A closer look at traditional contraceptive use in Turkey

Modern contraceptive method utilization and determinant factors among women in Ethiopia: Multinomial logistic regression mini- EDHS-2019 analysis

BACKGROUND

Globally, approximately 290,000 women between the ages of 15 and 49 died from pregnancy-related problems in 2014 alone, with these sub-Saharan Africa accounts for 65% (179,000) of the deaths. Although studies are conducted on modern contraceptives, information is scarce on multinomial regression analysis at the national level data. Therefore, this study aimed to assess modern contraceptive method utilization and determinant factors among women in Ethiopia.

METHODS

Data for this study were extracted from the national representative 2019 Ethiopian Mini Demographic and Health Survey. Data was collected using a 2-stage cluster design, in which enumeration areas formed the first stage and households made the second stage. The survey was conducted from March 21, 2019, to June 28, 2019. The analysis was done using multinomial logistic regression using STATA software version 14. The overall categorical variables with a P value of < 0.25 at the binomial analysis were included in the final model of the multinomial logistic regression model in which odds ratios with 95% CIs were estimated to identify the independent variables of women's modern contraceptive utilization. P values less than 0.05 were used to declare statistical significance. All analysis was done on weighted data.

RESULTS

A total of 8885 (weighted) participants were included in the current study from these,. The current study revealed that the prevalence of modern contraceptive utilization was 28.1% (95%CI: 27.6.7-28.6%). Factors like: women 25 to 34 years (aRRR = 1.5;95% CI:1.2-1.9), 35 to 44 years (aRRR = 2.4; 95% CI: 3.3-5.4), and greater than 45 years (aRRR = 2.9; 95% CI: 2.2-3.7); place of residence (rural; aRRR = 0.89; 95% CI 0.81-0.99), higher educational status (aRRR = 0.035;95%CI:0.61-0.98), grandmultipara (aRRR = 1.73;95%CI:1.6-1.9), and wealth index (poorer aRRR = 0.541;95%CI:0.46-0.631.9) were the factors significantly associated with the outcome variable.

CONCLUSIONS

In this, modern contraceptive utilization is low as compared to other countries. It was influenced by age, place of residence, education, the number of children, and wealth index. This suggests that creating awareness of contraceptive utilization is paramount for rural residence women by policymakers and health managers to empower women for family planning services. Moreover, all stakeholders, including governmental and nongovernmental organizations, better to emphasize on modern contraceptive use.

Childhood Origins, Migration, and First Modern Contraceptive Use in Turkey

This paper integrates contraception into the extant migrant-fertility framework using the case of internal migration within Turkey. Drawing from the 2013 Turkish Demographic and Health Survey data, we show that migration is positively associated with age of first modern contraceptive use. As women's migration is quickly followed by family formation, women also take up modern contraception after first childbirth, likely due to new encounters with medical professionals, differing contraceptive access and other social exposures. We also find that women whose childhoods were spent in urban areas have a higher risk of first modern contraception relative to women from rural areas, thus suggesting the enduring importance of socialization. These results show how selection processes, life-cycle factors, and sociocultural norms jointly shape modern contraceptive behavior in Turkey. Our results also demonstrate a need for increased reproductive care in rural areas and suggest continued fertility decline with urban migration.

Does cosmopolitan culture weaken ethnic and regional diversity: contraceptive behaviours of women in Istanbul, Turkey

OBJECTIVE

The primary aim of the study was to examine the relationship between self-reported ethnic identity, region of birth and contraceptive use, in Istanbul, Turkey.

METHODS

Cross-sectional data from a random sample of 3038 married women of reproductive age living in two urban districts of Istanbul were used in a series of logistic regression models to assess key relationships.

RESULTS

Kurdish ethnic minority women were less likely than Turkish ethnic majority women to use traditional contraceptive methods over no method (relative risk ratio [RRR] 0.69; 95% confidence interval [CI] 0.50, 0.96). However, there were no significant differences between ethnicities (i.e., Turkish, Kurdish and other) and modern method use. Among Turkish women, those born in regions farther away from the western region were more likely to use traditional methods (RRR_northern 2.06; 95% CI 1.31, 3.22).

CONCLUSION

While Kurdish ethnic minority women were less likely to use traditional methods, compared with Turkish ethnic majority women, the difference might have been due to the length of time living in a neighbourhood. Regional variations in contraceptive use were concentrated only among Turkish ethnic majority women and for traditional methods. Regional norms of traditional method use may be a barrier to modern contraceptive use in Turkey.

Explaining withdrawal's persistence: correlates of withdrawal use in Albania, Armenia, Jordan, and Turkey observed in a cross-sectional study

Background: Withdrawal dominates the contraceptive method mix in a geographical cluster of countries in South-Eastern Europe and Western Asia that have, in part, reached low fertility. This study examines the socio-demographic determinants associated with withdrawal use in Armenia, Albania, Jordan and Turkey that could explain withdrawal’s persistence and inform contraceptive programs in these unique settings.

Methods: Cross-sectional data on 31,569 married women 15 to 49 years were drawn from the Demographic and Health Surveys in Albania (2017-2018), Armenia (2015-2016), Jordan (2017-2018), and Turkey (2013). For each country, multinomial regression models estimating withdrawal use among all women and logistic regression models estimating withdrawal use among contraceptive users were used to evaluate the association with age, marital duration, parity, education, residence, and household wealth.

Results: The socio-demographic determinants associated with withdrawal use varied by country among all women and among all contraceptive users. While these associations were not all significant for all four countries general trends included that women were more likely to use withdrawal than not use contraception, but less likely to use withdrawal than other methods with increasing parity, higher education, and greater household wealth. Measures of association are reported by country for each correlate.

Conclusions: Despite the similar contraceptive mix in these four countries, no single set of factors was found to explain withdrawal’s persistence. Withdrawal’s prevalence in this geographical cluster may instead result from different balances of intertwined circumstances that include couples’ fertility decisions, access to modern contraception and availability of abortion services.

Women’s socioeconomic status and choice of birth control method: an investigation for the case of Turkey

This study investigated whether woman’s education, labour market status and the status within the household have any impact on their birth control behaviour in Turkey. Empirical analyses were implemented using the 2013 Demographic and Health Survey dataset, which includes information on women’s socioeconomic status and their current choice of contraceptives: whether they used any method, and if so, what method they used. Using a bivariate probit model with selection to control for any possible selection bias, the results suggest that whether a woman uses any birth control method, and whether the woman chooses modern methods over traditional methods, are primarily explained by education level and urban/rural residence, and that the determinants of contraceptive use vary across college-educated and non-college-educated women. The results also indicate that non-employed women are less likely to use any birth control method compared with women with regular, full-time jobs. However the effect was statistically insignificant.

Increasing misreporting levels of induced abortion in Turkey: is this due to social desirability bias?

Women tend to under-report or misreport their abortion experiences, mainly because abortion is considered a sensitive issue for cultural, religious, political or other reasons in many countries across the world. Turkey, where induced abortion is an increasingly sensitive issue due to intense statements against induced abortion on religious grounds by influential politicians, and a hidden agenda to prohibit the practice, especially in public health facilities, in recent years, is no exception. This study focused on the increase in level of misreporting of induced abortion in Turkey and its link to social desirability bias using pooled data from 1993 and 2013 Turkish Demographic and Health Surveys. A probabilistic classification model was used to classify women's reported abortions. The findings confirmed that the level of misreporting of induced abortions has increased from 18% to 53% among all terminated pregnancies over the period 1993-2013 in Turkey. This marked increase, especially among women in the lower socioeconomic sections of society, may be largely associated with the prevailing political environment, and increase in social stigmatization against induced abortion in Turkey over recent decades.

Space, agency, and withdrawal: birth control choices of women in Turkey

Withdrawal (WD) is not a reliable method for preventing unwanted pregnancies, yet it is still a very popular form of birth control in many societies, including Turkey. We look at the relationship between women's agency and physical space in relation to birth control choices of women in Turkey. Agency in our context refers to a woman's ability to resist domination and subordination to the patriarchal beliefs valuing her reproductivity over her pleasure. Our analysis of the Turkish Demographic Health Survey (TDHS) suggests that (a) the available space in the household for possible private encounters between husband and wife, and (b) the women's capacity to insert her agency into her life choices are closely correlated with WD choices. Women with better social and physical resources prefer WD less.

Exposure to international migration and its effect on childbearing in Turkey

International migration alters social norms, family structures, and population development in sending regions. Each of these factors affects fertility, making the impact of international migration on childbearing an increasingly important area of study. In many sending regions, the Demographic and Health Surveys (DHS) provide a promising, but underutilized, source of data for understanding the relationship between international migration and childbearing. Using the household and individual questionnaires in the 2003 Turkish DHS, we develop a multi-layered approach for measuring international migration. We then use these measures to examine differences in childbearing among women in migrant and non-migrant households, assessing the effects of migrant selection and migration-related roles and attitudes on the number of children born. After adjusting for selection characteristics, we find return female migrants and migrant wives are not significantly different from women in non-migrant households; role and attitude differences have only modest impacts on the association between women’s exposure to migration and childbearing.

Determinants of choosing withdrawal over modern contraceptive methods in Turkey

OBJECTIVES

The determinants of the use of withdrawal in Turkey are examined using a multinomial logistic model.

METHODS

Data were drawn from a nation-wide population-based cross-sectional study, the Turkish Demographic Health Surveys that took place in 1998 and 2003. Detailed interviews were conducted with 8576 women aged 15-49 and analysed using SPSS.

RESULTS

Contextual, cultural and demographic characteristics define women's choice of withdrawal over modern methods. Socio-economic status, education, employment status, and past fertility behaviour are among key determinants. First-ever used contraception method has a very strong impact on later choices. Urban women, the more educated, those with better socioeconomic status, and those living in less crowded households resort less to withdrawal. Experience and empowerment positively linked to modern contraceptive use among women in Turkey.

CONCLUSIONS

The use of contraceptive methods in Turkey differs greatly. Empowerment of women in terms of better socioeconomic status, better education, modern and liberal attitudes towards women and family planning seem to reduce withdrawal use as the main method of contraception. The results suggest the need for education (particularly targeting young women and couples), information and provision of modern contraceptive services particularly for disadvantaged groups.