Multilevel analysis of grand multiparity: Trend and its determinants in the Sidama National Regional State of Ethiopia: a cross-sectional study design from demographic and health survey 2000-2016

Objective The study was aimed at examining the magnitude, trends and determinants of grand multiparity in the Sidama regional state of Ethiopia. Design We retrieved cross-sectional data from the Ethiopia Demographic and Health Survey from 2000 to 2016. Setting Community-based demographic and health survey (DHS) was conducted in Ethiopia. Participants The study population was women (aged 15-49 years) who had delivered children with the available DHS data set. Outcomes Multilevel multivariate logistic regression analyses assessed the relationship between grand multiparity and its determinants. Results The magnitude of grand multiparity was 70.8% (95% CI 68.5% to 72.9%). The multilevel multivariable logistic regression model showed illiteracy (adjusted OR (AOR)=2; 95% CI 1.25 to 3.75), non-use of any contraceptive (AOR=3.8; 95% CI 1.2 to 12.2), early marriage (AOR=4.5; 95% CI 2.6 to 7.9), polygamous marriage (AOR=4.2; 95% CI 2.0 to 9.3), short birth intervals (AOR=2.3; 95% CI 1.4 to 3.5) and husband's low education status (AOR=5.8; 95% CI 2.1 to 16.1) were significantly associated with grand multiparity. Conclusions This study revealed that 7 of 10 women were grand multipara, and the magnitude did not show significant change over the last 16 years. Early marriage and early age at first birth, low literacy level, low family planning utilisation, polygamy, short interbirth interval and unmet need for family planning were determinants of grand multiparity. We recommended the stakeholders to design new strategies to address the root cause of high fertility factors in communities.