Contraceptive decision making in a sample of Jordanian Muslim women: delineating salient beliefs

Regional Variations of Fertility Control Behavior among Rural Reproductive Women in Bangladesh: A Hierarchical Analysis

Women's fertility decision is quite difficult in male-dominant rural culture due to their poor reproductive autonomy. A cross-sectional survey was conducted in rural community of Bangladesh between November 2017 and February 2018 among 1285 respondents selected by multi-stage stratified sampling to explore regional variations of rural women's fertility control behavior and its determinants using hierarchical and other inferential statistics. Data collection was done by face-to-face interview using questionnaire. Average parity was 2.5 per woman and 41% respondents had three or more children. About 60% of them used modern contraceptives (MCs) and oral contraceptive pill (OCP) was their first choice. Male participation in contraceptive use was less than 5%. Regional variation, women's empowerment, fertility control knowledge, family planning (FP) attitude, social influence, perceived behavioral control (PBC) and fertility intention were significant predictors of fertility control behavior (p < 0.05). Significant regional variations were determined in fertility control behavior of rural women (p < 0.05). Almost all of its predictors explained by Theory of Planned Behavior (TPB) also showed significant regional variations (p < 0.05). Current fertility control policy should be strengthened more not only to improve fertility behavior of rural women but also to establish regional equity in fertility control by improving their reproductive decision-making in a rational way.

Indirect and direct perceived behavioral control and the role of intention in the context of birth control behavior

Unintended pregnancies can have negative consequences for both mother and child. The focus of this study was to utilize perceived behavioral control measures (PBC; part of the theory of planned behavior) to identify relevant behavioral determinants of birth control use. This study also tested associations between direct and indirect PBC measures and intention of birth control use and between intention and birth control use. The methods included a randomly selected sample of patients at a health care system in the Upper Midwest who were sent a self-administered survey, with 190 non-pregnant women returning completed surveys. Participants indicated a high level of control over using birth control, and a significant positive correlation was observed between direct and indirect PBC measures. Participants also reported high intentions to use birth control, and a significant positive correlation was observed between intention and PBC. Additionally, both PBC measures and intention were independently and significantly associated with behavior, and PBC remained significantly associated with behavior when intention was added into the model. In conclusion, compared to the previous literature, this study is unique in that it examines indirect PBC measures and also the important role that PBC plays with actual birth control behavior.

Barriers to breast cancer screening participation among Jordanian and Palestinian American women

PURPOSE

Increasing breast cancer screening (BCS) among diverse women from minority groups is a goal of health care providers and national organizations as a way to help in the early detection and treatment of breast cancer. The purpose of this article is to investigate barriers to BCS encountered by Jordanian and Palestinian women living in the United States (US).

METHODS

Descriptive content analysis of interviews of 107 Jordanian and Palestinian immigrant women provided data on BCS barriers that were thematically analyzed.

RESULTS

Data revealed 4 barriers that affect Jordanian and Palestinian immigrant women's participation in BCS: (1) culture-specific barriers such as embarrassment, family relationships, fatalism, and traditional healers consultation; (2) immigration-related barriers (citizenship issues and language); (3) general barriers (including nonparticipation in health screening, stigmatization of cancer, fear, and ignorance about BCS); and (4) irrelevant barriers.

CONCLUSIONS

Clinicians should be cognizant of the culture, beliefs and practices of Arab Middle Eastern immigrant women and the influence of these factors on their decision to participate in routine BCS. To increase participation in BCS and knowledge of breast cancer, appropriate language and culturally sensitive educational materials should be created and made available to Arab Middle Eastern immigrant women.

Empowerment in family planning as viewed by Iranian women: a qualitative study

Women carry the primary responsibility for family planning in most parts of the world, and should be afforded the power of decision-making and control over their fertility. This study seeks to gain insight into Iranian women's perception of the meaning of empowerment in family planning. Using a qualitative study, seven focus group discussions and five individual interviews were conducted with 35 married Iranian women of reproductive age. The data were analysed using a conventional content analysis approach, in which themes and categories were explored to reveal women's experiences of empowerment in family planning. The results demonstrated four main categories: control over fertility plan, participative family planning, maintaining health and access to optimal family planning services. They viewed knowledge of family planning and autonomy of decision-making in fertility issues as essential elements for control of their fertility plan. Participants felt more empowered when joint family planning decisions were made with their partners in an atmosphere of agreement. Therefore, family planning policymakers should plan services with new approaches that focus on women's health and empowerment.

Significant effects of Fatwa-based perception on contraceptive practice among Muslim women in south Jordan under the early stage of fertility transition

An interview survey of 450 Muslim women in a rural village of south Jordan under the early stage of fertility transition was conducted to explore major causes of contraceptive use, taking both their sociodemographic attributes and fatwa (Islamic jurisprudence)-based perception into account. Discriminant analysis, which was performed for the subject women divided into 15- to 29-, 30- to 39-, and 40- to 49-year age groups, revealed that "the number of living children" in the former and "to do contraception for good care of children" in the latter played significant roles in discrimination into contraceptive user and nonuser groups for any age groups. To cope with demographically and socioeconmically vulnerable situations, contraceptive prevalence rate should be increased by means of government-led family planning programs in cooperation with the imam (Muslim religious leaders and priests) through fatwa, in which special attention is paid to traditional norms, represented by good childcare.

Intimate partner violence and interference with women's efforts to avoid pregnancy in Jordan

This study examines the association between intimate partner violence (IPV) and women's experience of interference with their attempts to avoid pregnancy among 353 women surveyed at reproductive health clinics throughout Jordan. Approximately 20 percent of respondents indicated that their husbands or someone else had interfered. Among those others than husbands who were identified, mothers-in-law were the most frequently mentioned, followed by the respondents' mothers and sisters-in-law. Multivariate logistic regression was used to control for potential confounders in determining whether each of the three measures of intimate partner violence (physical violence, sexual violence, and controlling behaviors) was significantly associated with having an increased risk of experiencing interference, as were several sociodemographic variables: nonconsanguineous marriage, residence with in-laws, and rural residence. Physicians, nurses, and family planning counselors must be made aware of the challenges that women may face from their families when they attempt to regulate their fertility.

Jordanian women's experiences with the use of traditional family planning

The United Nations Population Fund (UNFPA) and the Hashemite Kingdom of Jordan Ministry of Health (MOH) have identified the importance of strengthening national capacity through the integration of reproductive health (RH) services into the primary health care system. It is reported that a high percentage of Jordanian women use traditional family planning (TFP) methods, frequently using them incorrectly. Our purpose in this qualitative descriptive study was to explore the issues and challenges related to the use of TFP among Jordanian women. Six focus groups with women of childbearing age (18-44 years of age; n = 51) were held in the northern, central, and southern regions of Jordan. Study participants used traditional methods such as withdrawal, periodic abstinence, and breastfeeding. Often TFP methods were used incorrectly, resulting in a high failure rate with unplanned pregnancies occurring within short inter pregnancy intervals. Women preferred using TFP because of side effects experienced while using modern family planning (MFP) methods, misconceptions, and lack of correct information about MFP methods. Husbands often declined to use condoms but supported the use of TFP methods. Women indicated that they have unmet needs for family planning and that they would consider using MFP methods if accurate information was available at health centers. They emphasized the importance of competent and knowledgeable health care providers (HCPs) who contribute to decision making regarding use of family planning.

Satisfaction among women: differences between current users of barrier (male condom) and non-barrier methods

OBJECTIVES

To determine the differences in and factors related to satisfaction between barrier (male condom) and non-barrier method users.

METHODS

A semi-structured questionnaire was used for collecting data for this cross-sectional survey. The questionnaires were completed via one-on-one interviews by the researchers. The study group was selected using stratified random sampling. Exclusion criteria were, being unmarried, pregnant, in postmenopausal status and using traditional methods. A total of 434 currently married women using modern contraceptive methods participated in the study. Contraceptive users were dichotomized into two groups as non-barrier method users and barrier method users.

RESULTS

About half of the participants (n = 191, 44%) were barrier method users. Their mean age was 33.7 +/- 7.3 years, 66.6% (n = 131) were well educated and reported significantly less pregnancies, given births, living children and abortions (reproductive history events) than non-barrier users. Barrier method users were significantly more likely to be satisfied with their contraceptive method of choice (OR: 2.4; 95% CI 1.2-5.2). Among barrier method users, deciding the type of the contraceptive method themselves had significant effect on satisfaction.

CONCLUSION

In our study, satisfaction was mostly affected by heavy side effects and health risks of the methods resulting in less satisfaction with the contraceptive method among non-barrier method users. Other factors which may influence satisfaction deserve further investigation.

Effects of reproduction norms on contraception practice among Muslim women in Amman, Jordan

Based on the authors' interview survey for 275 Muslim women of an ethnically divergent community in Amman, Jordan, this study examined the psychosocial effects of reproduction norms on contraception practice, using the normative interpretations of legal provisions in Islam (hukm). The categorical principal component analysis (CATPCA) reduced the eight items regarding family planning and contraception use to two factors, i.e. the pressures of childbearing and acceptability of contraception use, accounting for 55% of the total variance. Even though the majority of the female subjects were conservative rather than innovative in terms of reproduction norms and significant interrelations were observed between their reproduction norms and contraception practice, approximately 70% of the female subjects who were closely in consonance with the normative interpretations of their religious leader had used contraception. It is thus indicated that religious leaders may play significant roles in increase of contraception practice among Muslim women.

Jordanian married Muslim women's intentions to use oral contraceptives

BACKGROUND

High fertility rates and moderate to low contraceptive use in the Arab Islamic countries, and Jordan in particular, are issues of international nursing importance.

AIM

By using the Theory of Planned Behaviour (TPB) as the conceptual framework, the relationships between married Jordanian Muslim women's previous contraceptive use, type of experience, and intention to use oral contraceptives (OCs) were examined. The relationship between selected demographic variables and intention to use OCs was also examined.

METHODS

The study was part of a large cross-sectional survey. The Intention to Use Oral Contraceptive Tool was used to elicit participants' intentions and beliefs regarding oral contraceptive use.

SAMPLE

The study sample was composed of 245 Jordanian married Muslim women.

RESULTS

Results revealed a significant relationship between previous oral contraceptive use and intention to use OCs. The relationships between type of experience, whether successful or unsuccessful, with previous OC use, and intention to use OCs were not significant.

CONCLUSION

Nursing implications regarding the provision of family planning services that are sensitive to Jordanian Muslim women's religious preferences are discussed.

Jordanian Muslim Women’s Intention to Use Oral Contraceptives

Oral contraceptives (OCs) are the second most popular method of contraception in Jordan; however, their use remains low compared with the intrauterine device. The purpose of this article is to report the effect of factors identified by The Theory of Planned Behavior (TPB) on Jordanian Muslim women’s intention to use OCs. TPB was used to develop an investigator-developed instrument, the Intention to Use Oral Contraceptive Tool (IUOCT). The IUOCT measured attitude (general attitude and attitudinal beliefs), social norms and perceived behavioral control factors in a total of 83 women participants. A stepwise regression analysis was calculated using the IUOCT subscales as predictors of Jordanian Muslim women’s intention to use OCs. The findings demonstrated that the attitude, specifically general attitude and positive beliefs, about OC use affect Jordanian Muslim women’s intention to use OCs. However, the findings provide limited support for social norms and perceived behavioral control as factors influencing Jordanian Muslim women’s intention to use OCs. The findings indicate that more attention should be devoted to health education programs on the benefits of using OCs rather than focusing only on correcting misinformation. Nursing implications and recommendations for future research are discussed.

Attitudes of married individuals towards oral contraceptives: a qualitative study in Istanbul, Turkey

OBJECTIVE

To determine positive and negative attitudes of married Turkish women and men regarding the use of oral contraceptives (OCs).

METHODS

Twenty focus group discussions were conducted during the period October 1998-March 1999 in Umraniye, which is one of the densely populated districts of Istanbul.

RESULTS

Most of the negative attitudes relating to OCs stemmed from concerns over side effects, particularly in the male focus groups. Health care professionals' behaviour, lack of concern or bias, and their reluctance to prescribe also limited the uptake of OCs. The female groups had very positive attitudes towards OCs compared to those of the male groups. It was identified that although OCs are largely provided free of charge in Turkey, beliefs and attitudes towards them are the important factors which affect the uptake of the method.

CONCLUSION

Special efforts may be needed to educate these groups and also to teach the health professionals about family planning counselling.

Establishing reliability and validity of an instrument measuring Jordanian Muslim women's contraceptive beliefs

We tested the psychometric properties of an instrument entitled intention to use oral contraceptive tool (IUOCT). This instrument was developed to evaluate Jordanian Muslim women's intention to use oral contraceptives (OCs). We used the theory of planned behavior (TPB) as a conceptual framework for developing the IUOCT. The internal consistency of the IUOCT ranged from .70 to .94. The stability of IUOCT ranged from.79 to.85. Factor analysis identified four factors that represented the three constructs of the TPB. The known-group technique showed significant difference between past users and nonpast users of OCs. The predictive validity analysis showed that each scale contributed to the variability in the intention.

Contraception in Jordan: a cultural and religious perspective

This report provides a content analysis of studies conducted with Jordanian women on contraception. Factors such as pressure to have children, number and gender of children, location of residence, influence of religion, level of education, age, employment status, source of contraceptive services and method of contraception are discussed. Non-demographic factors, such as social and psychosocial, were found to be only briefly investigated and discussed in the literature. Nursing implications discussed are conducting educational programmes, encouraging the participation of significant others and religious leaders, and using appropriate terminology when discussing contraception with Jordanian women.

Culturally sensitive care of the Muslim patient

The number of Muslims in the United States is growing. This article outlines a few of the major beliefs in Islam. Religious and philosophical factors that affect health care are discussed, and practical suggestions are made for nursing actions that lead to culture care preservation, culture care accommodation, and culture care restructuring. Major topics covered include the need for cleanliness, preparation for prayer, modesty, family structure, fasting and diet, and care of the dying.