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Agbana RD, Michael TO, Ojo TF. Family planning method discontinuation among Nigerian women: Evidence from the Nigeria Demographic and Health Survey 2018. J Taibah Univ Med Sci 2023; 18:117-124. [PMID: 36398014 PMCID: PMC9643553 DOI: 10.1016/j.jtumed.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The cessation of family planning among sexually active women who do not intend to have children increases the number of unplanned pregnancies and the risks to maternal health. This study examined the predictors of family planning method discontinuation among sexually active Nigerian women. Methods Data from the Nigeria Demographic and Health Survey (NDHS) were used. A total of 4553 women 15-49 years of age who had stopped using family planning methods in the previous 5 years were included in the study. Descriptive and binary logistic regression were used in the analysis. Results More than 60% of the women sampled had stopped family planning and had no intention of having children. Respondents discontinued family planning because of adverse effects (15.2%) and method failure (12.9%). Predictors of modern family planning discontinuation were secondary education (OR = 1.302, 95% CI: 1.006-1.685), Islamic religion (OR = 1.281, 95% CI: 1.059-1.550), residence in the South-East geopolitical zone (OR = 0.248, 95% CI: 0.195-0.316), having three or more children (OR = 0.848, 95% CI: 0.735-0.978) and having paid employment (OR = 0.838, 95% CI: 0.715-0.982). Conclusion Socio-economic and cultural factors influence discontinuation of family planning among Nigerian women. Policy options are needed to increase family planning uptake, identify common adverse effects of family planning and focus on raising public awareness regarding the negative consequences of discontinuing family planning on individuals, families and the nation.
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Affiliation(s)
- Richard D. Agbana
- Department of Community Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Turnwait O. Michael
- Demography and Population Studies Unit, Department of Sociology, University of Ibadan, Ibadan, Nigeria
| | - Tolulope F. Ojo
- Department of Public Health, Afe Babalola University, Ado-Ekiti, Nigeria
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Calhoun LM, Mandal M, Onyango B, Waga E, McGuire C, Zulu EM, van den Akker T, Benova L, Delvaux T, Speizer IS. Contraceptive method use trajectories among young women in Kenya: A qualitative study. Front Glob Womens Health 2022; 3:973971. [PMID: 36177336 PMCID: PMC9513027 DOI: 10.3389/fgwh.2022.973971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/15/2022] [Indexed: 12/15/2022] Open
Abstract
Background Many young women experience important key life transitions during adolescence and early adulthood, such as initiation of sexual activity, first use of contraceptives, marriage, and childbirth. For young women to be able to plan and manage their lives, it is critical to understand how these life events intersect and shape their contraceptive decision-making. This study aims to explore young women's contraceptive method use trajectories, including the factors that influence contraceptive decision-making throughout adolescence and youth. Methodology In 2019, the Full Access, Full Choice project (FAFC), implemented by the University of North Carolina at Chapel Hill and the African Institute for Development Policy, conducted 30 in-depth interviews with young women aged 18-24 years in three counties in Kenya (Nairobi, Mombasa and Migori). Eligible respondents had used two or more modern contraceptive methods. Interview guides utilized a modified life history approach to capture details about respondents' contraceptive use and life experiences from the time they first used contraception until the time of interview. Results We identified five separate contraceptive use trajectories based on the occurrence and timing of marriage, childbirth, and contraceptive method choice as well as various influences on contraceptive decision-making. The majority of respondents began their contraceptive journey by using male condoms or emergency contraception, but subsequent contraceptive decisions were varied across trajectories and influenced by different factors. For many women, the initiation of a non-coitally dependent method occurred after the birth of a child; for some, this was the first method used. Once women transitioned to using a non-coitally dependent method such as injectables or implants, many cycled through different methods to find one that had fewer side effects or provided the desired duration of protection. Discussion This study highlights the nuanced needs of young women throughout their adolescent and youth years in Kenya. This suggests that programs and policies need to encompass young women's diversity of experiences and motivations to best serve them.
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Affiliation(s)
- Lisa M. Calhoun
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States,Athena Institute, Vrije Universiteit, Amsterdam, Netherlands,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium,*Correspondence: Lisa M. Calhoun
| | - Mahua Mandal
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Erick Waga
- African Institute for Development Policy, Nairobi, Kenya
| | - Courtney McGuire
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eliya M. Zulu
- African Institute for Development Policy, Nairobi, Kenya
| | - Thomas van den Akker
- Athena Institute, Vrije Universiteit, Amsterdam, Netherlands,Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, Netherlands
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thérèse Delvaux
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ilene S. Speizer
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States,Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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LeMasters K, Costenbader E, Martinez A, Speizer IS, Igras S. Men's social networks, social norms, & family planning in Benin. Glob Public Health 2022; 17:1611-1625. [PMID: 34032186 PMCID: PMC8613300 DOI: 10.1080/17441692.2021.1933125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
To address low family planning (FP) use and high unmet need in West Africa, attention has been paid to addressing FP-related social networks and norms. Most work focuses on women. This analysis assesses men's FP-related social networks and norms and their relation to FP use in Benin using data from baseline surveys from the Tékponon Jikuagou intervention. We descriptively analysed men's egocentric FP-related social networks and norms at the village level. Multivariable logistic regression analyses (N = 885) examined the relationship between FP-related social networks, norms, and men's current and future FP use. Twenty-three percent of men reported current modern contraception use and 47% reported intended future use. Most had few network members. While most believed it was acceptable to discuss FP, few talked with peers about FP and most did not discuss FP with their partner(s). In multivariable analyses, neither networks nor norms were significantly related to men's FP use. Men's networks being small and men rarely discussing FP indicate an opportunity for village-based approaches to engage men in FP discussions and spark FP dialogue within couples, between men, and within villages. Future work should further explore the relationship between men's social networks, norms, and FP use.
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Affiliation(s)
- Katherine LeMasters
- Department of Epidemiology,Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | | | | | - Ilene S Speizer
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Susan Igras
- The Institute of Reproductive Health at Georgetown University, Washington D. C., United States
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Igras S, Burgess S, Chantelois-Kashal H, Diakité M, Giuffrida M, Lundgren R. Pathways to Modern Family Planning: A Longitudinal Study on Social Influence among Men and Women in Benin. Stud Fam Plann 2021; 52:59-76. [PMID: 33559166 PMCID: PMC8048892 DOI: 10.1111/sifp.12145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Despite improvements in family planning (FP) knowledge and services in West Africa, unmet need for FP continues to grow. Many programs apply a demographically and biologically driven definition of unmet need, overlooking the complex social environment in which fertility and FP decisions are made. This longitudinal, qualitative cohort study captures the changing nature of FP need, attitudes and behaviors, taking into account life context to inform understanding of the complex behavior change process. Purposively sampled, 25 women and 25 men participated in three rounds of in‐depth interviews over 18 months. Analyses used a social network influence lens. Findings suggest alignment of six foundational building blocks operating at individual, couple, services, and social levels is essential to meet FP need. If one block is weak, a person may not achieve met need. Women and men commonly follow five pathways as they seek to fulfill their FP need. Some pathways achieve met need (determined users, quick converters), some do not (side effect avoiders), and some do not lead to consistent FP outcomes (male‐priority decision makers, gender–egalitarian decision makers). Findings clarify the role of social determinants of FP and offer insight into program approaches informed by user typologies and return on program investments.
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Affiliation(s)
- Susan Igras
- Susan Igras, Mariam Diakité, Institute for Reproductive Health, Center for Child and Human Development, Georgetown University, Washington, DC, USA
| | | | | | - Mariam Diakité
- Susan Igras, Mariam Diakité, Institute for Reproductive Health, Center for Child and Human Development, Georgetown University, Washington, DC, USA
| | - Monica Giuffrida
- Monica Giuffrida, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecka Lundgren
- Rebecka Lundgren, Division of Infectious Disease and Global Public Health, Department of Medicine, Center on Gender Equity and Health, University of California, San Diego, CA, USA
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