Determinants of contraceptive use: from birth control to fertility awareness

Factors associated with modern contraceptive use among men in Pakistan: Evidence from Pakistan demographic and health survey 2017-18

Objective

The role of men in family planning is critical in patriarchal societies like Pakistan. The objective of this study is to explore the predictors of modern contraceptive use among Pakistani men.

Methods

This study is a secondary analysis of Pakistan demographic and health survey (PDHS) 2017–18 data. The study sample consists of 3691 ever married men aged 15–49 years. Pearson’s chi square test and logistic regression were used to find out the determinants of modern contraceptive use among men. Data analysis was carried out in December, 2020.

Results

Findings of logistic regression showed that men who were uneducated (aOR = 0.746; 95% CI = 0.568–0.980), residing in Sindh (aOR = 0.748; 95% CI = 0.568–0.985), Baluchistan (aOR = 0.421; 95% CI = 0.280–0.632) or FATA (aOR 0.313; 95% CI 0.176–0.556) and those who belonged to the poorest wealth quintile (aOR = 0.569; 95% CI = 0.382–0.846) were less likely to use modern contraceptives. Men who did not wish for another child (aOR = 2.821; 95% CI = 2.305–3.451) had a higher likelihood of modern contraceptive use. Finally, men who thought that contraception was women’s business (aOR = 0.670; 95% CI = 0.526–0.853) and those who did not discuss family planning with health worker (aOR = 0.715; 95% CI = 0.559–0.914) were also less likely to use modern contraceptives.

Conclusion

Reproductive health education of males, targeting males, in addition to, females for addressing family planning issues and improvement of family planning facilities in socioeconomically under-privileged regions are suggested to improve contraceptive use among couples.

Contraceptive counselling and factors affecting women's contraceptive choices: results of the CHOICE study in Austria

Empirical evidence of the impact of contraceptive counselling and factors affecting women's contraceptive choices are limited. CHOICE (Contraceptive Health Research Of Informed Choice Experience) was a large-scale study in 11 European countries. Women in Austria aged 15-40 years considering a short-acting, reversible form of combined hormonal contraceptive were eligible to participate. The choices included the combined daily pill, weekly transdermal patch, and monthly vaginal ring. This study assessed and compared 2478 women's original preferences with their post-counselling choices and evaluated their perceptions and criteria for their choice. Women who were 'undecided' decreased from 18.1% pre-counselling to 3.2% post-counselling; significantly more women post-counselling chose the monthly ring (8.7% to 23.8%; difference 15.1%, 95% CI 13.3-16.8%; P<0.0001) or the weekly patch (6.2% to 7.8%; difference 1.7%, 95% CI 0.5-2.9%; P=0.0014). Women's primary reasons for choosing a method included 'easy to use' (daily pill, weekly patch and monthly ring) and 'still effective if I experience vomiting, diarrhoea' (weekly patch and monthly ring). Structured and balanced counselling led to changes in the method chosen.

Profile of long-acting reversible contraception users in Europe

OBJECTIVES

To assess the profile of long-acting reversible contraceptives (LARCs) users in Europe.

METHODS

A random sample of women aged 15-49 years in 14 European countries (Germany, France, UK, Spain, Italy, Russian Federation, Estonia, Latvia, Lithuania, Austria, Czech Republic, Denmark, Norway, and Sweden) underwent web-based or computer-aided face-to-face interviews in June 2006. In this paper data pertaining to a subgroup of women using LARCs are presented.

RESULTS

A total of 11,490 women participated in the full study. Of these, 1,188 (10%) women were LARC (hormonal implant, injectables, levonorgestrel-releasing intrauterine system [LNG-IUS], copper intrauterine device [Cu-IUD]) users. The age of the LARC users exceeded 30 years for 57-91% of them. Furthermore, more than half of them found convenience an extremely important factor when selecting the LARC as a contraceptive method. As compared to those wearing a Cu-IUD, women using hormonal LARCs experienced fewer physical and emotional symptoms that appeared or worsened during menstruation.

CONCLUSIONS

LARCs have their place in the contraceptive market in Europe. The most popular LARCs among European women were the LNG-IUS and the Cu-IUD; both were mainly used by women who had children and had no wish to have more in the future.

Sexual intercourse and current contraceptive use among university students in Finland

OBJECTIVE

To ascertain the current frequency of sexual intercourse, the current use of contraceptives, the ever use of emergency contraception, and the ever experience of condom failure among Finnish university students.

STUDY DESIGN

The study population consisted of Finnish undergraduate university students (19-34 years of age) in 2004. The randomly selected sample comprised 5030 subjects. The data were collected by postal questionnaire, the response rate being 62.7%. Data were presented with frequency distributions and cross-tabulations. Chi-square test was used. Frequencies for women and men were presented and tested separately.

RESULTS

A total of 80% of students were currently practicing sexual intercourse. Approximately half of the female students currently used hormonal contraception and one-third used a condom. Almost half of the men currently used a condom. The simultaneous use of condom and hormonal contraception was rare. Condom failure was common. The ever use of emergency contraception appeared to be associated with condom failure.

CONCLUSION

Of Finnish university students 80% were sexually active and hormonal contraceptives were the most popular method of contraception among female students. The use of the condom should be practiced more often for prevention of sexually transmitted diseases.