unintended pregnancy, the husband not
wanting to limit family size, a desire for at least two children, the number of pregnancy 3-4 and
parity of 5 and above were factors significantly associated with unintended pregnancy. With over
one third of pregnancies unintended, having a previous unintended pregnancy, the number of
previous pregnancies, and husbands' disagreement over family size, and the desired number of
children are factors that reproductive health programs should aim to focus on to reduce
unintended pregnancy (26).
In 2010 Johannes Dibaba study on child spacing and fertility planning behavior among women
in Manna District, Jimma zone south west Ethiopia showed that about 39% of women reported
that there recent pregnancy was unplanned. (OR=4.53, 95% CI, 3.05–6.75) and did not desire
any more children (OR=1.84, 95% CI, 1.23–2.76).Women with unintended pregnancy are more
likely to be illiterate (OR=1.85, 95%CI, 1.23–2.79), have four or more living children (OR=2.77,
95% CI, 1.77–4.33), had a previous birth interval of less than 24 months (OR=1.78, 95%
CI(1.19–2.69), have never used contraception (27).
In east Ethiopia, a study in Harar town showed that from a total of 983 females aged 15–49 years
who were interviewed, 225 (33.3%) reported that their most recent pregnancies were
unintended .Less is known about the factors associated with women’s unwanted pregnancies in
Hossana town, southern Ethiopia. Thus, this study is aims to at determine the prevalence of
unintended pregnancy and associated factors among pregnant married women residing in
Hossana, southern Ethiopia (32).
Contraceptive methods comprise a set of procedures and techniques to prevent fertilization

at least temporarily. These include natural and modern methods. Natural methods do not use
external chemical or physical contribution to regulate natural fertility. They seek to reduce
the chance of becoming pregnant by planning sexual intercourse according to fertility periods
in the woman’s monthly cycle. Natural methods include ovulation calendar, method of
temperature and that of withdrawal at time of ejaculation . Modern contraceptive methods

use chemical or physical barriers for reducing the chance of becoming pregnant. They include
implant, injection, pills, spermicidal, condom, and intrauterine contraceptive device (34).
Unintended pregnancy mainly results from the lack of inconsistent or incorrect use of effective
contraceptive methods. The use of contraceptive various from person to person based on once
medical background. So the effectiveness is going to be different everyone, but being informed
about contraceptive can help prevent pregnancy. Unintended pregnancy may also be the result of
lack of knowledge by sexual active people. Pregnancy may also result from rape or various other
form of forced or unwanted sex(28).
There are many different ways in which to reduce the probability of unintended pregnancy.
People who engage in vaginal penetrative sexual activity may use contraception such as birth
control pills, condom, diaphragm, hormonal contraceptive, and spermicidal (29)
The risk factor for unplanned pregnancy is increase age, lower educational level, not benign
currently married, lack of knowledge, where access to contraceptive, increase the number of
sexual partners and younger reported age at sexual debut were associated with unplanned
pregnancy (26).

3. OBJECTIVE
3.1. General objective
To assess the prevalence of unwanted pregnancy and associated factors among pregnant women
attending ANC at Health center In Mettu town.
3.2. Specific objectives
 To assess the magnitude of unwanted pregnancy among ANC attendants at Health center
 To identify the associated factors of unwanted pregnancy among ANC attendants at

Health center

4. METHODS AND MATEERIALS

4.1. Study area and period
The study will be conducted at Health center in Mettu town. Mettu town is the capital city of
Illuababora zone and it is administratively classified in to three kebeles (01, 02, 03). The town is
located at a distance of 600 km from Addis Ababa to the southwest part of Ethiopia.
In this town there is one referral hospital, one health center, other private clinics, pharmacies and
nongovernmental organization. The study will be conducted at the Health center in Mettu town
central zone of Oromiya. The study will be conducted from April 2017, to May 2017.
4.2. Study Design
Across- sectional study design will be employed .
4.3. Population
4.3.1. Source population
The source population for this study will be all pregnant women attending ANC clinic at health
center at Mettu.
4.3.2. Study population
The study population will be all pregnant women who attend antenatal care during the study
period (, April to may).2017
4.4. Selection criteria
4.4.1 Inclusion criteria
All pregnant women whom will visit ANC during the study period.
4.4.2. Exclusion Criteria
Unable to communicate:- women who are seriously ill at the time of data collection
or women who are not hear or speak and mentally disabled was excluded.

4.5. Sample size and sampling techniques
4.5.1. Sample size
Sample size will be calculated using population formula based on the following assumption.
The prevalence rates of unplanned pregnancy were 39% from previous study in Jimma zonal
hospital zone Ethiopia.
2
( Z α /2 ) p ( 1− p )
n= 2
d
Where n= Sample size /the desired sample size)
Zα/2 Standard (1.96)
p = Prevalence=39%=0.39
d= margin of error = 5% = 0.05
( 1.96 )2 0.39 ( 1−0.39 )

Therefore n= 2
=366
( 0.05 )
n= 420+10% of the sample size for substitution of non-respondent client =403
Therefore, the estimated number of pregnancy attending ANC at health institution will be 403
4.5.2. Sampling technique
The sampling technique will be convenient sampling technique. The study subjects will be taken
until the desired sample size will be obtained from those who present themselves from the
service at the study area within the study period. i.e. from April to may 2017.
4.6. Data collection method and instrument
The data will be collected using pre-tested structured questionnaire by three trained data
collectors who will be selected from ANC clinic staffs. The data will be collected by face-to-face

interview from the respondents by using questionnaire. The questionnaire will be constructed
based on the variables to achieve the objectives of the study. It will be prepared in English.
4.6.1. Data Collection Procedure
I will train ANC staff. The training will be given for data collectors on how to collecting data,
handling data & over all sequence of data collection. Then, those trained staffs will collect the
data and I will supervise them on how to collecting the data and the principal investigator will
check all data.
4.7. Study Variables
4.7.1. Dependent Variables
 unwanted pregnancy
4.7.2. Independent Variables
 Age
 Marital status
 Educational level
 Occupation
 Ethnicity
 Monthly income
 Parity
 Use of FP
 Knowledge of FP
 Reason of pregnancy
4.8. Operational Definition
Pregnancy: - is the time between conception and child birth when women are charring the
unborn child in the womb.

Contraceptive: - the method or medication which prevent conception
Abortion: - is the situation when an unborn fetus leaves the womb before 28 weeks of gestation.
. Unwanted pregnancies˸- are defined as pregnancies that the time of conception or at any time
in the future.
4.9. Ethical Consideration
Before the actual data collection letter of permission will be obtained from Mettu University,
department of Midwifery then submitted to Mettu Health center authorities. The objective of the
study will be explained to the study participants. Privacy and confidentiality of the study
participants will be maintained. Furthermore, the study participant involvement will be based on
their willingness.
4.10. Quality Control measures
The questionnaire will be pre-tested, data collectors will be trained and supervised and data will
be checked for completeness in yayo town. In order to determine the validity and reliability of
the data collecting instrument, pilot study will be conducted on 10% of sample of respondents
from other health center. The questionnaire will be reconstructed based on information obtain
from pre-test result.
4.11. Data processing and analysis
The collected data will be checked for its completeness, consistency and accuracy by principal
investigators. After the data will be checked for its completeness, the collected data will be first
cleared; tallied, analyzed using tally sheet and frequency count will be done by using spss or
scientific Calculator. Then the analyzed data will be changed into numerical value and
percentages, and chi square test will be used for a test of association.
4.12. Data presentation and dissemination of the result
Descriptive statistics will be employed to examine the finding, and the result will be presented by
using table, percentage, charts and graphs.After the completion of the study, the finding will be

disseminated to Mettu University student research office, school of Midwifery as partial
fulfillment of BSC degree in Midwifery and also governmental and nongovernmental
organization that potentially could benefit from this study.
5. WORK PLAN
Table 1: Work plan
Year of 2016-2017

No Action Responsible
May
Mar
Nov
Dec
Jun
Feb
Jan
Apr
Oct
Jul
person
1 Research title The Researcher
submission
2 Selected topic approval The Advisor
3 Proposal development The Researcher
4 Development of drafts The Researcher
and communication
with advisor
5 Completion of final The Researcher
draft and proposal
submission
6 Preparation of data The Researcher
collection tools
7 Cross check and test of The Supervisor
the tools
8 Data collection The Researcher
9 Data analysis The Researcher
10 Communication with The Researcher
advisor
11 Presentation of results The Researcher
12 Submitting the research The Researcher
13 Evaluation The Advisor
6. Budget breakdown
Table 2: Stationary and personal cost
S.N Item Unit Quantity Unit price Total
price
1. Paper Pack 3 105.00 315.00
2. CD rewritable Pieces 3 30.00 90.00
3. Ruler PCS 1 10.00 10.00
5. Pen PCS 10 5.00 50.00
6. Pencil PCS 5 1.00 5.00
7. Eraser PCS 5 7.00 35.00
8. Sharper PCS 4 5.00 20.00
9. Note book PCS 3 12.00 36.00
10. Proposal photocopy Page 30 1.00 30.00
11. Proposal binding Number 3 10 30.00
12. Internet service Minute 500 0.30 150.00
13. Final result paper Page 60 1.00 60.00

photocopy
14. Questioner Number 430 1.00 430.00
15. Final result paper Number 3 10 30.00

binding
Subtotal 1291
S.N Personnel budget Number of Number Unit per day Total

person of days expense
1. Training data collectors 3 1 100.00 300.00
2. Data collectors 3 5 100.00 300.00
3. Transport 200.00
4. Supervisor 1 5 75.00 1225.00
5. Secretarial work 1 8 80.00 640.00

Subtotal 2665
S.N Budget summary Sub-total
1. Stationery budget 1291
2. Personnel budget 2665
4. Grand total 3956

7. Dummy tables
Table 3: Socio demographic characteristics of pregnant women attending ANC at Mettu health
center, Mettu town, central zone Oromia regional State, May 2017
Variables Frequency Percentage (%)

Age of the respondent
1. 15-19 years
2. 20 -24 years
3. 25-29years
4. 30-34 years
5. 35-39 years
6. 40-44 years
7. 45-49 years
Total
Marital status
1. Single
2. Married
3. Divorce
4. Widowed
Total
Educational level
1. Illiterate
2. Read and write
3. 1-6th grade
4. 7-12th grade
5. 12th and above
Total
Ethnicity
1. Oromo
2. Amara
3. Tigre
4. Others
Total
Religion
1. Muslim
2. Orthodox
3. Protestant
4. Others
Total
Occupational status
1. House wife
2. Government employee
3. Merchant
4. Farmer

5. Daily laborer
6. Others
Total
Monthly income
1. <100 birr
2. 101 – 300 birr
3. 301-600 birr
4. 601 -1000 birr
5. >1000 birr
Total
Residence
1. Rural
2. Urban
Total
Decision makers
1. Herself
2. Her husband
3. Together
Total
Table 4: Reproductive history of pregnant women among ANC attendants of Mettu health
center, Mettu town, central zone Oromia regional State, May 2017

Before current pregnancy
1. Yes
2. No
Total
Number of pregnancy
1. 1-2
2. 3-4
3. 5-6
4. >6
Total
previous unplanned pregnancy

1. Yes
2. No
Total
Number of previous unplanned pregnancy
1. 1-2
2. 3-4
3. 5-6
4. >6

Total
Reason of having unplanned pregnancy
1. Lack of means to protect
2. Mistimed
3. Unwanted
4. Failure of contraceptive usage
5. Husband preference
6. Others
Total
Method failure
1. Pills
2. Injectable
3. Implant
4. Others
Total
Methods according to instruction
1. Yes
2. No
3. Not instructed
Total
Number of children
1. One
2. Two
3. Three
4. Four
5. Five
6. Six or more
Total
FP program to get desired number of children
1. Yes
2. No
Total

Table 5: Awareness and source of information about modern FP methods among ANC attending
women at Mettu health center, Mettu town, central zone Oromia regional State, May 2017

Ever heard FB
1. Yes
2. No
Total
Source of information
1. Health workers
2. Relatives
3. Mass media
4. Written materials
5. Others
Total
Ever practiced FB
1. Yes
2. No
Total
Type of FB practiced
1. Pills
2. Injectable
3. Implant
4. Condoms
5. IUCD
6. Natural methods
7. Others
Total
Reason for not using FB
1. Lack of information
2. Child preference
3. Religious view
4. Fear of side effect
5. Husband domination
6. Inaccessibility of the service
7. Others
Total

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Annexes
Annex- I፡ English Version Questioners
METTU UNIVERSITY
PUBLIC HEALTH AND MEDICAL SCIENCES
DEPARTMENT OF MIDWFERY
The general purpose of this study is to assess the magnitude of unplanned pregnancy and
associated factors among pregnant mothers and to provide base line data for responsible
authorities and for extensive study to develop appropriate strategy that meets clients need.
INSTRUTION:
1. The client name will not be important and keep the rights of respondent if they do not
want to respond and to terminate at any time during interview.
2. For multiple choice items put mark “ X “in the box wherever appropriate
3. For items schedule calling “yes” or “No” put a mark “√ “ in front of in item which
corresponds the participant response.
4. For open-ended question items, please write the dissect client response in space provided.
Part I: Socio-demographic characteristics of pregnant women attending ANC clinic
1. Age class
A. 15-19 years D. 30-34 years G.45-49 years
B. 20 -24 years E. 35-39 years
C. 25-29years F. 40-44 years

2. Marital status:
A. Single C. Divorce
B. Married D. Widowed
3. What is educational level?
A. Illiterate D. 7-12th grade
B. read and write E. 12th and above
C. 1-6th grade
4. Ethnicity
A. Oromo C .Tigre
B. Amara D. others (please, specify) ------------------------------------
5. Religion
A. Muslim C. protestant
B. Orthodox D. Others
6. Occupational status
A. House wife D. farmer
B. Government Employee E. Daily laborer

C. Merchant F. other (please specify) ------------------------------
7. Monthly income
A. <100 birr D. 601 -1000 birr
B. 101 – 300 birr E. >1000 birr
C. 301-600 birr
8. Where are you living (residence)?
A. Rural B. Urban
9. Who is the decision maker?
A. My self B. My husband C. Together
Part II: Specific information regarding family planning service
1. Have you ever heard information about family planning methods before?
Yes No
2. If your answer is “yes” for the above question, what was your source of information?
A. health workers
B. relatives
C. mass media
D. written materials
E. Others (please specify) ---------------------------------------------------------

3. Have you ever practiced any type of family planning methods?
Yes No
4. If your answer is ‘yes’ for the above question what type of family planning methods did
you practice?
A) Pills B) Injectable C) Implant

D) IUCD E) Condoms F) Natural methods
G) Others (specify) ---------
5. If you answer is ‘No’ for question number 3 what is your reason for not to use family
planning methods (more than one answer is possible)
A. lack of information
B. child preference
C. religious view
D. fear of side effect
E. husband domination
F. inaccessibility of the service
G. other (please specify) ------------------------------

Part III: Reproductive history of pregnant women
1. Have you pregnant before your current pregnancy?
A) Yes B) No
2. If your answer is ‘yes’ for the above question how many of pregnancy did you have?
A. 1-2 C. 5-6
B. 3-4 D. > 6
3. Do you have previous unplanned pregnancy?
A) Yes B) No
4. If your answer is “yes” for question number 3 how many unplanned pregnancy do you
have?
A. 1-2 C. 5-6
B. 3-4 D. >6
5. What is your reason of having unplanned pregnancy?
A. lack of means to protect
B. mistimed
C. unwanted
D. failure of contraceptive usage
E. husband preference
E. other (please specify) ------------------------------
6. If the pregnancy is due to method failure, what type of method?

A) Pills B) Injectable C) Implant
D) Others (specify) -------------------------

7. Have you take contraceptive methods according to instruction?
A) Yes B) No C) not instructed
8. How many children do you think sufficient for life time
A. One D. four
B. Two E. five
C. Three F. Six or more
9. Would you expect family planning program help you to get the number of children that
you want to get?
Yes No
Interviewer: --------------------------- signature: ----------
Supervisor: --------------------------- signature: ----------
Date: ---------------------------------
Thank you for your cooperation

Annex- I I: Amharic Version Questioners
መቱ ዩኒቨርስቲ
የማህበረሰብ ጤና እና የህክምና ሳይንስ ፋኩልት
የአዋላጅ ነርስ ት/ክፍል
የዚህ ጥናት ዋና ዓላማ የልተፈለገ እርግዝና መጠን እንድሁም የእርጉዝ እናቶች ተዘማጅ ዩሆኑ ምክኒያቶችን መዳሠስ፡፡
በተጨማርም ለባለድርሻ አካላት የጥናቱን ዉጤት ጭብጥ መሥጠት እና የተጠቃምዎችን ፍላጎት ባሟላ መልኩ ተገብ ዘዴ
ማሣደጊ፡፡
መመርየ፡
1. በቃለ መጠይቅ ጊዜ ሥም መፃፍ አይጠበቂቦትም፤ እንድሁም የተጠያቋ መልስ መስጠት የማይፈልጉባቸዉ

ጥየቄዎች ካሉ ቃለመጠይቁን በማነኛዉም ሠዐት ማቋረጥ ይችላሉ፡፡
2. ለ ምርጫ ጥያቄዎች ምርጫዎትን የ “ X “ ምልክት ሳጥን ዉሥጥ በማሥቀመጥ ያመልክቱ፡፡
3. ለ “አዎ“ ወይም “አይደለም“ ጥያቄዎች የ “√ “ ምልክት በመረጡት ፊለፍት ያስቀምጡ፡፡
4. ትንታኔ በሚፈልጉ ጥያቅዎች በተሰጠዉ ባዶ ቦታ ላይ የተጠያቋን ምላሽ ያሥፍሩ፡፡
ክፍል አንድ፡ ማህበራዊና ስነ ህዝባዊ መረጃዎች
1. የእድሜ እርከን
ሀ. ከ 15-19 ዓመት መ. ከ 30-34 ዓመት ሰ. ከ 45-49 ዓመት
ለ. ከ 20-24 ዓመት ሠ. ከ 35-39 ዓመት
ሐ. ከ 25-29 ዓመት ረ. ከ 40-44 ዓመት
2. የጋብቻዎ ሁኔታ፡
ሀ. ያላገባ ሐ. የፈታች
ለ. ያገባ መ. ባል የሞተባት
3. የትምህረት ደረጃዎት ምን ያህል ነው ?
ሀ. ያልተማረ መ. ከ 7-12 ኛ ክፍል
ለ. ማንበብና መፃፍ ሠ. 12 ኛ እና ከዛም በላይ

ሐ. ከ 1-6 ኛ ክፍል
4. ብሄረሰብዎ ምንድ ነው?
ሀ. ኦሮሞ ሐ. ትግሬ
ለ. አማረ መ. ልላ (ይጥቀሱ) ------------
5. ሃይማኖትዎ ምንድ ነው?
ሀ. ሙስሊም ሐ. ፕሮተስታንት
ለ. ክርስቲያን መ. ሌላ (ይጥቀሱ) ------------
6. የሥራ ሁኔታ (ድርሻ)፡
ሀ. የቤት ኢመቤት መ. አርሶ አደር
ለ. የመንግስት ሰራተኛ ሠ. የቀን ሰራተኛ
ሐ. ነጋዴ
7. በራስዎ የሚያገኙት ወራዊ ገቢ ሥንት ነው?

ሀ. <100 ብር መ. 601 -1000 ብር
ለ. 101 – 300 ብር ሠ. >1000 ብር
ሐ. 301-600 ብር
8. የሚኖሩት ቦታ የት ነው ?
ሀ. ገጠር ለ. ከተማ
9. ዉሣኔ ሰጪዉ ማነዉ?
ሀ. እራሴ ለ. ባሌ ሐ. ሁሌታችንም
ክፍል ሁለት ፡ ስለ ቤተሰብ ምጣኔ አገልጊሎት መረጃ
10. ከዚህ በፊት ስለ ቤተሰብ ምጣኔ ዘዴዎችን ሰምተው ያውቃሉን?

ሀ. አዎ ለ. አይደለም
11. ለጥያቄ ቁጥር 10 መልስዎ አዎ ከሆነ፣ የመረጃ ምንጮዎ ምንድ ነዉ (የቤተሰብ ምጣኔ መረጃዎችን
ከየት ያገኛሉ)?
ሀ. የጤና ባለ ሙያዎች
ለ. ዘመድ
ሐ. መገናኛ ብዙሃን
መ. ከተፃፉ ዶክመንቶች

ሠ. ሌላ (ይጥቀሱ)…………………
12. ከዚህ በፊት የቤተሰብ ምጣኔ (የወሊድ መቆጣጠርያ) ዘዴዎችን ተጠቅመው ያውቃሉን?
13. ለጥያቄ ቁጥር 12 መልስዎ አዎ ከሆነ፤የትኛዉ የቤተሰብ ምጣኔ (የወሊድ መቆጣጠርያ) ዘዴዎችን ነዉ
የተጠቀሙት?
ሀ. ፒልስ ሠ. ኮንዶም
ለ. መርፌ ረ. የተፈጥሮ ዘዴ
ሐ. በክንድ ውስጥ የሚቀበር ሰ. ሌላ (ይጥቀሱት)-------
መ. አዩሲዲ (ማህፀን ውስጥ የሚቀበር )
14. ለጥያቄ ቁጥር 12 መልስዎ አይደለም ከሆነ፤ የቤተሰብ ምጣኔ(የወሊድ መቆጣጠርያ) ዘዴዎችን
የማይጠቀሙበት ምክንያት ምንድ ነው ?
ሀ. ያለማወቅ(የመረጃ ዕጥረት )
ለ. ልጅ እንድኖረኘ ስለ ምፈሊጊ
ሐ. በሃይማኖቴ ስለማይፈቀድ
መ. የወሊድ መቆጣጠርያ የሚያስከትላቸውን አሉታዊ ተጽኖ በማፍራት
ሠ. ባለቤቴ ስለማይፈሊጊ
ረ. አገልጊሎቱ ሰለ ልል
ሰ. ሌላ (ይጥቀሱት)-------
ክፍል ሦስት፡ የተጠያቂዋ / የእርጉዝ እናቶች / ስነ ተዋሌዶ ታሪክ
15. ከዚህ እርግዝናዎ በፊት አርግዘው ያውቃሉ?

16. ለጥያቄ ቁጥር 15 መልስዎ አዎ ከሆነ፣ከአሁኑ እርግዝናዎ ጋር ስንት ጊዜ አርግዘው ያውቃሉ?
ሀ. 1-2 ሐ. 5-6
ለ. 3-4 መ. > 6
17. ከዚህ እርግዝናዎ በፊት ሳያቅዱ አርግዘው ያውቃሉ?
18. ለጥያቄ ቁጥር 17 መልስዎ አዎ ከሆነ፣ስንት ያልታቀደ እርግዝናዎች ኖሮት ያውቃሌ?
ሀ. 1-2 ሐ. 5-6
ለ. 3-4 መ. > 6

19. ሳያቅዱ ለተከሰቱት እርግዝናዎች ምክንያቶ ምንድነው ?
ሀ. የእርግዝና መከላኪያ አለመኖር
ለ. ያለጊዜ
ሐ. የልተፈለገ
መ. የእርግዝና መከሊከያዉ ተገቢዉን ያህል መቆጣጠር አለመቻል
ሠ. የባለቤቴ ፍላጎት
ረ. ሌላ (ይጥቀሱት)-------
20. እርግዝናዎ በእርግዝና መከሊከያ አለመሳካትከሆነ፤ የትኛውን የእርግዝና መከሊከያ ዘዴ ነዉ?
ሀ. ፒልስ ሐ. በክንድ ውስጥ የሚቀበር
ለ. መርፌ መ. ሌላ (ይጥቀሱት)-------
21. የገለጹት የወሊድ መከላከያ መንገድ የተጠቀሙት በትክክለኛና የአጠቃቀም መመሪያው በሚለው
መሰረት ነው?
ሀ. አዎ ሐ. መመሪያዉ / አጠቃቀሙ/ አልተነገረኝም
ለ. አይደለም
22. በህወት ዘመኖ ስንት ልጅ በቅ ነዉ ቢሎ ያሥባሉ?
ሀ. አንድ መ. አራት
ለ. ሁለት ሠ. አምስት
ሐ. ሦስት ረ. ስድስትና ከዛምበላይ
23. የቤተሰብ ምጣኔ ዘዴዎች የምፈሊጉትን የልጅ ቢዛት ኢንድየገኙ የጊዛሉ ብሎ ያስባሉ?
ቃለ መጠይቁን ያደረገችዉ ስም---------------------------------ፊርማ---------------ቀን----------

የተቆጣጣሪዉ ስም--------------------------------------------------ፊርማ---------------ቀን----------
ስለ ትብብርዎ እናመሰግናለን!!!!!!


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METTU UNIVERSITY

FACALITY OF PUBLIC HEALTH AND MEDICAL SCIENCE

A research proposal to be submitted to Mettu University, faculty of public health and

Advisor: Lensa Gari (BSC Midwifery)

Key words: unwanted pregnancy,

Table 2: Stationary and personal cost............................................................................................16

Mettu town, central zone Oromia regional State, May 2017.........................................................19

KDHS Kenya demographic health survey

Unwanted pregnancy is a pregnancy that is either unplanned or unwanted at the time of

MEU, FPHMS, Department of Midwifery Page 1

Literatures of various studies describe the concepts of unintended or unplanned pregnancy

An estimated 80 million unwanted pregnancies occur each year worldwide, resulting in 42

MEU, FPHMS, Department of Midwifery Page 2

1.2. Statement of the problem

MEU, FPHMS, Department of Midwifery Page 3

1.3. Significance of the study

MEU, FPHMS, Department of Midwifery Page 4

MEU, FPHMS, Department of Midwifery Page 5

In Ethiopia, the few surveys conducted on issues related to unintended pregnancy

MEU, FPHMS, Department of Midwifery Page 6

According to in 2008 study in Ethiopia by Hailemicheal G/Selassie Ahmed Abdel an estimated

According to in 2011study in Hosanna town southern part of Ethiopia by Belayneh Homedale,

Contraceptive methods comprise a set of procedures and techniques to prevent fertilization

MEU, FPHMS, Department of Midwifery Page 7

MEU, FPHMS, Department of Midwifery Page 8

3.2. Specific objectives

 To identify the associated factors of unwanted pregnancy among ANC attendants at

MEU, FPHMS, Department of Midwifery Page 9

4. METHODS AND MATEERIALS

4.2. Study Design

Across- sectional study design will be employed .

4.3.1. Source population

4.3.2. Study population

4.4. Selection criteria

4.4.1 Inclusion criteria

4.4.2. Exclusion Criteria

MEU, FPHMS, Department of Midwifery Page 10

4.5. Sample size and sampling techniques

4.5.1. Sample size

Where n= Sample size /the desired sample size)

Zα/2 Standard (1.96)

d= margin of error = 5% = 0.05

( 1.96 )2 0.39 ( 1−0.39 )

n= 420+10% of the sample size for substitution of non-respondent client =403

4.5.2. Sampling technique

4.6. Data collection method and instrument

MEU, FPHMS, Department of Midwifery Page 11

4.6.1. Data Collection Procedure

4.7. Study Variables

4.7.1. Dependent Variables

4.7.2. Independent Variables

4.8. Operational Definition

MEU, FPHMS, Department of Midwifery Page 12

4.9. Ethical Consideration

4.10. Quality Control measures

4.11. Data processing and analysis

4.12. Data presentation and dissemination of the result

MEU, FPHMS, Department of Midwifery Page 13

MEU, FPHMS, Department of Midwifery Page 14

1. Paper Pack 3 105.00 315.00

2. CD rewritable Pieces 3 30.00 90.00

3. Ruler PCS 1 10.00 10.00

5. Pen PCS 10 5.00 50.00