{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:57:19Z","timestamp":1781607439413,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":166,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contraceptive discontinuation while a need for pregnancy prevention persists, often termed \u201cin\u2010need\u201d discontinuation, remains a significant barrier to achieving reproductive health goals in Ethiopia. Traditional survival analyses often overestimate this risk by failing to account for competing events, such as discontinuation due to an intentional desire for pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study utilized nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 1617 contraceptive episodes among currently married women were analyzed. To identify predictors of \u201cin\u2010need\u201d discontinuation while strictly accounting for the competing risk of \u201cdesire for pregnancy,\u201d a Fine\u2013Gray subdistribution hazards model was employed as the primary inferential framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall 12\u2010month\u2013adjusted cumulative incidence of \u201cin\u2010need\u201d discontinuation was heterogeneous across sociodemographic strata. Women in the 35\u201349 age cohort exhibited a significantly higher subdistribution hazard (2.91%) compared with those aged 15\u201324 (1.58%; aSHR: 1.85; 95% CI: 1.26\u20132.71). Secondary education was protective, reducing the 12\u2010month incidence to 1.27% compared with 1.85% for those with no formal education (aSHR: 0.62; 95% CI: 0.40\u20130.96). Conversely, women engaged in manual labor faced an increased probability of discontinuation (1.97%) compared with professional workers (1.29%; aSHR: 1.56; 95% CI: 1.08\u20132.25). Notably, women with undecided fertility preferences showed the highest persistence, with a 12\u2010month probability of only 1.03% (aSHR: 0.55; 95% CI: 0.32\u20130.93). Religious affiliation remained a strong predictor, with Catholic users exhibiting a higher subdistribution hazard (aSHR: 4.65; 95% CI: 2.06\u201310.49).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\u201cIn\u2010need\u201d discontinuation in Ethiopia is driven by a complex interplay of age, educational attainment, and occupational physical demands. The finding that older and less\u2010educated women are at higher risk suggests that national family planning programs should move beyond adolescent\u2010focused strategies to include targeted clinical counseling for long\u2010term users. Furthermore, the economic impact of side effects on manual laborers necessitates more flexible, community\u2010based follow\u2010up care to ensure contraceptive security for Ethiopia\u2032s most economically vulnerable women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/bmri\/9045082","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:33:53Z","timestamp":1781606033000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Duration and Predictors of \u201cIn\u2010Need\u201d Contraceptive Discontinuation in Ethiopia: A Competing Risks Analysis Using the Fine\u2013Gray Subdistribution Hazards Model"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1362-937X","authenticated-orcid":false,"given":"Asfawosen Aregay","family":"Berhe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-7451","authenticated-orcid":false,"given":"Abraham Aregay","family":"Desta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desalegn","family":"Meresa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9957-3199","authenticated-orcid":false,"given":"Ataklti Gebretsadik","family":"Woldegebriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nega Mamo","family":"Bezabih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gebreslassie Alemseged","family":"Bezabih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayelom","family":"Kahsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samson Atsbeha","family":"Tafere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4749-4629","authenticated-orcid":false,"given":"Brhane","family":"Ayele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_2_16_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60478-4"},{"key":"e_1_2_16_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s42379-023-00130-7"},{"key":"e_1_2_16_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30033-5"},{"key":"e_1_2_16_4_2","volume-title":"Levels, Trends, and Reasons for Contraceptive Discontinuation [DHS Analytical Studies]","author":"Bradley S. 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