Internet use, spatial variation and its determinants among reproductive age women in Ethiopia

Abstract

Background: The Internet is the preferred source of health information for retrieving relevant information. In Ethiopia, the Internet penetration rate is improving year to year, but it is still at a low level compared to the rest of the world and neighboring African countries. Due to a lack of adequate information, it is important to assess Internet use, spatial variation, and determinants of Internet use among reproductive-age group women in Ethiopia.

Method: Secondary data from EDHS 2016 were used to analyze 15,683 women aged 15-49 years. Spatial analysis was performed using ArcGIS 10.7. The Bernoulli model was used by applying Kuldorff's methods using SaTScan 10.1.2 software to analyze the purely spatial clusters of Internet use. A multilevel mixed-effect logistic regression was applied to estimate community variance to identify individual- and community-level factors associated with Internet use. All models were fitted in STATA version 17.0, and finally, the adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was reported.

Result: The magnitude of Internet use was 4.97% ± 95% CI (4.63-5.32). The overall average age of women was 24.21 ± 8.06 years, with the age range 15-24 years constituting the larger group (39.2%). Women with secondary and above education [AOR = 6.47; 95% CI (5.04, 8.31)], unmarried [AOR = 2.60; 95% CI (1.89, 3.56)], rich [AOR = 1.95; 95% CI (1.00, 3.80)], own a mobile phone [AOR = 3.74; 95% CI (2.75, 5.09)], media exposure [AOR = 2.63; 95% CI (2.03, 3.42)], and urban [AOR = 1.80; 95% CI (1.08, 3.01)] had higher odds of Internet use. The spatial variation in Internet use was found to be nonrandom (global Moran's I = 0.58, p value < 0.001). Fifty-seven primary clusters were identified that were located in Addis Ababa city with a relative likelihood of 10.24 and a log-likelihood ratio of 425.16.

Conclusions: Internet use among reproductive-age women in Ethiopia is 4.97 and has significant spatial variation across the country. Both community- and individual-level factors affect Internet use in Ethiopia. Therefore, educating women, improving access to media, encouraging women to use family planning, and supporting household wealth could improve women's Internet use.

Keywords: Ethiopia; Internet use; Spatial variation; Women.

Fig. 1

Study area map (Ethiopia) 2016. Shapefile source: CSA, 2013; URL: https://africaopendata.org/dataset/ethiopia-shapefiles

Fig. 2

Spatial variation in internet use across regions in Ethiopia, EDHS 2016

Fig. 3

Spatial autocorrelation of internet use among reproductive-age women in Ethiopia, 2016

Fig. 4

Hotspot analysis of internet use among reproductive-age women in Ethiopia, EDHS 2016

Fig. 5

Ordinary kriging interpolation of Internet use among reproductive-age women in Ethiopia, EDHS 2016

Fig. 6

Purely spatial analysis of Internet use among reproductive-age women in Ethiopia, EDHS 2016