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Dhaurali S, Acevedo A, Abrams L, Shrestha S. Psychosocial Stressors and Postpartum Depressive Symptoms Are Linked to Postpartum Contraceptive Use. J Womens Health (Larchmt) 2024; 33:1175-1184. [PMID: 38574265 DOI: 10.1089/jwh.2023.0719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background: Postpartum contraception plays a critical role in reducing the occurrence of rapid subsequent pregnancy, offering individuals reproductive choice, and promoting overall reproductive planning and well-being. In this study, we investigated the relationship between psychosocial stress during pregnancy, postpartum depressive symptoms (PDS), and postpartum contraceptive use. Materials and Methods: We analyzed data from the Pregnancy Risk Assessment Monitoring System (2012-2019), which included comprehensive information about maternal experiences, views, and needs before, during, and after pregnancy from four states and a large city, with a total sample size of N = 36,356. We conducted descriptive analyses as well as adjusted multivariable logistic regression models. Main Findings: Our findings demonstrate significant negative associations between partner-related (adjusted odds ratio [aOR] = 0.82, 95% confidence interval [95% CI]: 0.76-0.89, p ≤ 0.001) and trauma-related (aOR = 0.83, 95% CI: 0.75-0.92, p ≤ 0.001) stressors and postpartum contraceptive use. Additionally, we observed a negative association between PDS and postpartum contraceptive use (OR = 0.88, 95% CI: 0.80-0.97, p ≤ 0.01), indicating that individuals experiencing PDS are less likely to utilize contraception after giving birth. Furthermore, our study highlights racial/ethnic, socioeconomic, and parity postpartum contraceptive use disparities. Conclusions: Our findings emphasize the importance of incorporating psychosocial stressors and mental health into the promotion of effective postpartum contraception practices. These results have valuable implications for health care providers, policymakers, and researchers as they can guide the development of targeted interventions and support systems to contribute to improved reproductive health outcomes.
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Affiliation(s)
- Shubhecchha Dhaurali
- Department of Community Health, School of Arts and Sciences, Tufts University, Medford, Massachusetts, USA
- Department of Community Medicine and Public Health, Maternal Health Epidemiology and Data Synthesis Unit, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Andrea Acevedo
- Department of Community Health, School of Arts and Sciences, Tufts University, Medford, Massachusetts, USA
| | - Leah Abrams
- Department of Community Health, School of Arts and Sciences, Tufts University, Medford, Massachusetts, USA
| | - Shikhar Shrestha
- Department of Community Medicine and Public Health, Maternal Health Epidemiology and Data Synthesis Unit, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, Boston, Massachusetts, USA
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
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Kuug AK, Daniels-Donkor SS, Laari TT, Atanuriba GA, Kumbeni MT, Daliri DB, Afaya RA, Yakong VN, Akurugu JA, Adawudu EA, Salia SM, Afaya A. Assessment of intention to use modern contraceptives among women of reproductive age in Benin: evidence from a national population-based survey. Contracept Reprod Med 2024; 9:43. [PMID: 39215322 PMCID: PMC11363446 DOI: 10.1186/s40834-024-00294-8] [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: 07/07/2023] [Accepted: 06/25/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Women's intentions to use any contraceptive method are critical for better understanding their future needs and making them more likely to act on that intention. This study assessed the factors associated with the intention to use modern contraceptives among women of reproductive age in Benin. METHODS This was a cross-sectional study that used the 2017-2018 Benin Demographic and Health Survey (BDHS). The study analyzed a weighted sample of 13, 582 women of reproductive age who were non-users of contraceptives. The intention to use contraceptives was the outcome variable. Multivariate logistic regression analysis was conducted to determine the factors associated with the intention to use contraceptives among women of reproductive age. The results were estimated using an adjusted odds ratios (aOR) with a 95% confidence interval (CI) and statistical significance set at p < 0.05. RESULTS: Approximately 35.0% of the women had the intention to use modern contraception. We found that women aged between 30 and 34 (aOR = 0.70, 95%CI: 0.57, 0.86), 35-39 (aOR = 0.52, 95%CI: 0.42, 0.66), 40-44(aOR = 0.30, 95%CI: 0.22, 0.39) and 45-49 (aOR = 0.10, 95%CI: 0.07, 0.14), Muslim women (aOR = 0.68, 95%CI: 0.53, 0.85) and those who perceived the distance to a health facility not to be a big problem (aOR = 0.75, 95%CI: 0.67, 0.84) were less likely to have the intention to use modern contraceptives compared with their counterparts. On the other hand, women who attained primary (aOR = 1.21, 95%CI: 1.07, 1.36), secondary (aOR = 1.39, 95%CI: 1.21, 1.59), and higher education (aOR = 1.60, 95%CI: 1.13, 2.26), women who were employed (aOR = 1.39, 95%CI: 1.23, 1.57), women with no religion (aOR = 1.32, 95%CI: 1.04, 1.69), women whose partners were working (aOR = 1.69, 95%CI: 1.16, 2.44), women who heard about family planning in the media (aOR = 1.51, 95%CI: 1.16, 2.44), and women in the poorer (aOR = 1.31, 95%CI: 1.10, 1.54), middle (aOR = 1.42, 95%CI: 1.20, 1.67]), richer (aOR = 1.23, 95%CI: 1.03, 1.47), and richest households (aOR = 1.42, 95%CI: 1.15, 1.75) were more likely to have the intention to use contraceptives than their counterparts. CONCLUSION The study provides valuable insights into the intention to use contraceptives among women of reproductive age in Benin. The findings indicate that the proportion of women who have intention to use contraceptives remains low. The findings of this study could inform the development of targeted interventions and policies to increase access to and uptake of contraceptives in Benin, with the ultimate aim of improving the reproductive health and well-being of women and their families.
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Affiliation(s)
- Anthony Kolsabilik Kuug
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | | | | | | | - Maxwell Tii Kumbeni
- College of Public Health and Human Sciences, Oregon State University, Corvallis, USA
| | | | - Richard Adongo Afaya
- School of Nursing and Midwifery, Griffith University, Queensland, Australia
- Department of Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Vida Nyagre Yakong
- Department of Midwifery and Women's Health, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Jerry Apiini Akurugu
- Ghana Health Service, Kpikpira Health Centre, Tempane District, Bawku, Upper East Region, Ghana
| | - Emefa Awo Adawudu
- Elaine Marieb College of Nursing, University of Massachusetts, Amherst, USA
| | - Solomon Mohammed Salia
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
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Okunlola DA, Alawode OA, Jegede OT, Adeleye K. Exposure to Parental Violence and Self-Reported Sexual Violence among Unpartnered Adolescent Girls in Nigeria: Evidence from a National Survey. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:625-636. [PMID: 38601810 PMCID: PMC10903639 DOI: 10.1080/19317611.2023.2277442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/25/2023] [Indexed: 04/12/2024]
Abstract
Objectives Despite the high prevalence of sexual violence among young and adolescent women in Nigeria, there is a paucity of studies on the extent of sexual violence among adolescent girls, especially unpartnered girls, and the role of parental violence. This study assesses the prevalence of self-reported sexual violence and the influence of exposure to parental violence among unpartnered adolescent girls (aged 15-19) in Nigeria. Methods The women's data (n = 5,145) from the 2013 and 2018 Nigeria Demographic and Health Surveys were pooled and analyzed with descriptive analysis and multinomial logistic regressions. Results Of all adolescent girls, 5.65% had ever experienced sexual violence, 94.09% said they never did, and 0.26% did not respond. Adolescent Girls exposed to parental violence were more likely to have ever experienced sexual violence than the unexposed girls (aRRR= 1.90; 95% CI: 1.29-2.79). Conclusion Interventions to prevent sexual violence among adolescent girls should sensitize parents on the potential negative implications of parental violence for their daughters' wellbeing.
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Affiliation(s)
- David Aduragbemi Okunlola
- Department of Sociology, College of Social Sciences and Public Policy, Florida State University, Tallahassee, Florida, USA
- Viable Knowledge Masters, Abuja, Nigeria
| | - Oluwatobi A. Alawode
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, Florida, USA
| | - Olabisi T. Jegede
- Department of Epidemiology and Medical Statistics, University of Ibadan, Oyo State, Nigeria
| | - Khadijat Adeleye
- Elaine Marieb College of Nursing, University of Massachusetts, Amherst, Massachusetts, USA
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Mare KU, Sabo KG, Mohammed AA, Leyto SM, Mulaw GF, Tebeje TM, Aychiluhm SB, Ebrahim OA, Wuneh AG, Seifu BL. Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression. Reprod Health 2023; 20:132. [PMID: 37667285 PMCID: PMC10476311 DOI: 10.1186/s12978-023-01678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Despite the availability of exempted family planning services, a significant proportion of women in African countries continue to experience inadequately spaced pregnancies. To the authors' knowledge, evidence of suboptimal birth intervals at the SSA level is lacking and previous studies have been limited to specific geographic area. Therefore, this analysis was aimed to estimate the pooled prevalence of suboptimal birth spacing and its predictors among childbearing women in SSA. METHODS Pooled DHS data from 35 SSA countries were used and a weighted sample of 221,098 reproductive-age women was considered in the analysis. The survey across all countries employed a cross-sectional study design and collected data on basic sociodemographic characteristics and different health indicators. Forest plot was used to present the overall and country-level prevalence of suboptimal birth spacing. Multilevel mixed-effects models with robust Poisson regression were fitted to identify the predictors of suboptimal birth spacing. Akaike's and Bayesian information criteria and deviance were used to compare the models. In a multivariable regression model, a p-value less than 0.05 and an adjusted prevalence ratio with the corresponding 95% CI were used to assess the statistical significance of the explanatory variables. RESULTS The pooled prevalence of suboptimal birth spacing among women in SSA was 43.91% (43.71%-44.11%), with South Africa having the lowest prevalence (23.25%) and Chad having the highest (59.28%). It was also found that 14 of the 35 countries had a prevalence above the average for SSA. Rural residence [APR (95% CI) = 1.10 (1.12-1.15)], non-exposure to media [APR (95% CI) = 1.08 (1.07-1.11)], younger maternal age [APR (95% CI) = 2.05 (2.01-2.09)], non-use of contraception [APR (95% CI) = 1.18 (1.16-1.20)], unmet need for family planning [APR (95% CI) = 1.04 (1.03-1.06)], higher birth order [APR (95% CI) = 1.31 (1.28-1.34)], and desire to have at least six children [APR (95% CI) = 1.14 (1.13-1.16)] were the predictors of suboptimal birth spacing practice. CONCLUSION More than four out of ten reproductive-age women in SSA countries gave birth to a subsequent child earlier than the recommended birth spacing, with considerable variations across the countries. Thus, interventions designed at enhancing optimal birth spacing should pay particular attention to young and socioeconomically disadvantaged women and those residing in rural regions. Strengthening community health programs and improving accessibility and availabilities of fertility control methods that ultimately impacts optimal reproductive behaviors is crucial to address contraceptive utilization and unmet need.
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Affiliation(s)
- Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Simeon Meskele Leyto
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Getahun Fentaw Mulaw
- School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Oumer Abdulkadir Ebrahim
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abel Gebre Wuneh
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Takyi A, Sato M, Adjabeng M, Smith C. Factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District, Ghana: a qualitative study. Trop Med Health 2023; 51:40. [PMID: 37537649 PMCID: PMC10398952 DOI: 10.1186/s41182-023-00531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Fertility declines with age, but it remains important to protect women from unplanned pregnancies throughout their reproductive lives. The objective of this study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana. METHODS In-depth interviews were conducted remotely for 22 women, 15 male partners of the women interviewed and seven family planning (FP) providers. In all, a total of 44 participants took part in the study. Seven refusals were recorded, four females and three males. Four focus group discussions were organized for 21 participants who took part in the in-depth interviews. Data collected were transcribed and coded after exporting to Nvivo12 qualitative analysis software. Thematic analysis was undertaken using an abductive approach. RESULTS Factors that influenced the use of modern contraceptives included: achieved desired family size, providing for the family, counselling by health professionals, influence of the male partner, and health reasons. Barriers cited included: religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, declining fertility, and the belief that contraceptive use is a matter for women. Within the study group, roughly half of women used modern contraceptives, while the majority of male partners were non-users. CONCLUSION Contraception among women aged 35 to 49 years and their male partners is influenced by several factors such as achieved desired family size, influence of the male partner, rumors or misconceptions, and declining fertility. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.
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Affiliation(s)
- Amy Takyi
- School of Tropical Medicine and Global Health, Nagasaki University Japan, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Miho Sato
- School of Tropical Medicine and Global Health, Nagasaki University Japan, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Michael Adjabeng
- World Health Organization (WHO) Country Office Accra, Korle-Bu, Box KB 493, Accra, Ghana
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University Japan, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E7HT, UK.
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Alemayehu M, Medhanyie AA, Reed E, Kahsay ZH, Kalayu M, Mulugeta A. Effects of continuum of care for maternal health service utilisation on intention to use family planning among pastoralist women of Ethiopia: a robust regression analysis and propensity score matching modelling. BMJ Open 2023; 13:e072179. [PMID: 37438064 PMCID: PMC10347460 DOI: 10.1136/bmjopen-2023-072179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES This study examines the effect of continuum care for maternal health service utilisation on intention to use family planning among the pastoralist community in Ethiopia. DESIGN A community-based cross-sectional study. SETTING Data were collected from three districts of the pastoralist community of the Afar region. PARTICIPANTS Randomly selected 891 married pastoralist women. PRIMARY OUTCOME Intention to use family planning. RESULTS Intention to use family planning would increase (β=0.122, 95% CI: 0.036, 0.287) or by 12.2%, if all married pastoralist women received continuum of care for maternal health service utilisation compared with their counterparts. Results from the robust regression analysis indicate that intention to use family planning was higher among women who had a discussion about family planning with their husband (β=0.31, SE=0.035, p<0.001), women who possessed an electronic devices (β=0.096, SE=0.029, p<0.001) and women who had an unmet need for family planning (β=0.056, SE=0.026, p<0.000). However, intention to use family planning was lower for women who were in a polygamous marriage (β=-0.168, SE=0.065, p<0.01). There was a significant linear increase in the score of intention to use family planning for attitude towards family planning (β=0.009, SE=0.001, p<0.000), subjective norm (β=0.003, SE=0.001, p<0.003) and perceived control over family planning (β=0.002, SE=0.008, p<0.024) given other explanatory variables in the model. CONCLUSION Continuum of care for maternal health service utilisation increases pastoralist women's intention to use family planning. Maximising any opportunity to counsel women who come to health facilities about family planning would be vital to increase their intention to use family planning. TRIAL REGISTRATION NUMBER NCT03450564.
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Affiliation(s)
- Mussie Alemayehu
- Department of Public Health, College of Health Sciences, Mekelle, Ethiopia
| | | | - Elizabeth Reed
- Department of Public Health, San Diego State University, San Diego, California, USA
| | | | - Mebrhatu Kalayu
- Department of Public Health, College of Health Sciences, Mekelle, Ethiopia
| | - Afework Mulugeta
- Department of Public Health, College of Health Sciences, Mekelle, Ethiopia
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Solanke BL, Oyediran OO, Awoleye AF, Olagunju OE. Do health service contacts with community health workers influence the intention to use modern contraceptives among non-users in rural communities? Findings from a cross-sectional study in Nigeria. BMC Health Serv Res 2023; 23:24. [PMID: 36627614 PMCID: PMC9832820 DOI: 10.1186/s12913-023-09032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Studies in many developing countries have shown that community health workers (CHWs) are valuable for boosting contraceptive knowledge and usage. However, in spite of the evidence, studies in Nigeria have rarely examined whether in the absence of skilled health personnel such as doctors and nurses in rural and remote communities, the health service contacts of non-users with CHWs drive the intention to use modern contraceptives. This study, therefore, examines the extent to which health service contacts with CHWs are associated with the intention to use modern contraceptives among non-users in rural communities of Nigeria. METHODS This study adopted a descriptive cross-sectional design. Data were extracted from the most recent Nigeria Demographic and Health Survey (NDHS). The study analyzed a weighted sample of 12,140 rural women. The outcome variable was the intention to use modern contraceptives. The main explanatory variable was health service contacts with CHWs. Statistical analyses were performed at three levels with the aid of Stata version 14. Three multivariable regression models were estimated using an adjusted Odds Ratio (aOR) with a 95% confidence interval. Statistical significance was set at p < 0.05. RESULTS Findings showed that more than a quarter (29.0%) of women intends to use modern contraceptives. Less than one-fifth (15.9%) of the women had health service contacts with CHWs. In Model 1, women who had health service contacts with CHWs were more likely to intend to use modern contraceptives (aOR =1.430, 95% CI: 1.212-1.687). Likewise, in Model 2, women who had health service contacts with CHWs had a higher likelihood of intending to use modern contraceptives (aOR = 1.358, 95% CI: 1.153-1.599). In Model 3, the odds of intention to use modern contraceptives were higher among women who had health service contacts with CHWs (aOR =1.454, 95% CI: 1.240-1.706). CONCLUSION In rural areas of Nigeria, health service contacts with CHWs are significantly associated with the intention to use modern contraceptives. Family planning programmers should leverage the patronage of CHWs for the purpose of family planning demand generation in rural areas.
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Affiliation(s)
- Bola Lukman Solanke
- grid.10824.3f0000 0001 2183 9444Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olufemi O. Oyediran
- grid.10824.3f0000 0001 2183 9444Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Abayomi Folorunso Awoleye
- grid.10824.3f0000 0001 2183 9444Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
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Alawode OA, Okeke SR, Sah RK, Bolarinwa OA. Prevalence and determinants of intention to use modern contraceptives among grand-multiparous women in sub-Saharan Africa. Arch Public Health 2022; 80:246. [PMID: 36463217 PMCID: PMC9719656 DOI: 10.1186/s13690-022-01006-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa, characterised by high fertility and low contraceptive use prevalence, remains one of the settings with the poorest maternal and child health indices globally. Studies have established that grand-multiparous women are at increased risk of these adverse maternal health outcomes, and contraceptive use is important to averting these adverse outcomes. Thus, this study examines the prevalence and determinants of intention to use modern contraceptives among grand-multiparous women in 10 sub-Saharan African countries with high fertility rates. MATERIALS AND METHODS The study utilized data from the last installments of the Demographic and Health Survey from the 10 leading countries with the highest total fertility rates in sub-Saharan Africa. These countries include: Angola, Benin, Burundi, Chad, Cote d'Ivoire, the Republic of the Congo, Democratic Republic of Congo, Mali, Niger, and Nigeria. Data analysis of 23,500 grand-multiparous women was done at three univariate levels involving a frequency table and bar chart. We employed bivariate logit and multivariate logit regression at the bivariate and multivariate levels to achieve the study objectives. A significant level was determined at p < 0.05. RESULTS Our study found that less than 40% of grand-multiparous women in these high fertility countries in sub-Saharan Africa, have the intention to use modern contraceptives (39%), but country variations exist with as low as 32.8% in Angola to as high as 71.2% in the Republic of the Congo. The study found that modern contraceptives use intention among grand-multiparous women in these high fertility countries was predicted by a history of contraceptive use and pregnancy termination, exposure to family planning messages on social media, and knowledge of family planning methods. Others were women's fertility planning status, ideal family size, number of marriages (remarriage), couple's fertility desire, current age, and level of education. CONCLUSION In the high fertility context of sub-Saharan Africa, characterized by low contraceptive use, improving contraceptive use intention among grand-multiparous women is vital for preventing adverse maternal and child health outcomes, including mortality, resulting from a high-risk pregnancy. Hence, interventions should be more innovative in targeting this group of women to increase the contraceptive prevalence rate in line with Family Planning 2030 goals, and ultimately reduce high fertility rates in the region.
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Affiliation(s)
- Oluwatobi Abel Alawode
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL 32611 USA
| | | | - Rajeeb Kumar Sah
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH UK
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Global Public Health, School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU UK
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Okunlola DA. Women’s and male partners’ socio-demographic and economic characteristics associated with contraceptive decision making in Nigeria. BMC Womens Health 2022; 22:450. [DOI: 10.1186/s12905-022-02045-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Women’s ability to make contraceptive decision can determine their contraceptive use which can improve their reproductive health and career. Improvement in such ability can increase contraceptive prevalence in Nigeria. However, factors that promote contraceptive decision-making among women are scarcely studied. This study examined factors associated with women’s individual or joint contraceptive decision-making in Nigeria.
Methods
Secondary (cross-sectional) data were analysed. The data were extracted from the individual recode file of the 2018 Nigeria Demographic and Health Survey (DHS). Partnered women (i.e., currently married or living with a partner) aged 15–49 years and currently using contraceptives before the survey were considered. They constituted 4,823 in total. Their data were analysed using frequency and percentage distributions of variables, Chi-square tests of independence and multinominal logistic regression.
Results
Findings reveal that 23% (1,125) of women made their own contraceptive decision, nearly 67% (3,213) were joint decision makers, and 10% (491) stated that their male partners had decided for them. The probability of solely making contraceptive decision and being a joint decision maker (relative to being a male partner’s decision) was higher among women above 29 years and aged 30–34 years (than women aged 15–24 years) respectively as well as among the employed (than the unemployed) and among those from Yoruba ethnic group (than their counterparts from Hausa/Fulani/Kanuri/Beri Beri) respectively. The probability of being responsible for contraceptive decision (than being the male partner’s decision) was higher among women from the Igbo group and women whose male partners desired more children (than those with the same number of desired children) respectively. The probability of being the main decision maker (relative to being the male partner) was lower among women in the poorer (RRR = 0.39; 95%CI = 0.21–0.73; p = 0.01), middle (RRR = 0.47; 95%CI = 0.25–0.90; p = 0.02) and richest (RRR = 0.41; 95%CI = 0.20–0.82; p = 0.01) groups respectively, than the poorest women. The probability of being a joint decision maker was higher among women with secondary education (than the uneducated), practised Christianity (than the Muslims/ others), and among those residing in the North West region (than those in North East) respectively. However, the probability of being a joint decision-maker was lower among women whose partners desire more children and those who did not know their partners’ desires.
Conclusions
Women’s age, highest level of education, employment status, wealth index, ethnicity, religion, region of residence and male partners’ desire for children are associated with contraceptive decision making respectively. There is a need for reproductive empowerment interventions in Nigeria that devise effective ways of improving contraceptive decision-making power of partnered women aged 15–24 years, unemployed, in the poorer and richest groups, from the Hausa/Fulani/Kanuri/Beri Beri ethnic group, practising Islam/ other religions, have the same fertility desire as their partners and those who do not know their male partner’s desire for children respectively. Women whose partners desire more children should be empowered to participate effectively in contraceptive decision making.
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Laksono AD, Rohmah N, Megatsari H. Barriers for multiparous women to using long-term contraceptive methods in Southeast Asia: case study in Philippines and Indonesia. BMC Public Health 2022; 22:1425. [PMID: 35883076 PMCID: PMC9327156 DOI: 10.1186/s12889-022-13844-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Multiparous women are supposed to be able to end their reproductive cycle to decrease population growth. This study aimed to analyze barriers for multiparous women to use long-term contraceptive methods (LTCM) in the Philippines and Indonesia. Methods The study population was women aged 15–49 years old who have given birth to a live baby > 1 in the Philippines and Indonesia. The weighted sample size was 12,085 Philippines women and 25,543 Indonesian women. To identify variables associated with the use of LTCM, we analyzed place of residence, age group, education level, marital status, employment status, and wealth status. The final step employed multinomial logistic regression. Results In both countries, the results showed that variables associated with non-user LTCM were younger women, living in rural areas with poor education. Women without partner and unemployed had higher probability to not use LTCM. Finally, low wealth status had a higher probability than the richest multiparous to not use LTCM. Conclusion The study concluded that there were six barriers for multiparous women to use LTCM in the Philippines and Indonesia. The six obstacles were living in rural areas, being younger, poor education, single, unemployed, and low wealth.
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Affiliation(s)
- Agung Dwi Laksono
- National Research and Innovation Agency, The Republic of Indonesia, Jakarta, Indonesia
| | - Nikmatur Rohmah
- Faculty of Health Science, Muhammadiyah University of Jember, East Java, Indonesia
| | - Hario Megatsari
- Faculty of Public Health, University of Airlangga, Surabaya, Indonesia.
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Boydell V, Galavotti C. Getting Intentional about Intention to Use: A Scoping Review of Person-Centered Measures of Demand. Stud Fam Plann 2022; 53:61-132. [PMID: 35119110 PMCID: PMC9303959 DOI: 10.1111/sifp.12182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In recent years, there has been much reflection on the measures used to assess and monitor contraceptive programming outcomes. The meaning and measurement of intention‐to‐use (ITU) contraception, however, has had less attention and research despite its widespread inclusion in many major surveys. This paper takes a deeper look at the meaning and measurement of ITU around contraception. We conducted a scoping review guided by the following questions: What is the existing evidence regarding the measurement of ITU contraception? What definitions and measures are used? What do we know about the validity of these measures? We searched databases and found 112 papers to include in our review and combined this with a review of the survey instruments and behavioral theory. Our review found growing evidence around the construct of ITU in family planning programming and research. However there are inconsistencies in how ITU is defined and measured, and this tends not to be informed by advances in behavioral theory and research. Further work is needed to develop and test measures that capture the complexity of intention, examine how intention differently relates to longer‐range goals compared to more immediate implementation, and demonstrate a positive relationship between ITU and contraceptive use.
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Affiliation(s)
- Victoria Boydell
- School of Health and Social Care, University of Essex, Colchester, UK
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Owuor HO. Comparison of postpartum family planning uptake between primiparous and multiparous women in Webuye County Hospital, Kenya. S Afr Fam Pract (2004) 2020; 62:e1-e5. [PMID: 32787387 PMCID: PMC8378052 DOI: 10.4102/safp.v62i1.5093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/22/2020] [Accepted: 04/08/2020] [Indexed: 11/01/2022] Open
Affiliation(s)
- Henry O Owuor
- Department of Family Medicine, School of Medicine, Moi University, Eldoret.
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Shaweno T, Kura Z. Determinants of modern contraceptive use among sexually active men in Ethiopia; using EDHS 2016 national survey. Contracept Reprod Med 2020; 5:5. [PMID: 32391168 PMCID: PMC7201961 DOI: 10.1186/s40834-020-00108-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 04/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recently, the focus of family planning programs has changed from female oriented to men oriented, or both partner oriented to have effective outcomes. Although, contraceptive use among sexually active women was exhaustively researched; there is still a huge gap on modern contraceptive use and its determinants among sexually active men in Ethiopia. OBJECTIVES We assessed the determinants of contraceptive use among sexually active men in Ethiopia using national survey data. METHOD The data source for this study was the 2016's Ethiopian Demographic and Health Survey of men aged above 15-59 years. We analyzed data of 12, 688 sexually active men in the past 12 months prior to the survey using STATA version 14.1. Bivariate and multivariable multinomial logistic regression analysis was conducted and statistical significance was set at p value < 0.05. RESULT From a total of 12, 688 sexually active men in Ethiopia, 9378 (73.9%) didn't use any modern contraception or use traditional methods, 2394 (18.9%) use partner methods for those who reported using a method through their partner (such as pill, IUD, injections, female sterilization and Norplant) and the rest 916 (7.2%) used male methods for those who reported using male only methods (such as condoms and male sterilization). In the adjusted multinomial logistic regression model, men's age categories 25-34 years (AOR:2.0; 95%CI = 1.5-2.5), 35-44 (AOR: 2.8; 95%CI = (2.0-3.8), and 45+ years (AOR: 1.5; 95%CI = 1.0-2.6), being rural resident (AOR: 1.60; (95%CI = 1.3-2.2), married and living with partner (AOR: 0.03; (95%CI = 0.01-0.06), who attended secondary (AOR:1.2; (95%CI = 0.8-1.9) and higher (AOR: 1.4; (95%CI = 1.2-2.5) education, whose partner was working (AOR: 1.6; (95%CI = 1.3-2.2), having three and above children (AOR: 0.5; (95%CI = 0.3-0.8), reading newspaper/magazines at least once a week or less than once a week, listening to radio at least once a week, watching television at least once a week and watching television less than once a week were significantly associated with use of male method than traditional/no method as compared to their respective references. CONCLUSION Modern contraceptive use among sexually active men in Ethiopia is low and multiple factors determined it. Close monitoring and supporting of sexually active men with age above 25 years, rural background, higher educational level, whose partner was working, having three and more children and little exposure to media may increase men's use of modern contraceptives.
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Affiliation(s)
- Tamrat Shaweno
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Zerihun Kura
- Biostatistics Unit, Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Quality of life and the related factors in early postnatal women in Malawi. Midwifery 2020; 85:102700. [PMID: 32179390 DOI: 10.1016/j.midw.2020.102700] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the quality of life (QOL) and related factors in early postnatal women. DESIGN A descriptive, cross-sectional study. SETTING Liwonde, Malawi. PARTICIPANTS Women who underwent a normal vaginal birth (N = 173) were included from August to September 2018. MEASUREMENTS The QOL of participants was assessed using a World Health Organization QOL instrument. Demographic, obstetric, and health variables were collected using a structured questionnaire. Childbirth fear and depression were respectively assessed using the Wijma Delivery Experience Questionnaire and the Edinburgh Postnatal Depression Scale. A multiple linear regression was used to examine factors associated with the QOL. RESULTS The mean age of participants was 29 (standard deviation 6.7) years. The overall QOL and health were satisfactory. The mean score of the QOL was highest in the psychological health and social relationships domains, followed by the environmental and physical health domains. A higher educational level was negatively related to the physical health of QOL (p ≤ 0.01), with physician care positively related (p = 0.01). The employment status was positively related to psychological health and the environmental QOL (p ≤ 0.01). Furthermore, a higher income, and physician care were positively related to the environmental QOL (p ≤ 0.05). High levels of childbirth fear and depressive symptoms were negatively related to all domains of the QOL (p ≤ 0.05), except for the social relationships domain. CONCLUSION AND IMPLICATIONS FOR PRACTICE The physical health QOL was lower in postnatal mothers in Malawi. Measures to improve physical health aspects and address women's fears and depressive symptoms during postpartum care are warranted. The findings should alert the health providers of the importance of assessing and improving women's physical health and psychological well-being during postpartum care.
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