Time to uptake of long-term postpartum family planning and factors associated with it among Ethiopian mothers: A shared frailty survival analysis

Time to uptake of long-term postpartum family planning and factors associated with it among Ethiopian mothers: A shared frailty survival analysis. Time to uptake of long-term postpartum family planning and factors associated with it among Ethiopian mothers: A shared frailty survival analysis Article Open access Published: 29 October 2026 Cite this article You have full access to this open access article Download PDF View saved research Time to uptake of long-term postpartum family planning and factors associated with it among Ethiopian mothers: A shared frailty survival analysis Download PDF Abstract Long-term postpartum family planning (LTPPFP) involves the use of long-acting contraceptive methods within one year after childbirth. Delayed initiation increases the risk of unintended and closely spaced pregnancies, leading to adverse maternal and neonatal outcomes.

This study assessed the time to LTPPFP uptake and associated factors during the extended postpartum period among mothers in Ethiopia. A secondary analysis of data from the Performance Monitoring for Action (PMA) Ethiopia Cohort II, 2021 to 2023 was performed. A total of 2,167 postpartum mothers were included using a multistage stratified sampling technique.

Data management and analysis were conducted using Stata 17 and R. Multicollinearity was checked using the variance inflation factor, while the proportional hazards assumption was assessed using the global Schoenfeld residual test. Three shared frailty survival models (cluster-level, region-level, and nested frailty models) were fitted and compared.

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