Prevalence and associated factors of unintended pregnancy in Nguenyyiel Refugee Camp, Southwestern Ethiopia

Abstract

Unintended pregnancy remains a significant driver of maternal morbidity and mortality, particularly in humanitarian settings where health systems and social structures are disrupted. In Ethiopia, while the national prevalence is 26%, there is a critical research gap regarding the unique reproductive challenges faced by displaced populations. This study assessed the prevalence and associated factors of unintended pregnancy in Nguenyyiel Refugee Camp, southwestern Ethiopia. A community-based cross-sectional study was conducted from January 8 to February 10, 2026, among 422 ever-pregnant women selected through proportional allocation and simple random sampling. Data were collected using interviewer-administered questionnaires via the Kobo Collect application. Bivariable and multivariable logistic regression analyses were employed to identify predictors of unintended pregnancy, with statistical significance set at P < 0.05. The overall prevalence of unintended pregnancy was 57.1% (95% CI: 52.2%, 61.9%), consisting of 43.4% mistimed and 13.7% unwanted pregnancies. Multivariable analysis revealed that maternal age ≥ 36 years (AOR = 0.14, 95% CI: 0.03, 0.67) and no history of previous unwanted pregnancy (AOR = 0.04, 95% CI: 0.02, 0.08) were significantly inversely associated with unintended pregnancy. Conversely, grand multigravida women were 7.23 times more likely to report an unintended pregnancy compared to primigravida women (AOR = 7.23, 95% CI: 1.66, 31.45). The prevalence of unintended pregnancy in Nguenyyiel Refugee Camp is substantially higher than national and regional estimates. These findings suggest a significant gap in reproductive health autonomy and underscore the need for targeted interventions, including youth-friendly services and expanded access to long-acting reversible contraceptives (LARCs) for grand multigravida women in humanitarian settings.