Jordanian married Muslim women's intentions to use oral contraceptives

Patterns and correlates of intention to use contraceptives among fecund sexually active women in developing countries

BACKGROUND

Understanding a woman's future contraceptive needs and enhancing her chances of putting those needs into action depend heavily on her intentions to use contraceptive methods. However, there is little information about global perspectives of intention to utilise contraceptives among fecund sexually active women.

OBJECTIVES

This study examines the patterns and determinants of contraception intention of fecund sexually active women.

METHODS

The most recent Demographic and Health Surveys (DHS) from 59 countries were used for secondary data analysis. The DHSs applied a cross-sectional survey design to collect data from women between the ages of 15 and 49. The study comprises a sample of 697,590 fecund sexually active women in the reproductive ages. The desire to utilise contraceptive methods was examined using a multivariable binary logistic regression analysis. All analyses were weighted to allow for a complex survey design.

RESULTS

A pooled prevalence of intention to utilise contraception was 42.8% (95% CI: 42.5, 43.1) at the global level. Eastern and Southern Europe had the lowest prevalence, 17.3% (95% CI: 16.4, 18.2), and the highest prevalence was observed in countries from Latin America and the Caribbean, 68.0% (95% CI: 67.5, 69.9). Attaining secondary-level education (adjusted odds ratio (aOR) = 1.68; 95% CI: 1.62-1.72) or higher (aOR = 1.71; 95% CI: 1.63-1.80), working (aOR = 1.21; 95% CI: 1.18-1.24), experience of a pregnancy loss (aOR = 1.06; 95% CI: 1.03-1.09), or being exposed to media family planning messages (aOR = 1.51; 95% CI: 1.48-1.55) were factors associated with an increased likelihood of intent to use contraceptives.

CONCLUSIONS

The study has established that contraceptive use intention was low in many developing countries. Education, age, employment status, fertility preference, and exposure to family planning messages influenced contraceptive use intention. Health policy-makers ought to consider these factors when designing sexual and reproductive health strategies in developing countries.

Knowledge and beliefs about the use/abuse of oral contraceptive pills among males: A mixed-method explanatory sequential study in community pharmacy settings

BACKGROUND

Oral contraceptive pills (OCPs) are considered one of the most important birth control methods globally. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists' observations.

METHOD

A mixed-method explanatory sequential study was conducted using an online self-administered survey, followed by semi-structured in-depth interviews for registered pharmacists, assistant pharmacists and pharmacy interns. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively.

RESULTS

A total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the participating pharmacists highlighted that males use OCPs mostly for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel).

CONCLUSION

This study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse. However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.

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.

Current knowledge, attitude, and patterns of oral contraceptives utilization among women in Jordan

Background

Studies exploring the knowledge, attitude and patterns of OCs use among women in Jordan are lacking. The aim of this study was to assess knowledge, attitude, and patterns of oral contraceptives (OCs) utilization among women in Jordan.

Methods

A face-to-face questionnaire inquiring demographic information and issues related to knowledge and use of OCs was completed by women (n = 1571), who have had used OCs at least once in their lifetime. A model was created to assess the effects of knowledge, attitude and previous experience on the patterns of OCs utilization.

Results

Jordanian women exhibited positive attitudes towards OCs efficacy and safety. This positive attitude was approvingly associated with the patterns of use. However, only half of participating women reported that they knew how to use OCs. About 60 % of women received recommendations for OCs use from a physician. Moreover, women’s knowledge about OCs mechanism of action was obtained namely from physician (29.9 %). Side effects were reported in 75.1 % of participating women. Reported side effects were headache (41.2 %), mood swings (35.5 %), irritability (33.5 %) and weight gain (28.7 %). Interestingly, the occurrence of side effects was the main reason for OCs discontinuation.

Conclusion

The study showed that women who have positive attitude toward OCs tend to utilize them more appropriately. However, there is still need for educational programs to enhance knowledge about OCs utilization in Jordan.

Electronic supplementary material

The online version of this article (doi:10.1186/s12905-015-0275-1) contains supplementary material, which is available to authorized users.

Religious leaders gain ground in the Jordanian family-planning movement

OBJECTIVE

To assess the effect of a training program designed to enhance the role of Muslim religious leaders (RLs) in promoting family welfare, including reproductive health generally and family planning more specifically.

METHODS

A panel study design was utilized; 136 and 115 RLs completed the self-administered questionnaires at baseline (pre-training) and endline (6 months post-training), respectively. Scales were generated to assess RLs' knowledge of the number of family-planning methods deemed to be acceptable according to Islamic teachings (9 methods, Cronbach α=0.85), attitudes toward family planning (7 statements, Cronbach α=0.67), and preaching and/or counseling on family-planning topics (7 topics, Cronbach α=0.85).

RESULTS

Linear regressions controlling for sex, age, and educational attainment showed that, on average, RLs cited more methods deemed acceptable according to Islamic teachings (β=1.381; P<0.001), expressed more positive attitudes toward family planning (β=0.514; P<0.05), and preached and/or counseled on family-planning topics more frequently at endline compared with baseline (β=0.965; P<0.01).

CONCLUSION

Culturally appropriate training for RLs can lead to a deeper understanding of, and appreciation for, reproductive health and family planning, with the effects manifesting as increased preaching and/or counseling about these important topics.

Contraception and women over 40 years of age: mixed-method systematic review

AIM

This paper is a report of a mixed-method systematic review to identify barriers to, and facilitators of, contraceptive needs and choices of women over 40 years old.

BACKGROUND

Women over 40 years of age who do not want to conceive have specific needs for contraception to prevent unwanted, unplanned and unintended pregnancies prior to menopause.

DATA SOURCES

Six databases were searched for published and grey literature from September 1997 to September 2007, along with the Cochrane Central Register of Controlled Trials. The Internet, professional networks and hand searching were also used.

REVIEW METHODS

Mixed-method synthesis using Evidence for Policy and Practice Information and Co-ordinating Centre phased design.

FINDINGS

Guidelines to inform clinical decision-making were located but did not take account of age-related social factors affecting women's choices or local service availability. Women's access to services and contraceptive choices were influenced by educational level, general awareness of available methods, fear of side effects, women's social standing, religious and cultural beliefs, personal control, and confidentiality. The main factors influencing compliance and continuation rates were knowledge, positive experience and confidence, unacceptable side effects and safety concerns, information, support and advice, and ongoing husband/partner influences.

CONCLUSION

The utility of clinical guidelines could be improved by incorporating socio-cultural factors and women's views. Novel approaches to evidence translation and facilitation are required. Focusing on user-led, age-appropriate services rather than a 'one size fits all' approach could improve the contraceptive choices and outcomes for women over 40 years old.

Religious and cultural influences on contraception

OBJECTIVE

To elucidate the religious and cultural influences that may affect the acceptance and use of various methods of contraception, including emergency contraception.

METHODS

Literature searches were conducted to identify religious teachings related to family, sexual relations, and family planning for Christianity, Judaism, Islam, Hinduism, Buddhism, and Chinese religious traditions. Religious scholars from each of the major religions were consulted for additional information regarding how various subgroups within that religion may interpret and apply religious teachings in specific circumstances.

RESULTS

Religious and cultural factors have the potential to influence the acceptance and use of contraception by couples from different religious backgrounds in very distinct ways. Within religions, different sects may interpret religious teachings on this subject in varying ways, and individual women and their partners may choose to ignore religious teachings. Cultural factors are equally important in couples' decisions about family size and contraception.

CONCLUSION

When new immigrants are faced with the challenges of acclimating to a new society and a new way of life, they may anchor strongly to traditional religious and cultural expectations regarding family, sexuality, and fertility. While health care providers must be cautious not to attribute stereotypical religious, social, and cultural characteristics to women seeking advice about contraception, they do need to recognize that different value systems may influence contraception decision-making in couples of different faiths. This increased cultural awareness needs to be tempered by the understanding that each patient encounter is unique. The values that an individual woman holds may not be in keeping with the official teachings of her religion or the cultural norms reported by other members of the same culture.

Attitudes toward oral contraceptive use among women of reproductive age: a systematic review

Despite the effectiveness of oral contraceptives (OCs), their popularity differs across populations. Attitudes are a significant factor that influences OC use. This report systematically reviews 28 studies on attitudes toward OC use among women. The Matrix Method was used to review the literature. Affective, cognitive, and behavioral components of attitudes were analyzed, including satisfaction, safety, fear/anxiety, and inconvenience. In general, negative attitudes still prevail across countries. Positive attitudes are more prevalent in Europe. Effective counseling and education are needed for those negatively disposed toward OC use. For favorable users, compliance strategies for longer continuation with OC regimen must be provided.

"Women do what they want": Islam and permanent contraception in Northern Tanzania

Based on fieldwork in Ugweno, Tanzania, this research explores a case that contradicts popular understandings and representations of Muslim African women-specifically with respect to reproduction and family planning. Building on case studies of women who articulate their motivations regarding contraceptive use in general, and sterilization in particular, I argue that religious (and, in this case, Islamic) values and reasoning are fashioned pragmatically. The study was based on in-depth, unstructured and open-ended interviews with 40 women (20 of whom had been sterilized), as well as men, religious leaders and hospital workers. Women (and men) in Ugweno construct reproductive lives that challenge overly deterministic understandings of the relationship between religion and contraceptive practices. It was found that perceptions of Islamic rules about family planning are inconsistent. Individuals are able to define their own approach by manipulating the rules and resisting them.