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Lahole BK, Banga D, Mare KU. Modern contraceptive utilization among women of reproductive age in Ghana: a multilevel mixed-effect logistic regression model. Contracept Reprod Med 2024; 9:46. [PMID: 39334465 PMCID: PMC11438017 DOI: 10.1186/s40834-024-00310-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: 06/12/2024] [Accepted: 09/21/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Worldwide, sexual and reproductive health remains a prominent public health concern for women of reproductive age. Modern contraceptive methods play a crucial role in enabling individuals and families to regulate fertility, thereby reducing unintended pregnancies, abortions, pregnancy-related complications, and mortality. Due to the scarcity of reliable and current data regarding the factors affecting the adoption of modern contraceptives among women of reproductive age at the national level in Ghana, this research aimed to explore the determinants of modern contraceptive usage among reproductive age women. METHODS The study analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 6,839 reproductive-age women. By employing a multilevel logistic regression model, the study sought to determine factors associated with the utilization of modern contraceptives. Associations between explanatory variables and the outcome were evaluated using adjusted odds ratios (AORs) along with 95% confidence intervals (CIs). Statistical significance was established using a p-value threshold of less than 0.05. All statistical analyses were conducted using STATA version 17 software. RESULTS The study found that 26.36% (95% CI: 25.33-27.34%) of women of reproductive age in Ghana used modern contraceptives. Secondary education (AOR = 1.26, 95% CI = 1.03-1.53), poorer household (AOR = 1.30, 95% CI = 1.05-1.61), women's marital status, i.e. married (AOR = 1.46, 95% CI = 1.16-1.83), living with a partner (AOR = 1.65, 95% CI = 1.32-2.06), divorced (AOR = 2.53, 95% CI = 1.48-4.31), and separated (AOR = 1.70, 95% CI = 1.21-2.37), multipara (AOR = 1.39, 95% CI = 1.04-1.87), were the factors that promote modern contraceptive utilization. Women's age in years, i.e. 35-39 (AOR = 0.71, 95% CI = 0.52-0.97), 40-44 (AOR = 0.63, 95% CI = 0.44-0.90), and 45-49 (AOR = 0.45, 95% CI = 0.25-0.79), history of pregnancy loss (AOR = 0.86, 95% CI = 0.76-0.98), region, i.e. Greater Accra (95% CI = 0.42-0.92), Bono East (95% CI = 0.32-0.81), Northern (95% CI = 0.28-0.67), Savannah (95% CI = 0.28-0.81), and North East (95% CI = 0.20-0.63), were all associated with a lower use of modern contraceptives. CONCLUSIONS Modern contraceptive utilization was low in this study. Factors such as women's education, socioeconomic status, and marital status were associated with increased modern contraceptive utilization, whereas women's age and regional disparities were linked to lower usage rates. These findings emphasize the need for targeted interventions to address socioeconomic barriers and regional disparities in access to family planning services across Ghana.
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Affiliation(s)
- Begetayinoral Kussia Lahole
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Debora Banga
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Bolarinwa OA. Inequality gaps in modern contraceptive use and associated factors among women of reproductive age in Nigeria between 2003 and 2018. BMC Womens Health 2024; 24:317. [PMID: 38824536 PMCID: PMC11143664 DOI: 10.1186/s12905-024-03167-z] [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: 05/22/2023] [Accepted: 05/28/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Inequalities in modern contraceptive use among women in low-income countries remain a major public health challenge. Eliminating or reducing the inequalities in modern contraceptive use among women could accelerate the achievement of Sustainable Development Goals, Targets 3.7 & 5.6. Thus, this study examined the inequality gaps in modern contraceptive use and associated factors among women of reproductive age in Nigeria between 2003 and 2018. METHODS This study employed the World Health Organisation's Health Equity Assessment Toolkit to analyse the 2003 and 2018 Nigeria Demographic Health Surveys. Modern contraceptive use was aggregated using five equity stratifiers: age, economic status, educational level, place, and region of residence among women of reproductive aged 15 to 49, with a sample size of 5,336 and 29,090 for 2003 and 2018, respectively. Inequality was measured in this study using difference (D), ratio (R), population-attributable risk (PAR), and a population-attributable fraction (PAF). RESULTS The study shows an increase in modern contraceptive use among women of reproductive age in Nigeria from 8.25% in 2003 to 12.01% in 2018, with the use being more prominent among women of reproductive age 20-49 and those in the richest economic quintile. In both surveys, women with primary education showed the most upward increase in modern contraceptive use. Women residing in the urban areas also show an upward use of modern contraceptives use. The study further highlights inequality gaps, with age being a substantial factor, while economic status and sub-national regions showed mild to marginal inequality gaps. Finally, the educational level of women of reproductive age in Nigeria significantly shows inequality in modern contraceptive use, with a PAF of 129.11 in 2003 and 65.39 in 2018. CONCLUSION The inequality gap in modern contraceptive use among women of reproductive age in Nigeria between 2003 and 2018 reported in this study includes age, education, wealth quintile, residence, and region-related inequalities. The study highlights the need for policies and programmes that target the groups with low use of modern contraceptives to promote equity in family planning services.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St John University, London, UK.
- Department of Demography and Population Studies, University of Witwatersrand, Johannesburg, South Africa.
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Demeke H, Legese N, Nigussie S. Modern contraceptive utilization and its associated factors in East Africa: Findings from multi-country demographic and health surveys. PLoS One 2024; 19:e0297018. [PMID: 38241359 PMCID: PMC10798634 DOI: 10.1371/journal.pone.0297018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/27/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The use of modern contraceptives has been low in most Sub-Saharan African countries despite high population growth and a sluggish economy. This study aimed to identify the prevalence and determinants of modern contraceptive use among married reproductive-age women in East Africa. METHODS For this study, the Demographic and health survey (DHS) data from nine countries in East Africa were analyzed, yielding a weighted sample of 32,925 married women. A multilevel mixed-effect logistic regression model was used to identify characteristics associated with the utilization of modern contraceptives at a p-value less than 0.05. For model comparison, we used the Akaike and Bayesian Information Criteria (AIC and BIC). For assessing variation (random effects), we used community-level variance with standard deviation and intra-cluster correlation coefficient (ICC). RESULTS The overall prevalence of modern contraceptive use was 45.68%, 95% CI (45.15, 46.21). Women's age, maternal education level, husband education level, media exposure, wealth status, occupation, religion, the total number of children ever born, distance to health facilities, history of termination of pregnancy, couple's desire for children, women's participation in decision making, living country and place of residence were significantly associated with modern contraceptive use in Eastern Africa. CONCLUSIONS Conferring to this study, utilization of modern contraceptives is low in East Africa. Interventions to improve the use of modern contraceptives should encompass disseminating awareness through mass media, enrolment of males in family planning, giving maternal education, building health facilities in remote areas, and encouraging family planning programs in rural areas.
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Affiliation(s)
- Henok Demeke
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Nanati Legese
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Shambel Nigussie
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
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Compton S, Nakua E, Moyer C, Dzomeku V, Treleaven E, Otupiri E, Lori J. Contraceptive use by number of living children in Ghana: Evidence from the 2017 maternal health survey. PLoS One 2023; 18:e0295815. [PMID: 38096259 PMCID: PMC10721096 DOI: 10.1371/journal.pone.0295815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND There is a significant literature describing the link between parity and contraceptive use. However, there is limited knowledge about the disaggregation by parity of the type of contraceptives. In this study, we describe the use of contraceptives by parity among women of reproductive age in Ghana, focusing on use of highly effective methods (injection, pill, intrauterine device, implant, and sterilization). METHODS Using the 2017 Ghana Maternal Health Survey, a nationally-representative cross-sectional household survey, we describe contraceptive method use by number of living children among sexually active women of reproductive age. We then estimated predictors of use of highly effective contraception in a multilevel logistic regression model. RESULTS Most women in this survey are not using any method of contraception, although this varies by whether or not they have begun childbearing. Contraceptive method use varies by number of living children. Before having children, natural (periodic abstinence and withdrawal) and episodic (condoms) methods dominate. Once a woman has one living child, method preference changes to injectables and implants. Factors associated with using a highly effective method of contraception are: having >3 children, being in a relationship, having had an abortion, being younger than age 30, and having had sexual intercourse within days of answering the survey (p < .001 for all). CONCLUSION In this analysis, the number of living children a woman has, her age, and timing of last intercourse are the most significant predictors of using a highly effective method of contraception. However, the majority of participants in this study report not using any method of contraception to avoid unwanted pregnancies. Future research that attempts to unpack the disconnect between not wanting to become pregnant and not using contraception is warranted.
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Affiliation(s)
- Sarah Compton
- Department of Obstetrics and Gynecology, Program on Women’s Healthcare Effectiveness Research, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Emmanuel Nakua
- Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Cheryl Moyer
- Department of Learning Health Sciences and Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Veronica Dzomeku
- Department of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emily Treleaven
- Institute for Social Research, Survey Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Easmon Otupiri
- Department of Population, Family, and Reproductive Health, Kwame Nkrumah University for Science and Technology, Kumasi, Ghana
| | - Jody Lori
- Global Affairs and Community Engagement, School of Nursing, University of Michigan, Ann Arbor, Michigan, United States of America
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Kebede N, Kefale B, Yigezu M, Bogale EK, Zewdie A, Wasihun Y, Adane M. Individual and community level factors associated with modern contraceptive utilization among married women in the emerging region of Ethiopia: a multilevel mixed effects analysis of the 2019 Ethiopia Mini-Demographic and health survey. BMC Womens Health 2023; 23:652. [PMID: 38062400 PMCID: PMC10704797 DOI: 10.1186/s12905-023-02822-1] [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: 04/24/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND A demonstrated technique to enhance reproductive health and economic progress is through ensuring that family planning services are accessible universally. Those studies that used Ethiopia Demographic and Health Survey (EDHS) data did not assess individual and community-level factors in contraceptive utilization. Thus, the study employs a multilevel mixed effects analysis approach, which allows for the examination of individual and community-level factors that influence contraceptive utilization. METHODS This study analyzed the 2019 Ethiopia Min Demographic and Health Survey datasets. A total of 1916 married women in the 2019 surveys were included in the analysis. The data were analyzed using Stata version 17.0. The data were analyzed using Multi-level mixed-effect logistic regression to identify the individual and community-level factors associated with modern contraceptive utilization. An adjusted odds ratio with a 95% confidence interval was used to. Show the strength and direction of the association and statistical significance was declared at a P value less than 0.05. RESULTS Factors significantly associated with modern contraceptive utilization were; Muslim and protestant followers [AOR = 0.31, 95% CI: (0.134, 0.714)] and [AOR = 0.35, 95% CI: (0.173, 0.691)] respectively, women with no education (OR = 0.46; 95% CI: 0.293, 0.710), those women who belong to the poor and middle wealth of household [AOR = 0.35, 95% CI: (0.237, 0.527)] and [AOR = 0.56, 95% CI: (0.347, 0.919)] respectively, women who had one to five and greater than or equal to six living children [AOR = 11.36, 95% CI:(2.119, 60.918)] and [AOR = 7.44, 95% CI:(1.437, 38.547)]respectively, Women in clusters poor wealth status [AOR = 0.40, 95% CI: (0.183, 0.875)] and women who belong to the Somali region [AOR = 0.20, 95% CI: (0.0.070, 0.506)]. CONCLUSION The study revealed that both individual and community-level factors determined modern contraceptive utilization. At the individual level, the religion of women, educational status, the wealth of the household, and the total number of living children were significantly associated with modern contraceptive utilization. At community-level factors, community wealth status and belonging to the Somali region were significantly associated with modern contraceptive utilization. The findings suggest that interventions aimed at increasing modern contraceptive utilization should target women with lower levels of education, those living in households with lower wealth, and those with larger families. Additionally, efforts should be made to improve access to modern contraceptives in communities with lower wealth status and in regions where traditional beliefs may hinder their use.
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Affiliation(s)
- Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Muluken Yigezu
- Department of Public Health College of Medicine & Health Science, Dire Dawa, Dire Dawa University, Dire Dawa, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion, College of Medicine Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite 07, Ethiopia
| | - Yitbarek Wasihun
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Segbefia C, Campbell J, Tartaglione I, Asare EV, Andemariam B, Zempsky W, Colombatti R, Boatemaa GD, Boruchov D, Rao S, Piccone CM, Smith A, Haile H, Kim E, Wilson S, Farooq F, Urbonya R, Rivers A, Manwani D, Gai J, Sey F, Inusa B, Antwi-Boasiako C, Strunk C, Campbell AD. Pain Frequency and Health Care Utilization Patterns in Women with Sickle Cell Disease Experiencing Menstruation-Associated Pain Crises. J Womens Health (Larchmt) 2023; 32:1284-1291. [PMID: 38011013 PMCID: PMC10712351 DOI: 10.1089/jwh.2023.0023] [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] [Indexed: 11/29/2023] Open
Abstract
Background: Pain crises in sickle cell disease (SCD) lead to high rates of health care utilization. Historically, women have reported higher pain burdens than men, with recent studies showing a temporal association between pain crisis and menstruation. However, health care utilization patterns of SCD women with menstruation-associated pain crises have not been reported. We studied the frequency, severity, and health care utilization of menstruation-associated pain crises in SCD women. Materials and Methods: A multinational, cross-sectional cohort study of the SCD phenotype was executed using a validated questionnaire and medical chart review from the Consortium for the Advancement of Sickle Cell Research (CASiRe) cohort. Total number of pain crises, emergency room/day hospital visits, and hospitalizations were collected from a subcohort of 178 SCD women within the past 6 months and previous year. Results: Thirty-nine percent of women reported menstruation-associated pain crises in their lifetime. These women were significantly more likely to be hospitalized compared with those who did not (mean 1.70 vs. 0.67, p = 0.0005). Women reporting menstruation-associated pain crises in the past 6 months also experienced increased hospitalizations compared with those who did not (mean 1.71 vs. 0.75, p = 0.0016). Forty percent of women reported at least four menstruation-associated pain crises in the past 6 months. Conclusions: Nearly 40% of SCD women have menstruation-associated pain crises. Menstruation-associated pain crises are associated with high pain burden and increased rates of hospitalization. Strategies are needed to address health care disparities within gynecologic care in SCD.
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Affiliation(s)
- Catherine Segbefia
- Department of Child Health, University of Ghana Medical School, Accra, Ghana
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Jillian Campbell
- Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA
| | - Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | | | - Biree Andemariam
- Division of Hematology-Oncology, New England Sickle Cell Institute, Neag Comprehensive Cancer Center, University of Connecticut, Farmington, Connecticut, USA
| | - William Zempsky
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Raffaella Colombatti
- Department of Women's and Child Health, Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Gifty Dankwah Boatemaa
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Donna Boruchov
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Sudha Rao
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Connie M. Piccone
- Department of Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Ashya Smith
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Haikel Haile
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Esther Kim
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Samuel Wilson
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Angela Rivers
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Jiaxiang Gai
- Division of Biostatistics and Study Methodology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Baba Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, College of Nursing, London, United Kingdom
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
- College of Health Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Crawford Strunk
- Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Andrew D. Campbell
- Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
- Division of Hematology, Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Nimani TD, Tadese ZB, Tadese EE, Butta FW. Trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women, based on the 2000, 2005, 2011, and 2016 Ethiopian demographic and health survey. BMC Womens Health 2023; 23:629. [PMID: 38012691 PMCID: PMC10683082 DOI: 10.1186/s12905-023-02789-z] [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: 05/19/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The most common family planning method is modern contraception. It is a cost-effective way to reduce maternal and neonatal morbidity and mortality and enable women to make informed choices about their reproductive and sexual health. The trend of modern contraceptive utilization has shown drastic change in Ethiopia, and identifying the major factors contributing to such a drastic change is vital to improving plans and strategies for family planning programs. Therefore, this study analyzed the trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women in Ethiopia. METHOD This study used secondary data from the EDHS 2000-2016, collected from a population-based cross-sectional study by the Central Statistical Agency, focusing on married reproductive-age women aged 15-49. The study analyzed the modern contraceptive use trends through descriptive analyses conducted in three phases: 2000-2005, 2005-2011, and 2011-2016. The study utilized bivariable and multivariable logistic regression analyses to identify determinant factors, with significant variables declared using a P-value of 0.05 and an adjusted OR with 95% confidence interval. Analysis was conducted using STATA.14 and R. Spatial analysis was done using ArcGIS version 10.8 and SatScan™ version 9.6. RESULT A weighted total of 33,478 women are included in the study, with a mean age of 31.4 years (8.6 SD). There was a significant increase in the trend of modern contraceptive use among married women over the study period, from 2000 to 2016, from 7.2% to 2000 to 15.7% in 2005, to 30% in 2011, and to 39.5% in 2016. The maximum increase was seen in the second phase (2005-2011), with a 14.3% increase. Factors like age of respondents, educational status, religion, residence, region, wealth index, number of living children, husbands' desire to have more children, and media exposure were found to be predictors for modern contraceptive utilization. CONCLUSION The prevalence of modern contraceptive use is below 50%, and there is also evidence of wide geographical variation in modern contraceptive use in Ethiopia. Thus, policymakers, high institutions, and other stakeholders must work collaboratively with the government in order to improve awareness about modern contraceptive use.
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Affiliation(s)
- Teshome Demis Nimani
- Department of epidemiology and biostatistics, School of Public Health College of medicine and Health Science, Haramaya University, Harar, Ethiopia.
| | - Zinabu Bekele Tadese
- Department of Health Informatics, School of Public Health, College of Medicine and Health Science, Samara University, Samara, Ethiopia
| | - Eyob Eshete Tadese
- Department of nursing, College of medicine and Health Science, Mettu University, Mettu, Ethiopia
| | - Fikadu Wake Butta
- Department of Health Informatics, School of Public Health College of medicine and Health Science, Mettu University, Mettu, Ethiopia
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Bibi F, Saleem S, Tikmani SS, Rozi S. Factors associated with continuation of hormonal contraceptives among married women of reproductive age in Gilgit, Pakistan: a community-based case-control study. BMJ Open 2023; 13:e075490. [PMID: 37996239 PMCID: PMC10668236 DOI: 10.1136/bmjopen-2023-075490] [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: 05/10/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE This study aimed to determine the factors associated with continuation of hormonal contraceptive methods among married women of Gilgit, Pakistan at least 6 months after their initiation. DESIGN Unmatched case-control study. SETTING Community settings of Gilgit, Pakistan from 1 April 2021 to 30 July 2021. PARTICIPANTS The cases were married women of reproductive age who, at the time of interview, were using a hormonal method of contraception for at least 6 months continuously, and controls were married women of reproductive age who had used a hormonal method in the past and currently were using a non-hormonal method for at least 6 months. PRIMARY AND SECONDARY OUTCOME MEASURES OR for continuation of hormonal contraceptive. RESULTS The factors significantly associated with continuous use of hormonal contraceptive methods for our sample from Gilgit were the family planning centre's distance from home (adjusted OR (AOR) 6.33, 95% CI 3.74 to 10.71), satisfaction with current method used (AOR 3.64, 95% CI 2.06 to 6.44), visits to the family planning centre to avail services (AOR 1.86, 95% CI 1.07 to 3.45) and relatively older age of women (AOR 1.07, 95% CI 1.02 to 1.12). In addition, women with formal education (AOR 0.27, 95% CI 0.12 to 0.6) were less likely to use a modern contraceptive method. CONCLUSION Continuation of using a hormonal method was associated with easy access to family planning centres, satisfaction with the current method and frequent visits to the family planning centres. Continuation of using a hormonal method was also seen in women with low education status. The importance of the presence of family planning centres near residential areas cannot be emphasised more. This does not only provide easy access to family planning methods, but also reassure women of continuation of modern methods when they face any unpleasant effects while using these.
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Affiliation(s)
- Fazila Bibi
- Center of Excellence for Trauma and Emergencies, Aga Khan University, Karachi, Pakistan
| | - Sarah Saleem
- Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Shiyam S Tikmani
- Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Shafquat Rozi
- Community Health Sciences, Aga Khan University, Karachi, Pakistan
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Tampah-Naah AM, Yendaw E, Sumankuuro J. Residential status and household wealth disparities in modern contraceptives use among women in Ghana: a cross-sectional analysis. BMC Womens Health 2023; 23:550. [PMID: 37875940 PMCID: PMC10594689 DOI: 10.1186/s12905-023-02684-7] [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: 11/25/2022] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Modern contraceptive refers to "a product or medical procedure that interferes with reproduction from acts of sexual intercourse". The aim of this study was to assess the relationship between residential status and wealth quintile, and modern contraceptive use among women in Ghana. METHODS We examined residential status and wealth quintile on contraceptive use analysing the 2006, 2011 and 2018 Multiple Indicator Cluster Surveys datasets. A sample of 30,665 women in their reproductive ages (15-49 years) were enrolled in the surveys across Ghana. STATA version 13 was used to process and analyse the data. It examined socioeconomic and demographic characteristics, assessed modern contraceptive use prevalence among women, and used logistic regression models to determine predictors. The results were presented in odds ratio and adjusted odds ratio with 95% confidence intervals. All statistical tests were measured with p < 0.05. RESULTS In the three survey years, the highest prevalence of modern contraceptive usage was observed in 2011 (27.16%). The odds of using modern contraceptive increased by 19% in rural places (AOR = 1.19; 95% CI = 1.097-1.284) compared to urban places. The likelihood of women in second (AOR = 1.17; 95% CI = 1.065-1.289), middle (AOR = 1.24; 95% CI = 1.118-1.385), and fourth (AOR = 1.25; 95% CI = 1.113-1.403) wealth quintile using contraceptives increased compared to those of low wealth quintile. With the interactive terms, rural-second (AOR = 1.38; 95% CI = 1.042-1.830), rural-middle (AOR = 1.45; 95% CI = 1.084-1.933), rural-fourth (AOR = 1.52; 95% CI = 1.128-2.059), and rural-high (AOR = 1.42; 95% CI = 1.019-1.973) were more likely to use contraceptives compared to urban-low women. Despite lower odds, women of the age groups 20-24 (AOR = 2.33; 95% CI = 2.054-2.637), cohabitaing (AOR = 1.07; 95% CI = 0.981-1.173), secondary or higher education (AOR = 1.55; 95% CI = 1.385-1.736), Central (AOR = 1.48; 95% CI = 1.296-1.682) and Eastern (AOR = 1.48; 95% CI = 1.289-1.695) regions significantly predicted modern contraceptive use. CONCLUSION Modern contraceptive use in Ghana is low. Women in rural-rich categories are more likely to use modern contraceptives. Background factors such as age, marital status, educational attainment, and previous child experiences predict modern contraceptive use. It is recommended for the intensification of contraceptive awareness and utilization for all reproductive age women, regardless of education, marriage, or wealth.
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Affiliation(s)
- Anthony Mwinilanaa Tampah-Naah
- Department of Geography, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Post Office Box WA64, Ghana.
| | - Elijah Yendaw
- Department of Governance and Development Management, Faculty of Public Policy and Governance, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
- Centre for Environment, Migration and International Relations, Simon Diedong Dombo, University of Business and Integrated Development Studies, Wa, Ghana
| | - Joshua Sumankuuro
- Department of Public Policy and Management, Faculty of Public Policy and Governance, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Allied Health, Exercise and Sports Sciences, Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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Negash BT, Chekol AT, Wale MA. Modern contraceptive method utilization and determinant factors among women in Ethiopia: Multinomial logistic regression mini- EDHS-2019 analysis. Contracept Reprod Med 2023; 8:40. [PMID: 37488640 PMCID: PMC10367398 DOI: 10.1186/s40834-023-00235-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
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.
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Affiliation(s)
- Berhan Tsegaye Negash
- Department of midwifery, College of medicine and Health sciences, Hawassa University, Hawassa city, Ethiopia.
| | - Aklile Tsega Chekol
- Department of Nursing, College of Medicine and Health sciences, Hawassa University, Hawassa city, Ethiopia
| | - Mastewal Aschale Wale
- Department of Nursing, College of Medicine and Health sciences, Hawassa University, Hawassa city, Ethiopia
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Gbagbo FY, Ameyaw EK. Stakeholders' perceptions of the trends in contraceptive prevalence rate and total fertility rate in Ghana. PLoS One 2023; 18:e0288924. [PMID: 37486905 PMCID: PMC10365302 DOI: 10.1371/journal.pone.0288924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Studies in Ghana have reported discrepancies between trends in Total Fertility Rate (TFR) and Contraceptive Prevalence Rate (CPR). Yet, there is limited empirical literature on stakeholders' perceptions on the trends in CPR and TFR in Ghana. We, therefore, examined the perceptions of key stakeholders about the documented trends in CPR and TFR in Ghana. METHODS We adopted an exploratory (qualitative) research design with a qualitative approach of data collection from stakeholders in Ghana, focusing on the trends of the TFR and CPR. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist provided additional guidance for reporting the study results. We employed the Theory of Planned Behavior (TPB) as a theoretical framework/construct to explain and predict individual changes in health behaviors resulting in trends in CPR and TFR from stakeholders' perspectives and analyzed the data using framework analysis approach. RESULTS Two main themes emerged from the data: contraceptive prevalence and total fertility ratio, with five sub-themes identified: barriers to contraception, motivations for contraception uptake, unmet need for family planning, induced abortion, and effectiveness of planning programs. Specifically, participants indicated that there is a discrepancy between the trends of CPR and TFR based on the Ghana Demographic and Health Survey, conducted between 1988 and 2014. The high unmet needs for contraceptives were attributed to CRP trends, whilst abstinence, infertility, and high demands for induced abortions were identified to impact the TFR trends significantly. CONCLUSION The findings show that an extensive quantitative enquiry into the exact relationships between Ghana's CPR and TFR as well as the contributions of abstinence, infertility, and induced abortion are worth considering.
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Affiliation(s)
- Fred Yao Gbagbo
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Lingnan, Hong Kong
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Rade BK, Tamiru AT, Aynalem GL, Taye EB, Melkie M, Abera A, Cherkos EA, Asaye MM. Prevalence and factors associated with sexual and reproductive health services use among reproductive age women with disabilities: a community based cross-sectional study. BMC Womens Health 2023; 23:215. [PMID: 37131161 PMCID: PMC10155295 DOI: 10.1186/s12905-023-02373-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND According to International Convention on the Right of Person with Disabilities (CRPD), all nations should discern Sexual and Reproductive Health (SRH) as human rights and needs of all people living with disabilities. Women and girls with disabilities are highly vulnerable to SRH disparities including unintended pregnancy, acquiring sexual transmitted infections and unsafe abortion. Little has known about SRH service uptake and influencing factors among reproductive aged women living with disabilities. METHODS A community-based cross-sectional study was conducted from January 1-30, 2021, the central Gondar zone selected districts. A total of 535 reproductive-age (18-49 years) women with disabilities had been interviewed through face-to-face using structured questionnaire. Multistage cluster sampling method was applied. A binary logistic regression model was computed to look the relationship between independent variables and uptake of SRH, and p-value < 0.05 was a cut-off point to declare statistical significance. RESULTS A total of 33.27% (178/535) women with disabilities used at least one SRH service in the last twelve months preceding the survey. Those who had three or more children [AOR = 4.85; 95% CI (1.24-9.71)], autonomy to visit health care facilities [AOR = 3.30; 95% CI (1.45-6.92)], lived with sexual partner [AOR = 9.2; 95% CI (2.84-13.60)], subjected to radio/television in daily bases [AOR = 5.9; 95% CI (1.26-13.04)], autonomy to visit friends and relatives [AOR = 3.95; 95% CI (1.28-12.17)], had a discussion with family members about sexual and reproductive health [AOR = 9.36; 95% CI (3.44-17.47)], and engaged in sexual activity after the age of 18 years [AOR = 7.2; 95% CI (2.51-14.45)] were important predictors for service uptake. CONCLUSIONS Only one in three reproductive age women with disabilities used at least one SRH service. These findings suggest that accessing information through mainstream media exposure, having full autonomous to visit friends and families, open discussion with family members, live with sexual partner, having optimal family size and starting sexual act at the recommended age improve the uptake of SRH services. Therefore, the stakeholders (both governmental and non-governmental) need to make efforts to increase the uptake of SRH services.
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Affiliation(s)
- Bayew Kelkay Rade
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
| | - Animut Tagele Tamiru
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Getie Lake Aynalem
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Eden Bishaw Taye
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkie
- Department of Special Need, College of Social Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Endeshaw Admassu Cherkos
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Mengstu Melkamu Asaye
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Mensah F, Okyere J, Azure SA, Budu E, Ameyaw EK, Seidu AA, Ahinkorah BO. Age, geographical and socio-economic related inequalities in contraceptive prevalence: evidence from the 1993-2014 Ghana Demographic and Health Surveys. Contracept Reprod Med 2023; 8:20. [PMID: 36750918 PMCID: PMC9903545 DOI: 10.1186/s40834-022-00194-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/18/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Contraceptives afford individuals the opportunity to meet their reproductive needs and reduce maternal mortality. We aimed at assessing the trend and inequalities of contraceptive use in Ghana based on the 1993-2014 Ghana Demographic and Health Surveys. METHODS We used the World Health Organization's Health Equity Assessment Toolkit (HEAT) software in analysing the data. We adopted two approaches for the analysis. First, we disaggregated inequalities in contraceptive use using four equity stratifiers: wealth index, education, residence, and region. Second, summary measures (D), (PAR), (R), and (PAF) were also employed. A 95% uncertainty interval (UI) was constructed for point estimates to measure statistical significance. RESULTS Contraceptive prevalence increased from 20.3% in 1993 to 26.7% in 2014. The contraceptive prevalence among women aged 20-49 increased from 20.6% [95% UI = 19.1, 22.3] in 1993 to 26.8% [95% UI = 24.9, 28.9] in 2014 and this exceeded the increase that was recorded among those aged 15-19 (from 13% [95 UI = 8.7, 19] to 18% [95% UI = 11.5, 28.6]), in the same period. It was evident that substantial inequality existed with respect to contraceptive use, from 1993 to 2014, with widest inequality occurring in 2003 (PAF = 2.7, 95% UI = -16.6-21.9; D = 17.4, 95% UI = 12.7-22.1). In terms of wealth index, the least inequality was observed in 2014 (PAR = 1.3, 95% UI = -1-3.6; D = 5.9, 95% UI = -0.1-12). Regarding education, the widest inequality occurred in 1993 (PAF = 138.6, UI = 132.1-145.1; D = 40.1, 95% UI = 34.4-45.9). With place of residence, the widest gap in inequality occurred in 1993 (PAF = 51.2, 95% UI = 46.2-56.3; D = 15.3, 95% UI = 11.8-18.7). There was inequality in contraceptive use with respect to sub-national regions. In 2014, the Difference (D = 21, 95% UI = 14.6-27.4) and the PAF (PAF = 20.9, 95% UI = 11.2 - 30.5) measures revealed substantial absolute and relative regional inequality between the regions. CONCLUSION There was a steady increase in contraceptive use from 20.3% in 1993 to 26.7% in 2014. Nevertheless, the percentage change is minimal. The trends of inequality indicate that inequalities in contraceptive use was evident across the dimension of age, place of residence, wealth index, education, and region. Yet, there was a substantial reduction in inequalities related to contraceptive use in 2014. Therefore, targeting adolescents, women in rural areas, low wealth quintile, and those with no formal education is key to substantially improving contraceptive use across the country.
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Affiliation(s)
- Felix Mensah
- grid.413081.f0000 0001 2322 8567Department of Data Science and Economic Policy, University of Cape Coast, Cape Coast, Ghana
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. .,Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Simon Agongo Azure
- grid.412737.40000 0001 2186 7189School of Public Health, Population and Reproductive Health Division, University of Port Harcourt, Choba, Nigeria
| | - Eugene Budu
- grid.415489.50000 0004 0546 3805Korle Bu Teaching Hospital, P. O. Box, 77, Accra, Ghana
| | - Edward Kwabena Ameyaw
- L & E Research Consult Ltd., Wa, Upper West Region Ghana ,grid.411382.d0000 0004 1770 0716Institute of Policy Studies and School of Graduate Studies, Lingnan University, Tuen Mun, New Territories, Hong Kong
| | - Abdul-Aziz Seidu
- REMS Consult LTD, Takoradi, Ghana ,grid.1011.10000 0004 0474 1797College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Bright Opoku Ahinkorah
- REMS Consult LTD, Takoradi, Ghana ,grid.117476.20000 0004 1936 7611School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Compton SD, Manu A, Maya E, Morhe ESK, Dalton VK. Give women what they want: contraceptive discontinuation and method preference in urban Ghana. Contracept Reprod Med 2023; 8:5. [PMID: 36642723 PMCID: PMC9841713 DOI: 10.1186/s40834-022-00200-0] [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: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Unmet need for contraception remains high in Ghana. Reducing the number of women who discontinue their contraceptive use is one way to decrease the number of women with an unmet need. In this study, we investigated factors associated with discontinuation among a cohort of Ghanaian women. METHODS Women who were beginning a new method of contraception at one of six urban clinics in Accra and Kumasi, Ghana were invited to participate in our study. Participants were interviewed before and after their counseling session, and at 3-, 6-, 9-, and 12-months post-enrollment to determine continuation. During follow-up, participants who were no longer using their method were asked why, if they were using any method of contraception, and if so, which method. Logistic regression analysis was performed to identify factors associated with discontinuation for reason other than pregnancy or desired pregnancy. RESULTS Of the 472 women who reported leaving their counseling session with a method, 440 (93.2%) had at least one follow-up contact. Of the 440 women, 110 (25%) discontinued their method at some point over the 12-month period, and 94 (85.5%) did so for reasons other than pregnancy or desired pregnancy. In the multivariate regression analysis, women who reported they were given their method of choice were 12.0% less likely to discontinue due to a non-pregnancy reason (p=0.005); those who used a long-acting reversible contraceptive (LARC) method were 11.1% less likely (p=.001); and those who reported they would choose to use that method again, one measure of satisfaction, were 23.4% less likely (p<.001). CONCLUSIONS To our knowledge, the current study is the first to explore method preference and its relation to continuation. Women in our study who reported they were given the contraceptive method of their choice were less likely to discontinue using that method for non-pregnancy-related reasons. Further, those who adopted a LARC method and those who reported they would make the same method choice again were less likely to discontinue. Women should be supported in selecting a contraceptive method of their choice. Providers should work with their clients to find a method which meets their preferences.
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Affiliation(s)
- Sarah D. Compton
- grid.214458.e0000000086837370University of Michigan Department of Obstetrics and Gynecology, 1500 E. Medical Center Dr, Ann Arbor, MI 48109 USA
| | - Adom Manu
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Ernest Maya
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Emmanuel S. K. Morhe
- grid.449729.50000 0004 7707 5975University of Health and Allied Sciences Department of Obstetrics and Gynaecology, PMB 31, Ho, Volta Region Ghana
| | - Vanessa K. Dalton
- grid.214458.e0000000086837370University of Michigan Department of Obstetrics and Gynecology, 1500 E. Medical Center Dr, Ann Arbor, MI 48109 USA
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Contraceptive use among female head porters: implications for health policy and programming in Ghana. Heliyon 2022; 8:e11985. [PMID: 36506400 PMCID: PMC9732301 DOI: 10.1016/j.heliyon.2022.e11985] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/10/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Despite the growing literature on the barriers to contraceptives use among women, the perspective of female head porters has not been exhaustively researched. Using Bronfenbrenner's socio-ecological theory, we explore the factors that influence the contraceptive decision-making of migrant female head porters in the Kumasi Metropolis and the implications for health policy and planning. Methodology A case study of female head porters in the Kumasi Metropolis was conducted. We employed a qualitative approach in the collection and analysis of the data. A combination of cluster, purposive, and convenience sampling procedures was used to select 48 migrant female head porters to participate in semi-structured in-depth interviews. The data collected were analyzed using the thematic analytical framework. Results We found the main barriers to the uptake of contraception among the head porters to include high cost of contraceptives, perceived side effects associated with contraceptive use, and the disapproval of a male sexual partners. Conclusion The findings indicate that head porters' contraceptive decision-making is largely influenced by their social and economic circumstances. To address these, we recommend a carefully tailored approach, starting with a free National Health Insurance Scheme (NHIS) enrollment policy for all head porters in the country. There is also the need for the Ghana Health Service, and NGOs in health to work together to create effective awareness among female head porters on the benefits and misconceptions of contraception by incorporating culturally appropriate education that would facilitate the adoption of positive attitudes towards contraception. Additionally, NGOs in health in collaboration with the health facilities should initiate a process that encourages joint reproductive health decision-making among partners which recognises the added value of men's participation. We argue that men's active participation in contraception decision-making could potentially address their scepticism towards uptake.
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Merera AM, Lelisho ME, Pandey D. Prevalence and Determinants of Contraceptive Utilization among Women in the Reproductive Age Group in Ethiopia. J Racial Ethn Health Disparities 2022; 9:2340-2350. [PMID: 34780019 DOI: 10.1007/s40615-021-01171-9] [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: 07/19/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Despite the huge advantages of family planning programs, contraception use in Ethiopia remains low. Determining the magnitude and associated factors of contraceptive utilization helps to take action for further improvement. Therefore, this study aimed to assess the prevalence and identify determinants of using contraceptives among women of reproductive age in Ethiopia. METHODS The 2019 Ethiopian Mini Demographic and Health Survey 2019 (EMDHS 2019) dataset was utilized in this population-based investigation. In the current study, 8885 reproductive-age women were included. Binary logistic regression analysis was employed to examine significant factors associated with the utilization of contraceptive methods. The analysis was done using SPSS software version 20. RESULTS The prevalence of contraceptive utilization amongst women's reproductive age in Ethiopia was 37.6%. Of all contraceptive users, a large number of women, 57.0%, used injectable kinds of contraceptives followed by implants (24.3%). Participants aged 20-29 (AOR = 2.32, 95%CI: 1.79-3.01) and aged 30-39 years (AOR = 3.12, 95%CI: 2.58-3.78); from Addis Ababa (AOR = 3.27, 95%CI:2.42-4.43), Dire Dawa (AOR = 2.96, 95%CI:2.28-3.84), and urban residence (AOR = 2.49, 95%CI:2.13-2.91); who had secondary education level 1.391(AOR = 1.14-1.70), diploma and above (AOR = 1.39, 95%CI:1.12-1.72); being in rich wealth index (AOR = 1.260, 95%CI:1.06-1.50); having five or more children (AOR = 1.37, 95%CI:1.17-1.61); and who had knowledge about contraceptives (AOR = 1.88, 95%CI:1.42-2.48) and being married (AOR = 5.82, 95%CI: 4.60-7.36) had higher odds of utilizing contraceptives, while women aged 40-49 years (AOR = 0.93, 95%CI: 0.89-0.96) and from residential region of Oromia (AOR = 0.516, 95%CI: 0.40-0.67), Somalia (AOR = 0.48, 95%CI: 0.38-0.62) and Benishangul (AOR = 0.53, 95%CI: 0.40-0.70) had lower odds of using contraception. CONCLUSIONS The study concluded that the use of contraceptives remained very low (found below the national target) in Ethiopia. Factors like age, educational level, number of children, and region of the women, religion, wealth index, and marital status are determinant factors associated with contraceptive use among reproductive-age women in Ethiopia. For a more successful intervention approach that encourages the use of contraceptive methods, these variables should be considered.
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Affiliation(s)
- Amanuel Mengistu Merera
- Department of statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
| | - Mesfin Esayas Lelisho
- Department of statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia
| | - Digvijay Pandey
- Department of Technical Education, IET, Dr. A.P.J Abdul Kalam Technical University, Lucknow, India
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Budu E, Ahinkorah BO, Seidu AA, Armah-Ansah EK, Salihu T, Aboagye RG, Yaya S. Intention to use contraceptives among married and cohabiting women in sub-Saharan Africa: a multilevel analysis of cross-sectional data. BMJ Open 2022; 12:e060073. [PMID: 36424119 PMCID: PMC9693891 DOI: 10.1136/bmjopen-2021-060073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the factors associated with intention to use contraceptives among married and cohabiting women in sub-Saharan Africa (SSA). DESIGN Data for the study were extracted from the most recent Demographic and Health Surveys of 29 countries in SSA conducted from 2010 to 2020. We included a total of 180 682 women who were married or cohabiting. Multilevel regression analysis was carried out and the results were presented as adjusted odds ratio (AOR), with 95% confidence interval (CI). SETTING 29 countries in SSA. PARTICIPANTS Women aged 15-49 years in sexual unions. OUTCOME MEASURE Intention to use contraceptives. RESULTS The pooled prevalence of intention to use contraceptives among married and cohabiting women in the 29 countries was 41.46%. The prevalence ranged from 18.28% in Comoros to 71.39% in Rwanda. Intention to use contraceptives was lower among women aged 45-49 (AOR=0.06, 95% CI= 0.05 to 0.07), those with no education (AOR=0.60, 95% CI= 0.58 to 0.61), and primary education (AOR=0.90, 95% CI 0.88 to 0.93), married women (AOR=0.81, 95% CI= 0.79 to 0.84), those of the poorest wealth quintile (AOR=0.78, 95% CI= 0.75 to 0.82), and women who were not exposed to mass media (AOR=0.87, 95% CI= 0.86 to 0.90). Women with four or more births (AOR=2.09, 95% CI= 1.99 to 2.19) had greater likelihood of contraceptive use intention compared to those with no birth. Women in rural settings were found to have greater likelihood of intention to use contraceptives compared to those in urban settings (AOR=1.10, 95% CI= 1.07 to 1.14). CONCLUSION There is a low prevalence of contraceptive use intention among married and cohabiting women in SSA with differences between countries. It is imperative for policymakers to consider these factors when developing and executing contraceptive programmes or policies to enhance contraceptive intents and use among married and cohabiting women. To resolve discrepancies and increase contraceptive intention among women, policymakers and other key stakeholders should expand public health education programmes.
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Affiliation(s)
- Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ebenezer Kwesi Armah-Ansah
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Population Dynamics Sexual and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
- Department of Population and Development, National Research University - Higher School of Economics, Moscow, Russia
| | - Tarif Salihu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Healtj, Imperial College London, London, UK
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Bolarinwa OA, Babalola TO, Adebayo OA, Ajayi KV. Health insurance coverage and modern contraceptive use among sexually active women in Nigeria: Further analysis of 2018 Nigeria Demographic Health Survey. Contracept Reprod Med 2022; 7:22. [PMID: 36316721 PMCID: PMC9624092 DOI: 10.1186/s40834-022-00187-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/14/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Studies have shown that affordable health insurance can influence healthcare visits and increase the choice of medication uptake in sub-Saharan Africa. However, there is a need to document the influence of health insurance coverage and modern contraceptive use in order to encourage its uptake. Thus, this study examined the influence of health insurance coverage on modern contraceptive use among sexually active women in Nigeria. METHODS The secondary dataset utilised in this study were derived from the 2018 Nigeria Demographic and Health Survey (NDHS). Data analyses were restricted to 24,280 women of reproductive age 15-49 years who were sexually active in the survey dataset. Weighted bivariate and multivariable logistic regression models were used to examine the influence of health insurance coverage on modern contraceptive use while controlling for possible confounders. A Significant level of alpha was determined at p < 0.05 using STATA 16.0. RESULTS The prevalence of health insurance coverage and modern contraceptive use among sexually active women in Nigeria were 25.47% and 13.82%, respectively. About 1 out of every 4 sexually active women covered by health insurance were using a modern contraceptive, while 86.50% of the women not covered by health insurance were not using any modern contraceptive method. After adjusting for socio-demographic characteristics, the odds of using any modern contraceptive were significantly higher for sexually active women who were covered by any health insurance [aOR = 1.28; 95% (CI = 1.01-1.62)] compared to sexually active women not covered by health insurance in Nigeria. CONCLUSION The study demonstrated that health insurance coverage is a significant driver of health service utilization, including modern contraceptive use. Health insurance benefits are recommended to be expanded to cover a broader spectrum of family planning services in Nigeria. More research is required to understand the influence of different health insurance schemes and the use of modern family planning methods in Nigeria.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Global Public Health, Canterbury Christ Church University, Canterbury, UK.
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
| | - Taiwo Oladapo Babalola
- Institute of Governance, Humanities, and Social Sciences [PAUGHSS], PAN African University, Yaoundé, Cameroon
| | | | - Kobi V Ajayi
- Education, Direction, Empowerment, & Nurturing (EDEN) Foundation, Abuja, Nigeria
- Department of Health Behavior, School of Public Health, Texas A&M University, 77843, College Station, TX, USA
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Impact of community and provider-driven social accountability interventions on contraceptive uptake in Ghana and Tanzania. Int J Equity Health 2022; 21:142. [PMID: 36171614 PMCID: PMC9516523 DOI: 10.1186/s12939-022-01736-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background Social accountability, which is defined as a collective process for holding duty bearers and service providers to account for their actions, has shown positive outcomes in addressing the interrelated barriers to quality sexual and reproductive health services. The Community and Provider driven Social Accountability Intervention (CaPSAI) Project contributes to the evidence on the effects of social accountability processes in the context of a family planning and contraceptive programme. Methods A quasi-experimental study utilizing an interrupted time series design with a control group (ITS-CG) was conducted to determine the actual number of new users of contraception amongst women 15–49 years old in eight intervention and eight control facilities per country in Ghana and Tanzania. A standardized facility audit questionnaire was used to collect facility data and completed every year in both intervention and control groups in each country from 2018–2020. Results In Ghana, the two-segmented Poisson Generalized Estimating Equation (GEE) model demonstrated no statistically significant difference at post-intervention, between the intervention and control facilities, in the level of uptake of contraceptives (excess level) (p-value = 0.07) or in the rate of change (excess rate) in uptake (p-value = 0.07) after adjusting for baseline differences. Similarly, in Tanzania, there was no statistical difference between intervention and control facilities, in the level of uptake of contraceptives (excess level) (p-value = 0.20), with the rate of change in uptake (p-value = 0.05) after adjusting for the baseline differences. There was no statistical difference in the level of or rate of change in uptake in the two groups in a sensitivity analysis excluding new users recruited in outreach activities in Tanzania. Conclusions The CAPSAI project intervention did not result in a statistically significant increase in uptake of contraceptives as measured by the number of or increase in new users. In evaluating the impact of the intervention on the intermediate outcomes such as self-efficacy among service users, trust and countervailing power among social groups/networks, and responsiveness of service providers, cases of change and process evaluation should be considered. Trial registration The CaPSAI Project has been registered at the Australian New Zealand Clinical Trials Registry (ACTRN12619000378123, 11/03/2019).
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Lasong J, Bougangue B, Nyarko Agyeman Y. Modern contraceptive use among women of reproductive age in Zimbabwe: analysis of 1999-2015 Zimbabwe Demographic Health Survey. EUR J CONTRACEP REPR 2022; 27:445-453. [PMID: 35959761 DOI: 10.1080/13625187.2022.2107198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Modern contraception use is the fundamental fulfilment of women's rights to choose when and how many children to have. The study explored predictors of modern contraceptive use among women in Zimbabwe. METHOD Data from the 1999, 2005/2006, 2010/2011 and 2015 Zimbabwe Demographic and Health Survey (ZDHS) was used in a secondary analysis that involved 5474 women of reproductive age. The outcome measure was modern contraceptive use as reported by women. Multiple logistic regression was done to determine the predictors of modern contraceptive use. RESULTS The trend showed that since 1999 to 2015 there has been a steadily increase in modern contraceptive use from 54.9% to 72.9%. The use of contraceptives was lower among age 40 to 49 years (aOR = 0.49, p = 0.001)], other religion (aOR = 0.34, p = 0.005), induced abortion (aOR = 0.70; p ≤ 0.001), desire for having children within 2 years (aOR = 0.21; p ≤ 0.001) and polygamy (aOR = 0.43; p ≤ 0.001). The odds of contraceptives used was higher among richer wealth index (aOR = 1.45, p = 0.017), partners with higher education (aOR = 2.00, p = 0.029)], parity 1-2 (aOR = 15.53; p ≤ 0.001), 3-4 (aOR = 19.60; p ≤ 0.001), 5 or more (aOR = 17.50; p ≤ 0.001)] and media exposure (aOR = 1.79; p = 0.003). CONCLUSIONS The study asserts that women's financial status, partners educational level, and media exposure might be important in promoting the use of modern contraceptives among women in a union in Zimbabwe and other low-income and middle-income countries.
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Affiliation(s)
- Joseph Lasong
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Bassouma Bougangue
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Yaa Nyarko Agyeman
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana.,Faculty of Paediatrics and Adult Nursing, Ghana College of Nurses and Midwives, Accra, Ghana
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Tsegaw M, Mulat B, Shitu K. Modern Contraceptive Utilization and Associated Factors Among Married Women in Liberia: Evidence from the 2019 Liberia Demographic and Health Survey. Open Access J Contracept 2022; 13:17-28. [PMID: 35210875 PMCID: PMC8857995 DOI: 10.2147/oajc.s350117] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/26/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Contraceptive methods help individuals control the number, interval, and timing of pregnancies and prevent unwanted pregnancies. OBJECTIVE This study aimed to assess the prevalence of modern contraceptive utilization and associated factors among married reproductive-age women in Liberia. METHODS This study was based on a large community-based cross-sectional survey, conducted from October 16, 2019, to February 12, 2020, in Liberia. The survey employed a multistage cluster sampling technique to recruit study participants. Binary logistic regression was used to identify associated factors of contraceptive utilization. A p-value of <0.05 and a 95% confidence interval were used to declare statistical significance. RESULTS The overall modern contraceptive utilization among reproductive-age women in Liberia was 23.87% (95% CI: 27.3, 29.9). Women with the age group of 20 and 24 years [AOR = 2.08 (95% CI:1.37, 3.14)], 25-29 years [AOR = 1.73 (95% CI: 1.13, 2.65)], 45-49 years [AOR = 0.46, 95% CI: 0.27, 0.76], being Muslim [AOR = 0.52, 95% CI: 0.399, 0.67], residing in South Eastern Regions (B) [AOR = 1.40, 95% CI: 1.11, 1.79], south central [AOR=0.48 95% CI:0.37, 0.61] and North Central region [AOR = 0.48, 95% CI: 0.37, 0.61], being employed [AOR = 1.26, 95% CI:1.06, 1.51], having 1-2 child/children [AOR = 2.81, 95% CI:1.80, 4.39] 3-4 children [AOR = 3.87, 95% CI:3.87, 6.24] and 5 and above [AOR = 7.06, 95% CI: 4.27, 11.69], completed primary [AOR = 1.52, 95% CI: 1.22, 1.88] and higher education [AOR = 1.72, 95% CI: 1.01, 2.94], having educated husband [AOR = 1.35, 95% CI: 1.12, 1.63], being from richer households [AOR = 1.41, 95% CI:1.09, 1.82], and had declared infecund [AOR = 0.13, 95% CI: 0.046, 0.36] were independently associated with modern contraceptive utilization among married women in Liberia. CONCLUSION The prevalence of modern contraceptive utilization among reproductive-age women in Liberia was low. Contraceptive utilization was affected by partners' education and participants' socio-demographic and obstetric attributes. Thus, public health interventions are urgently required to enhance use of contraceptives among this group of population.
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Affiliation(s)
- Menen Tsegaw
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Bezawit Mulat
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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22
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Boadu I. Coverage and determinants of modern contraceptive use in sub-Saharan Africa: further analysis of demographic and health surveys. Reprod Health 2022; 19:18. [PMID: 35062968 PMCID: PMC8781110 DOI: 10.1186/s12978-022-01332-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age (15-49 years) in sub-Saharan Africa (SSA). Methods Data for the study were obtained from the Demographic and Health Surveys (DHS) conducted between 1995–2020 across 37 SSA countries. Women of reproductive age (15–49 years) was the unit of analysis. Analysis of data was done using STATA version 16 for windows. A bivariate Rao Scott’s Chi-square test of independence was done to determine factors associated with the use of modern contraceptives. Factors that showed significance (p < 0.05) were included in a multilevel logistic regression to determine significant predictors of modern contraceptives. Clustering, stratification and sample weighting were accounted for in the analyses. Results The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of MC used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use modern contraceptive if they: had no education (aOR = 0.4, 95% CI 0.38–0.44), had no children (aOR = 0.27–0.42), not told of family planning at a health facility (aOR = 0.69, 95% CI 0.67–0.71), not heard of family planning in the media (aOR = 0.77, 95% CI 0.74–0.79) and being poor (aOR = 0.76, 95% CI 0.73–0.79). On the other hand, women were more likely to use modern contraceptive if they were between the age of 35–39 years (aOR = 1.69, 95% CI 0.73–0.79), married (aOR = 2.66, 95% CI 2.50–2.83), had seven or more children (aOR = 1.27, 95% CI 1.17–0.38), had knowledge of any method of contraceptives (aOR = 303.8, 95% CI 89.9–1027.5) and when field worker visited and talked about family planning (aOR = 1.53, 95% CI 1.39–0.68). Conclusion The study showed a low prevalence of modern contraceptive use in sub-Saharan Africa. Findings from the study highlight the need to provide education to women to increase uptake of modern contraceptive and also re-enforce contraceptive interventions to improve women’s health and well-being. The use of modern contraceptives (MC) to protect against sexually transmitted diseases, unwanted pregnancy and mortality as a result of unsafe abortion is low in many African countries. This study sought to determine the coverage and factors associated with the use of MC among women of child-bearing age in sub-Saharan Africa (SSA). Data for the study were obtained from the Demographic and Health Surveys (DHS) conducted in 37 SSA countries. Interpretation of the data focussed on women of children bearing age (15–49 years). The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of MC used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use MC if they had no education, no children, were not told of family planning at a health facility, had not heard of family planning on the Television, radio, newspaper and were poor. On the other hand, women who were between 35–39 years, were married, had seven or more children, had knowledge of any method of contraceptives and had a field worker visited and talked about family planning were more likely to use modern contraceptives. The study showed a low prevalence of MC use in sub-Saharan Africa. The results from the study is important and emphasize the need to provide education to women of child-bearing age to increase uptake of MC to reduce mortality and improve on women’s health and well-being.
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Shagaro SS, Gebabo TF, Mulugeta BT. Four out of ten married women utilized modern contraceptive method in Ethiopia: A Multilevel analysis of the 2019 Ethiopia mini demographic and health survey. PLoS One 2022; 17:e0262431. [PMID: 35030213 PMCID: PMC8759669 DOI: 10.1371/journal.pone.0262431] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 12/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background
Modern contraceptive method is a product or medical procedure that interferes with reproduction from acts of sexual intercourse. Globally in 2019, 44% of women of reproductive age were using a modern method of contraception but it was 29% in sub-Saharan Africa. Therefore, the main aim of this analysis was to assess the prevalence of modern contraceptive utilization and associated factors among married women in Ethiopia.
Method
The current study used the 2019 Ethiopia mini demographic and health survey dataset. Both descriptive and multilevel mixed-effect logistic regression analysis were done using STATA version 14. A p-value of less than 0.05 and an adjusted odds ratio with a 95% confidence interval were used to report statistically significant factors with modern contraceptive utilization.
Result
The overall modern contraceptive utilization among married women in Ethiopia was 38.7% (95% CI: 37.3% to 40.0%). Among the modern contraceptive methods, injectables were the most widely utilized modern contraceptive method (22.82%) followed by implants (9.65%) and pills (2.71%). Maternal age, educational level, wealth index, number of living children, number of births in the last three years, number of under 5 children in the household, religion, and geographic region were independent predictors of modern contraceptive utilization.
Conclusion
In the current study only four out of ten married non-pregnant women of reproductive age utilized modern contraceptive methods. Furthermore, the study has identified both individual and community-level factors that can affect the utilization of modern contraceptive methods by married women in the country. Therefore, concerned bodies need to improve access to reproductive health services, empower women through community-based approaches, and minimize region wise discrepancy to optimize the utilization.
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Affiliation(s)
- Sewunet Sako Shagaro
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- * E-mail:
| | - Teshale Fikadu Gebabo
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Be’emnet Tekabe Mulugeta
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Kayi EA, Biney AAE, Dodoo ND, Ofori CAE, Dodoo FNA. Women's post-abortion contraceptive use: Are predictors the same for immediate and future uptake of contraception? Evidence from Ghana. PLoS One 2021; 16:e0261005. [PMID: 34932576 PMCID: PMC8691597 DOI: 10.1371/journal.pone.0261005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/26/2021] [Indexed: 11/18/2022] Open
Abstract
This study seeks to identify the socio-demographic, reproductive, partner-related, and facility-level characteristics associated with women’s immediate and subsequent use of post-abortion contraception in Ghana. Secondary data from the 2017 Ghana Maternal Health Survey were utilized in this study. The weighted data comprised 1,880 women who had ever had an abortion within the five years preceding the survey. Binary logistic regression analyses were performed to examine the associations between the predictor and outcome variables. Health provider and women’s socio-demographic characteristics were significantly associated with women’s use of post-abortion contraception. Health provider’s counselling on family planning prior to or after abortion and place of residence were associated with both immediate and subsequent post-abortion uptake of contraception. Among subsequent post-abortion contraceptive users, older women (35–49), women in a union, and women who had used contraception prior to becoming pregnant were strong predictors. Partner-related and reproductive variables did not predict immediate and subsequent use of contraception following abortion. Individual and structural/institutional level characteristics are important in increasing women’s acceptance and use of contraception post abortion. Improving and intensifying family planning counselling services at the health facility is critical in increasing contraceptive prevalence among abortion seekers.
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Affiliation(s)
- Esinam Afi Kayi
- Department of Adult Education and Human Resource Studies, School of Continuing and Distance Education, University of Ghana, Legon, Ghana
- * E-mail:
| | | | - Naa Dodua Dodoo
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | | | - Francis Nii-Amoo Dodoo
- Department of Sociology, Pennsylvania State University, State College, Pennsylvania, United States of America
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Hailegebreal S, Seboka BT, Ahmed MH, Teferi GH, Regasa Z, Tekabe B, Sako S, Gilano G. Individual and community-level factors associated with modern contraceptive use among adolescent girls and young women in Ethiopia: a multilevel analysis of 2016 Ethiopia demographic and health survey. Arch Public Health 2021; 79:204. [PMID: 34809708 PMCID: PMC8607592 DOI: 10.1186/s13690-021-00736-8] [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: 01/27/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The importance of contraception use is immense for young girls of age 15-24 years. In literatures, there were significant attempts made to study factors associated with adolescent and young women contraception use in Africa. Despite the resulting interventions followed those studies, the contraception uses among youth population in Africa remained below average. Thus, this study is aimed to assess individual and community-level factors associated with contraceptive use in Ethiopian context to support further interventions. METHODS Our analysis was based on the secondary data from Ethiopia Demography and Health Survey (EDHS) 2016. Adolescent girls and young women (AGYW) aged 15-24 years were the target population. Means, standard deviations, and proportions were used to describe the study population. To control for the variations due to the differences between clusters, a series of multilevel logistic regression modeling steps were followed and determinants of contraceptive use were outplayed. All variables with bivariate p-value < 0.25 were included in the models and p-value < 0.05 was used to declare associations. RESULTS The prevalence of modern contraceptive use among AGYW in Ethiopia was 34.89% [95% CI, 0.32, 0.36]. Married adolescents were 2.01 times [AOR = 2.01, 95% CI = 1.39,3.16], having work was 1.36 times [AOR = 1.36, 95% CI = 1.06,1.71], living in urban areas was 1.61 times [AOR = 1.61, 95% CI = 1.16,2.45], being in middle wealth status was 1.9 times [AOR = 1.90, 95% CI = 1.32,2.65], being in rich wealth quintile was 1.99 time [AOR = 1.99, 95% CI = 1.35,2.68], and having TV exposure was 1.61 times [AOR = 1.6, 95% CI = 1.17,2.20] more likely associated with modern contraceptive uses. CONCLUSION The use of modern contraception among AGYW in the country remained appealing and factors like region, residence, marital status, wealth index, religion, working status, parity, husband desire children, ever aborted AGYW, and the television exposures were attributed for the poor improvements. Therefore, the enhancements that consult those factors remained remarkable in improving contraception use, while further increasing in educational engagement, access to health services, and economic empowerment of the AGYW might be the good advantages for the improvements.
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Affiliation(s)
- Samuel Hailegebreal
- Department of Health Informatics, College of Medicine and Health Science, School of Public Health, Arba Minch University, Arba Minch, Ethiopia.
| | - Binyam Tariku Seboka
- Department of Health Informatics, College of Medicine, and Health Science, Dilla University, Dilla, Ethiopia
| | | | - Gizaw Hailiye Teferi
- Department of Health Informatics, Debre-Markos University, Debre Markos, Ethiopia
| | - Zegaye Regasa
- Department of Health Informatics, Debre-Markos University, Debre Markos, Ethiopia
| | - Beemnet Tekabe
- Department of Health Informatics, College of Medicine and Health Science, School of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Sewunet Sako
- Department of Health Informatics, College of Medicine and Health Science, School of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Gilano
- Department of Health Informatics, College of Medicine and Health Science, School of Public Health, Arba Minch University, Arba Minch, Ethiopia
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Antarini A. Factors influencing the use of modern contraception among reproductive aged women in Bangka Belitung Province, Indonesia. Pan Afr Med J 2021; 39:39. [PMID: 34422162 PMCID: PMC8356938 DOI: 10.11604/pamj.2021.39.39.28870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction contraceptives in family planning are used to control the timings between pregnancies. Although the number of those using family planning has increased, determinants of contraceptive use among women in Indonesia remain insufficient. This research aimed to identify the factors associated with contraceptive use among reproductive aged women in Bangka Belitung Province. Methods this study employed data from the Indonesian demographic and health survey (IDHS) 2017. The selected respondents were 768 women aged 15-49 years. Then, the determinants of contraceptive use among women were examined by multinomial logistic regression. Results women’s aged 15-49 years (adjusted Odds Ratio (aOR) =8.955; 95% CI=3.573-22.439), level of education (aOR=2.017; 95% CI=1.053-3.862), the number of children (aOR=1.207; 95% CI=0.498-2.926), residential location (aOR=0.877; 95% CI=0.601-1.282), wealth index (aOR=2.23; 95% CI=0.953-5.218), visited health facilities (aOR=1.683; 95% CI=1.174-2.412), knowledge of contraceptive method (aOR=2.043; 95% CI=2.043-2.043) were significantly associated with contraceptive use among reproductive age women. Conclusion factors such as women’s age, education, number of living children, area of residence, wealth index, knowledge, and visits to health facilities were still considered significant issues in determining contraceptive use among reproductive-age women in Bangka Belitung Province.
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Affiliation(s)
- Antarini Antarini
- Department of Midwifery, Health Polytechnic Pangkalpinang, Bangka Belitung, Indonesia
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Ahinkorah BO, Budu E, Aboagye RG, Agbaglo E, Arthur-Holmes F, Adu C, Archer AG, Aderoju YBG, Seidu AA. Factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa: evidence from cross-sectional surveys of 29 countries. Contracept Reprod Med 2021; 6:22. [PMID: 34332644 PMCID: PMC8325798 DOI: 10.1186/s40834-021-00165-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa, the majority of women of reproductive age who want to avoid pregnancy do not use any method of contraception. This study sought to determine the factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa. METHODS This study used data from the Demographic and Health Surveys of 29 countries in sub-Saharan Africa. A total of 87,554 women aged 15-49 with no fertility intention and who had completed information on all the variables of interest were considered in this study. Using a multilevel logistic regression analysis, four models were used to examine the individual and contextual factors associated with modern contraceptive use. The results were presented as adjusted odds ratios (aOR), with their respective confidence intervals (CIs). Statistical significance was set at p< 0.05. RESULTS The prevalence of modern contraceptive use was 29.6%. With the individual-level factors, women aged 45-49 had lower odds of using modern contraceptives (aOR = 0.33, 95% CI = 0.28, 0.39). Women who had their first sex at age 15-19 (aOR = 1.12, 95% CI = 1.07, 1.17), those with higher education (aOR = 1.93, 95% CI = 1.75, 2.13), and women who were exposed to newspaper (aOR = 1.15, 95% CI = 1.10, 1.20) and radio (aOR = 1.21, 95% CI = 1.17, 1.26) had higher odds of modern contraceptive use. In terms of the contextual factors, women living in urban areas (aOR = 1.06, 95% CI = 1.02, 1.11), women in the richest wealth quintile (aOR = 1.55, 95% CI = 1.43, 1.67), and those in communities with medium literacy level (aOR = 1.11, 95% CI = 1.06, 1.16) and medium community socio-economic status (aOR = 1.17, 95% CI = 1.10, 1.23) had higher odds of modern contraceptive use. Across the geographic regions in sub-Saharan Africa, women in Southern Africa had higher odds of modern contraceptive use (aOR = 5.29, 95% CI = 4.86, 5.76). CONCLUSION There is a relatively low prevalence of modern contraceptive use among women with no fertility intention in sub-Saharan Africa, with cross-country variations. Women's age, age at first sex, level of education, mass media exposure, place of residence, community literacy level and community socio-economic status were found to be associated with modern contraceptive use. It is, therefore, important for policy makers to consider these factors when designing and implementing programmes or policies to increase contraceptive use among women who have no intention to give birth. Also, policymakers and other key stakeholders should intensify mass education programmes to address disparities in modern contraceptive use among women.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anita Gracious Archer
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Yaa Boahemaa Gyasi Aderoju
- Department of Adult Health Nursing, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Services, James Cook University, Townsville, Australia
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Keogh SC, Otupiri E, Castillo PW, Li NW, Apenkwa J, Polis CB. Contraceptive and abortion practices of young Ghanaian women aged 15-24: evidence from a nationally representative survey. Reprod Health 2021; 18:150. [PMID: 34275462 PMCID: PMC8286596 DOI: 10.1186/s12978-021-01189-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022] Open
Abstract
Background Young Ghanaian women experience high rates of unmet need for contraception and unintended pregnancy, and face unique barriers to accessing sexual and reproductive health services. This study provides a comprehensive national analysis of young women’s contraceptive and abortion practices and needs. Methods In 2018, we conducted a nationally representative survey of women aged 15–49, including 1039 women aged 15–24. We used descriptive statistics, multivariable logistic and multinomial regression to compare young versus older (25–49 year-old) women’s preferred contraceptive attributes, reasons for discontinuing contraception, quality of counseling, use of Primolut N-tablet, method choice correlates, and friends’ and partners’ influence. We also examined youth’s self-reported abortion incidence, abortion methods, post-abortion care, and barriers to safe abortion. Results Among Ghanaian 15–24 year-olds who had ever had sex, one-third (32%) were using contraception. Compared to older women, they had higher desires to avoid pregnancy, lower ever use of contraception, more intermittent sexual activity, and were more likely to report pregnancies as unintended and to have recently ended a pregnancy. Young contraceptors most commonly used condoms (22%), injectables (21%), withdrawal (20%) or implants (20%); and were more likely than older women to use condoms, withdrawal, emergency contraception, and N-tablet. They valued methods for effectiveness (70%), no risk of harming health (31%) nor future fertility (26%), ease of use (20%), and no effect on menstruation (19%). Infrequent sex accounted for over half of youth contraceptive discontinuation. Relative to older women, young women’s social networks were more influential on contraceptive use. The annual self-reported abortion rate among young women was 30 per thousand. Over half of young women used abortion methods obtained from non-formal providers. Among the third of young women who experienced abortion complications, 40% did not access treatment. Conclusions Young people’s intermittent sexual activity, desire for methods that do not harm their health, access barriers and provider bias, likely contribute to their greater use of coital-dependent methods. Providers should be equipped to provide confidential, non-discriminatory counseling addressing concerns about infertility, side effects and alternative methods. Use of social networks can be leveraged to educate around issues like safe abortion and correct use of N-tablet. Young Ghanaian women can experience difficulties accessing sexual and reproductive health services, and many are not using contraception despite wanting to avoid pregnancy. To better understand their needs, we describe their preferences and behaviors around contraception and abortion. We surveyed a nationally representative sample of women aged 15–49, and compared young (15–24) versus older (25–49) women’s contraceptive preferences, reasons for stopping contraception, quality of counseling, friends’ and partners’ influence on contraceptive use, and use of abortion. One-third of 15–24 year-olds who ever had sex were using contraception. Compared to older women, young women’s pregnancies were more likely to be unintended and to end in abortion. Young women most commonly used condoms, injectables, withdrawal or implants; and were more likely than older women to use condoms, withdrawal, emergency contraception, and Primolut N-tablet. They preferred methods that were effective, did not harm their health or future fertility, were easy to use, and did not disrupt their menstrual cycle. Over half of young women who stopped contraception did so because they were not having sex regularly. Friends had more influence on contraceptive use among young women than older women. Each year on average, there were 30 abortions per 1000 young women. Over half of young women who had abortions used methods from non-formal providers, and 40% of those who had complications did not get treated. Providers should be equipped to provide confidential, non-discriminatory counseling about contraceptive side effects and options. Social networks can be used to educate women about safe abortion.
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Affiliation(s)
- Sarah C Keogh
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA.
| | - Easmon Otupiri
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Naomi W Li
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA
| | - Joana Apenkwa
- St. Michael's Nursing and Midwifery Training College, Pramso, Ghana
| | - Chelsea B Polis
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA
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Akinyemi AI, Mobolaji JW, Abe JO, Ibrahim E, Ikuteyijo O. Women Deprivation Index and Family Planning Utilisation in Urban Geography of West African Countries. Front Glob Womens Health 2021; 2:656062. [PMID: 34816213 PMCID: PMC8594053 DOI: 10.3389/fgwh.2021.656062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/28/2021] [Indexed: 11/19/2022] Open
Abstract
Inequalities in health care utilisation and outcomes vary significantly across geographies. Though available evidence suggests disparity in contraceptive uptake in favour of urban compared with rural geographies, there are unassessed nuances among women in urban communities. This study examines some of these disparities within the context of socioeconomic deprivations and family planning utilisation among urban women in West Africa. A secondary analysis of the most recent Demographic and Health Survey dataset of five selected West African countries was conducted, using pooled data of 21,641 women aged 15-49 years. Associations between family planning utilisation and women's deprivation status were investigated using a binary logistic regression model. The findings show that more than one-quarter of the women were severely deprived across the countries except Senegal (17.4%), and the severely deprived consistently have relatively low contraceptive prevalence rates (CPR) (16.0-24.3%) compared with women with no/low deprivation across the countries except Senegal (39.8%). The results for long-acting reversible contraceptives (LARC) were not consistent across the five countries: whereas, LARC utilisation was lower among severely deprived women in Nigeria (9.1%), Guinea (9.6%), and Mali (19.3%), utilisation was similar across the deprivation groups in Benin and Senegal. In the multivariable analyses, the log-odds of modern contraceptive utilisation decreases by 0.27 among the moderately deprived (ß = -0.27, SE = 0.05, p < 0.01) and by 0.75 among the severely deprived women (ß = -0.75, SE = 0.05, p < 0.01) compared with those with no/low deprivation, with variations across the countries. Similarly, the log-odds of LARC utilisation decreases by 0.44-0.72 among the severely deprived women compared with those with no/low deprivation across the countries except Senegal. This study concluded that family planning intervention programmes and policies need to underscore the deprivation context of urban geographies, particularly among women living in informal settlements.
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Affiliation(s)
- Akanni Ibukun Akinyemi
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Jacob Wale Mobolaji
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - John Olugbenga Abe
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Elhakim Ibrahim
- Department of Demography, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Olutoyin Ikuteyijo
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
- Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, University of Basel, Basel, Switzerland
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Nkunzimana E, Babale MS, Ndoreraho A, Nyandwi J. Uptake of Modern Contraceptive Methods among Burundian Women and Associated Factors: Analysis of Demographic and Health Survey Data, Burundi 2016-2017. East Afr Health Res J 2021; 5:75-81. [PMID: 34308248 PMCID: PMC8291214 DOI: 10.24248/eahrj.v5i1.654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/05/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Globally in 2017, Burundi was the 9th country with the highest population growth rate of 3.2% and a fertility rate of 5.5 children per woman. This probably suggested low uptake of Modern Contraceptive methods (MCM) in the country. Our analysis investigated factors associated with low uptake of MCM among women of reproductive age in Burundi. Methods: Cross sectional data of non-pregnant women aged 15-49 years was extracted from the Burundi Demographic and Health Survey (2016-2017). We analysed the data at univariate, bivariate and multivariate levels to assess factors influencing MCM uptake among these women using Epi-Info 7.2.2.6. Results: Of the 9,945 women, 2,372 (23.8%) were using MCM. Ngozi province had the highest prevalence of MCM users [284/691(37.7%)]. The most used MCM among respondents was injectable contraceptive (48.3%). As respondent's age increases, the odds of using MCM decreases; 20-24 years (aOR=0.9, 95% CI [0.6–1.2]), 30–34 years (aOR=0.8, 95% CI [0.5–1.0]), 35-39 years (aOR=0.7, 95% CI [0.5–0.9]), 40-44 years (aOR=0.5, 95% CI [0.5–0.9]) and 45-49 years (aOR=0.4, 95% CI [0.2–0.5]) compared with those in the age group 15–19 years. Muslims (aOR=1.5, 95% CI [1.2–1.9]) and Jehovah witnesses (aOR=3.1, 95% CI [1.7–6.5]) were more likely to use MCM than Catholics. Conclusion: The prevalence of MCM remains low among women of reproductive age in Burundi, with injectables being the most used method. Factors such as respondent's age and religion were significantly associated with MCM use. Enhanced access to family planning information and services targeting women who are 30 years or more and engaging religious leaders for their active participation is recommended.
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Affiliation(s)
- Edouard Nkunzimana
- Ministry of Public Health and Fight against AIDS, National Institute of Public Health, Bujumbura, Burundi
| | - Mu'awiyyah Sufiyan Babale
- Department of Community Medicine, College of Medical Sciences, Faculty of Clinical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Adolphe Ndoreraho
- Ministry of Public Health and Fight against AIDS, National Institute of Public Health, Bujumbura, Burundi
| | - Joseph Nyandwi
- Ministry of Public Health and Fight against AIDS, National Institute of Public Health, Bujumbura, Burundi
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31
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Grabert BK, Speizer IS, Domino ME, Frerichs L, Corneli A, Fried BJ. Couple communication and contraception use in urban Senegal. SAGE Open Med 2021; 9:20503121211023378. [PMID: 34158943 PMCID: PMC8182225 DOI: 10.1177/20503121211023378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 05/19/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives: Couple communication about family planning has been shown to increase uptake
of contraception. However, couple communication is often measured based
solely on one partner’s report of communication. This research investigates
the influence of couple-reported communication about family planning on
current and future use of contraception using couple-level data. Methods: We used baseline data from the Measurement, Learning, and Evaluation (MLE)
project collected through household surveys in 2011 from a cross-sectional
representative sample of women and men in urban Senegal to conduct secondary
data analysis. We used multivariable logit models to estimate the average
marginal effects of couple communication about family planning on current
contraception use and future intention to use contraception. Results: Couple communication about family planning reported by both partners was
significantly associated with an increased likelihood of current use of
contraception and with future intention to use contraception among
non-contracepting couples. Couples where one partner reported discussing
family planning had a 25% point greater likelihood of current contraception
use than couples where neither partner reported discussing, while couples
where both partners reported discussing family planning had a 56% point
greater likelihood of current contraception use, representing more than
twice the effect size. Among couples not using contraception, couples where
one partner reported discussing family planning had a 15% point greater
likelihood of future intention to use contraception than couples where
neither partner reported discussing, while couples where both partners
reported discussing family planning had a 38% point greater likelihood of
future intention to use contraception. Conclusion: These findings underscore the importance of the inclusion of both partners in
family planning programs to increase communication about contraception and
highlight the need for future research using couple-level data, measures,
and analysis.
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Affiliation(s)
- Brigid K Grabert
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ilene S Speizer
- Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.,Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marisa Elena Domino
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.,Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leah Frerichs
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Amy Corneli
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Bruce J Fried
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
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32
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Keogh SC, Otupiri E, Castillo PW, Chiu DW, Polis CB, Nakua EK, Bell SO. Hormonal contraceptive use in Ghana: The role of method attributes and side effects in method choice and continuation. Contraception 2021; 104:235-245. [PMID: 33992609 DOI: 10.1016/j.contraception.2021.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To understand the barriers and facilitators of hormonal contraceptive use among Ghanaian women, in order to help improve contraceptive counseling and reduce the high rates of unintended pregnancy. STUDY DESIGN We conducted a nationally representative community-based survey of 4143 women aged 15-49 in 2018, and used descriptive statistics and logistic regression to examine correlates of current hormonal method use, preferred method attributes and their association with method choice, and the role of side effects in hormonal method discontinuation. RESULTS Hormonal method use (vs. contraceptive non-use) was associated with younger age, higher parity and education, but not with union status, wealth or residence. Preferences for key method attributes were associated with choosing particular methods. Most valued attributes were effectiveness at preventing pregnancy, and low risks of harming health and future fertility. These last 2 concerns are echoed in the second most common reason for discontinuation (health concerns). While menstrual changes were a common concern, leading some respondents to discontinue hormonal contraceptives, many were willing to endure these effects. In contrast, having experienced long-term health issues as a perceived result of hormonal method use more than halved the odds of current use. Contraceptive counseling on menstrual changes, other side effects, and impacts on future fertility had not been universally provided. CONCLUSIONS Ghanaian women value hormonal methods for their effectiveness against pregnancy. However, concerns about side effects (particularly bleeding changes), future fertility impairment, and long-term health issues led some women to discontinue hormonal methods. Counseling on these issues was reportedly inadequate. IMPLICATIONS Identifying barriers to, and facilitators of, hormonal contraceptive use, as well as method attributes important to Ghanaian women, can help to better tailor contraceptive counseling to individual needs, in order to ensure that all women can access the method that suits them best, and decide whether and how to manage side effects, switch methods or discontinue.
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Affiliation(s)
| | - Easmon Otupiri
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | | | - Doris W Chiu
- Guttmacher Institute, New York, NY, United States.
| | - Chelsea B Polis
- Guttmacher Institute, New York, NY, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Emmanuel K Nakua
- Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Suzanne O Bell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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Tessema ZT, Teshale AB, Tesema GA, Yeshaw Y, Worku MG. Pooled prevalence and determinants of modern contraceptive utilization in East Africa: A Multi-country Analysis of recent Demographic and Health Surveys. PLoS One 2021; 16:e0247992. [PMID: 33735305 PMCID: PMC7971875 DOI: 10.1371/journal.pone.0247992] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 02/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND According to the 2017 estimate, around 214 million reproductive-age women in developing regions who want to avoid pregnancy do not use a modern contraceptive method. Although there are studies done on factors associated with modern contraceptive utilization in individual East African countries, as to our search of the literature, there is limited evidence on the pooled prevalence and determinants of modern contraceptive utilization in the East African region. Therefore, this study aimed to estimate the pooled prevalence and determinants of modern contraceptive utilization in the East African region. METHODS The pooled prevalence of modern contraceptive utilization and the strength of determinants were estimated using STATA version 14. Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance were used for model fitness and comparison. The multilevel logistic regression model was fitted to identify determinants of modern contraceptive use in the region. Adjusted Odds Ratio with its 95% Confidence Interval was presented, and variables with a p-value ≤of 0.05 were declared significant determinants of modern contraceptive utilization. RESULTS Overall, about 20.68% (95%CI:-20.46.,20.91)of women used modern contraceptive, ranging from 9.08% in Mozambique to 61.49% in Comoros. In the multilevel logistic regression model; maternal age group 25-34 (AOR: 0.79, 95%CI:0.76,0.82) and 35-49 (AOR:0.49, 95%CI:0.46,0.51). Being married (AOR:0.85, 95%CI:0.82,0.88), mothers with primary education (AOR:1.48, 95%CI:1.43,1.54) and secondary and above education level (AOR:1.60, 95%CI:1.52,1.69), husbands with primary education (AOR:2.43, 95%CI:2.35,2.51) and secondary and above education level (AOR:2.92, 95%CI:2.76,3.05). The mothers who had occupation (AOR:2.11, 95%CI:1.23,1.33), mothers from households with middle wealth index (AOR:1.23, 95%CI:1.19,1.28) and rich wealth index (AOR:1.28, 95%CI:1.23,1.33) were found to be significant determinants of modern contraceptive use. CONCLUSION We found that modern contraceptive utilization in the 12 East Africa countries was low compared to SDG target 2030(75%). The governmental and non-governmental organizations should scale up their public health programs to the poor and marginalized communities to scale up modern contraceptive utilization uptake in the region. In addition, reforming the health system and reproductive health education through mass media to create awareness of modern contraceptive use benefits are effective strategies to improve modern contraceptive use among East Africa women.
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Affiliation(s)
- Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bawah AA, Sato R, Asuming P, Henry EG, Agula C, Agyei-Asabere C, Canning D, Shah I. Contraceptive method use, discontinuation and failure rates among women aged 15-49 years: evidence from selected low income settings in Kumasi, Ghana. Contracept Reprod Med 2021; 6:9. [PMID: 33632324 PMCID: PMC7908716 DOI: 10.1186/s40834-021-00151-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/04/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND This paper provides estimates of contraceptive discontinuation and failure rates in a poor urban setting in Ghana. Contraceptive use is for the purposes of preventing unintended or mistimed pregnancies. Unfortunately, evidence abounds in many parts of the world where there is considerable levels of contraceptive failure and high levels of discontinuation resulting in unintended pregnancies. METHODS We estimated discontinuation rates during a 12-month period since starting use by applying single and multiple decrement life table methods to the contraceptive calendar data collected in a survey of women in reproductive age of 15-49 years. RESULTS Modern contraceptive method use was estimated to be 13.7% at the time of the survey. The results show that contraceptive method discontinuation vary markedly by type of contraceptive method but are high for almost all methods, except for implants (23.7%). Discontinuation rate for emergency contraception was estimated at 88.5%, withdrawal 87.6%, and male condom use 80.9%. However, discontinuation rates were moderately high for rhythm (63.6%), pills (65.6%) and injectables (56%). In terms of failure rates, overall contraceptive failure for all methods was estimated at 7.9%. The factors significantly associated with method failure include being within age bracket 40-44 years (OR = 0.3, p < 0.05), having secondary/higher education (OR = 0.4, p < 0.01), belonging to the richest household wealth scale (OR = 3.3, p < 0.01), currently in union with a partner (OR = 2.2, p < 0.01), and using contraceptive methods such as rhythm (OR = 5.6, p < 0.01) and withdrawal (OR = 3.7, p < 0.01). On the flip side, the odds for method discontinuation were significantly higher for women in their 20s and mid 30s, formerly in union (OR = 1.9, p < 0.05) and use of withdrawal method (OR = 1.4, p < 0.05) and lower for women formerly in union (OR = 0.4, p < 0.01) and use of implants (OR = 0.2, p < 0.01) and injectables (OR = 0.6, p < 0.01). CONCLUSION While contraceptives use is low, both discontinuation and failure rates are high and variable among different methods. Failure and discontinuation rates are lowest for long-acting methods such as implants while higher failure rates are more prevalent among women who rely on withdrawal and the rhythm methods.
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Affiliation(s)
| | - Ryoko Sato
- TH Chan School of Public Health, Harvard University, Boston, USA
| | | | | | | | | | - David Canning
- TH Chan School of Public Health, Harvard University, Boston, USA
| | - Iqbal Shah
- TH Chan School of Public Health, Harvard University, Boston, USA
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35
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Ahinkorah BO, Seidu AA, Armah-Ansah EK, Ameyaw EK, Budu E, Yaya S. Socio-economic and demographic factors associated with fertility preferences among women of reproductive age in Ghana: evidence from the 2014 Demographic and Health Survey. Reprod Health 2021; 18:2. [PMID: 33388063 PMCID: PMC7777390 DOI: 10.1186/s12978-020-01057-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 12/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding women's desire to have more children is critical for planning towards future reproductive health behaviour. We examined the association between socio-economic and demographic factors and fertility preferences among women of reproductive age in Ghana. METHODS This study used data from the 2014 Ghana Demographic and Health Survey. The sample consisted of 5389 women of reproductive age. We fitted Binary logistic regression models to assess the association between socio-economic status and fertility preferences, whiles controlling for demographic factors. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs) together with their corresponding 95% confidence intervals. RESULTS Approximately 60% of women of reproductive age in Ghana desired for more children. Women with no formal education were more likely to desire for more children compared to those with higher level of education (aOR = 2.16, 95% CI 1.29-3.48). The odds of desire for more children was higher among women who lived in rural areas compared to those who lived in urban areas (aOR = 1.24, 95% CI 1.01-1.53). With region, women who lived in the Northern region were more likely to desire for more children compared to those who lived in the Ashanti region (aOR = 4.03, 95% CI 2.69-6.04). Similarly, women who belonged to other ethnic groups were more likely to desire for more children compared to Akans (aOR = 1.78, 95% CI 1.35-2.35). The desire for more children was higher among women with 0-3 births compared to those with four or more births (aOR = 7.15, 95% CI 5.97-8.58). In terms of religion, Muslim women were more likely to desire for more children compared to Christians (aOR = 1.87, 95% CI 1.49-2.34). CONCLUSION This study concludes that women in high-socio economic status are less likely to desire more children. On the other hand, women in the Northern, Upper East and those belonging to the Islamic religious sect tend to desire more children. To aid in fertility control programmes designing and strengthening of existing ones, these factors ought to be critically considered.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD Australia
| | | | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, The University of Oxford, Oxford, UK
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Ahuja M, Frimpong E, Okoro J, Wani R, Armel S. Risk and protective factors for intention of contraception use among women in Ghana. Health Psychol Open 2020; 7:2055102920975975. [PMID: 33329897 PMCID: PMC7720324 DOI: 10.1177/2055102920975975] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The use of various forms of contraception in Ghana gained prominence after the government resorted to investing more in family planning programs when maternal mortality was declared an emergency in the country. In Ghana, the intention to use and actual usage of contraceptives is influenced by many factors, which may lead to non-usage or discontinuation. This quantitative study was conducted to determine risk and protective factors impacting on the intention and usage of contraceptives. Survey data from the Ghana 2014 Demographic and Health Survey (DHS) (n = 9396) was used. A sub-sample of 7661 women in their reproductive age were included in this study, who reported being sexually active within the last year. Logistic regression analyses were conducted to test the association between a broad range of risk and protective factors including religion, early sexual intercourse, frequency of sex, number of lifetime sexual partners with intention to use contraception. We controlled for income, educational attainment, and age. Overall (n = 3661; 47.8%) reported no intention of contraception use. Logistic regression analysis revealed that no formal education (OR = 1.49; 95% CI, 1.29–1.72; p < 0.001), and primary school as highest educational level (OR = 1.19; 95% CI, 1.04–1.25; p < 0.001), Islamic religion (OR = 0.73; 95% CI, 0.59–0.90; p < 0.001), not currently employed (OR = 1.50; 95% CI, 1.34–1.69; p < 0.001), husband opposing contraception use (OR = 2.19; 95% CI, 1.42–3.46; p < 0.001), and currently pregnant (OR = 1.30; 95% CI, 1.09–1.54; p < 0.001) were also positively associated with no intention of use. Engaging religious leaders for advocacy in the community was identified as an approach to address barriers and increase awareness on contraceptive use. Targeted family planning programs should intensify public education on safe sex behaviors.
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Affiliation(s)
| | | | - Joy Okoro
- East Tennessee State University, USA
| | - Rajvi Wani
- University of Nebraska Medical Center, USA
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Ahinkorah BO. Predictors of modern contraceptive use among adolescent girls and young women in sub-Saharan Africa: a mixed effects multilevel analysis of data from 29 demographic and health surveys. Contracept Reprod Med 2020; 5:32. [PMID: 33292675 PMCID: PMC7678092 DOI: 10.1186/s40834-020-00138-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022] Open
Abstract
Background The use of modern contraceptives among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) remains an issue that needs urgent attention. This present study assesses the individual and contextual factors associated with modern contraceptive use among AGYW in SSA. Methods Data for this study was obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 29 countries in SSA. Data were analysed with Stata version 14.2 by employing both Pearson’s chi-square test of independence and a multilevel binary logistic regression. The selection of variables for the multilevel models was based on their statistical significance at the chi-square test at a p < 0.05. Model fitness for the multilevel models was checked using the log likelihood ratios and Akaike’s Information Criterion (AIC) and the results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results It was found that 24.7% of AGYW in SSA use modern contraceptives. In terms of the individual level factors, the study showed that AGYW aged 15–19 [aOR = 0.86, CI = 0.83–0.90], those who were married [aOR = 0.83, CI = 0.79–0.87], Muslims [aOR = 0.59, CI = 0.57–0.62], working [aOR = 0.92, CI = 0.89–0.95], those who had no child [aOR = 0.44, CI = 0.42–0.47], those who had no exposure to newspaper/magazine [aOR = 0.44, CI = 0.63–0.71] and radio [aOR = 0.82, CI = 0.78–0.86] had lower odds of using modern contraceptives. Conversely, the use of modern contraceptives was high among AGYW whose age at first sex was 15–19 years [aOR = 1.20, CI = 1.12–1.28]. With the contextual factors, the odds of using modern contraceptives was low among AGYW who lived in rural areas [aOR = 0.89, CI = 0.85–0.93] and in communities with low literacy level [aOR = 0.73, CI = 0.70–0.77] and low socio-economic status [aOR = 0.69, CI = 0.65–0.73]. Conclusion Several individual and contextual factors are associated with modern contraceptive use among AGYW in SSA. Therefore, Governments in the various countries considered in this study should intensify mass education on the use of modern contraceptives. This education should be more centered on AGYW who are in socio-economically disadvantaged communities, those who are not married, Muslims, those with high parity and high fertility preferences and those who are working.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
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Seidu AA, Agbaglo E, Dadzie LK, Ahinkorah BO, Ameyaw EK, Tetteh JK, Yaya S. Modern contraceptive utilization and associated factors among married and cohabiting women in Papua New Guinea: a population-based cross-sectional study. Contracept Reprod Med 2020; 5:22. [PMID: 33292793 PMCID: PMC7672901 DOI: 10.1186/s40834-020-00125-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Universal access to family planning has been emphasized by the international development agenda, as evident in the Sustainable Development Goal 3.7. This notwithstanding, the use of modern contraceptives has been minimal in low- and middle-income countries, especially in Papua New Guinea. In view of this, we investigated the factors associated with the use of modern contraceptives and the associated factors among married and cohabiting women in Papua New Guinea. METHODS The study utilised the Demographic and Health Survey data of 2345 women in sexual unions in Papua New Guinea. We employed a descriptive and binary logistic regression analyses. We presented the results as crude Odds Ratios (COR) and adjusted Odds Ratios (AOR), with 95% confidence intervals (CI) signifying level of precision. Level of statistical significance was set at p < 0.05. RESULTS We found that 74.4% of the women were using modern contraceptives ranging from injectables (44.5%) to other modern methods (0.23%). Women aged 15-19 [AOR = 7.425, 95% CI = 2.853, 19.32], residents of the Highland region [AOR = 1.521, 95% CI =1.086, 2.131], self-employed women in the agricultural sector [AOR = 1.710, 95% CI = 1.218, 2.400], and women who listened to radio at least once a week [AOR = 1.409, 95% CI = 1.048, 1.895] had higher odds of modern contraceptive usage. However, women in the Islands region [AOR = 0.291, 95% CI = 0.224, 0.377], women whose husbands had higher education [AOR = 0.531,95%CI = 0.318,0.886], women in professional/technical/managerial work [AOR = 0.643, 95% CI = 0.420, 0.986], and those with no child [AOR = 0.213, CI = 0.0498,0.911] had lower odds of modern contraceptive use. CONCLUSION Out of the 2345 participants, we found that majority of them were using modern contraceptives and the commonly used modern contraceptive was injectables. Age, region of residence, partner's education, employment, partner's desire for children, and frequency of listening to radio are associated with modern contraceptive usage. Tailored reproductive healthcare should be developed for women who are disadvantaged when it comes to the usage of modern contraceptives in order to boost modern contraceptive use among them. Further investigation is needed to unravel the motivation for the high usage of injectables among married and cohabiting women in Papua New Guinea.
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Affiliation(s)
- Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Louis Kobina Dadzie
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada.,The George Institute for Global Health, The University of Oxford, Oxford, UK
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Ahinkorah BO, Seidu AA, Appiah F, Budu E, Adu C, Aderoju YBG, Adoboi F, Ajayi AI. Individual and community-level factors associated with modern contraceptive use among adolescent girls and young women in Mali: a mixed effects multilevel analysis of the 2018 Mali demographic and health survey. Contracept Reprod Med 2020; 5:27. [PMID: 33062298 PMCID: PMC7547459 DOI: 10.1186/s40834-020-00132-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/30/2020] [Indexed: 12/02/2022] Open
Abstract
Background Unintended pregnancy constitutes a significant public health challenge in sub-Saharan Africa and particularly among young people, who are more likely to closely space births and experience adverse obstetric outcomes. Studies on modern contraceptive use have mostly focused on women of reproductive age in general with limited attention to factors associated with modern contraceptive use among adolescents and young women (aged 15–24) in Mali. We examined the individual and community-level factors associated with modern contraceptive use among this age cohort using the 2018 Mali demographic and health survey data. Methods We analyzed data from 2639 adolescent girls and young women, and our outcome of interest was current use of modern contraceptives. We performed descriptive analysis using frequencies and percentages and inferential analysis using mixed-effects multilevel logistic regression. The results of the mixed-effects multilevel logistic regression were presented as adjusted odds ratios with their corresponding 95% confidence intervals. Results The prevalence of modern contraceptive use among adolescent girls and young women in Mali was 17.1% [95% CI, 15–19%]. Adolescent girls and young women who were married [aOR = 0.20, CI = 0.09–0.41], had no formal education [aOR = 0.43, CI = 0.32–0.59], in the poorest wealth quintile [aOR = 0.38, CI = 0.19–0.79] and had no children [aOR = 0.38, CI = 0.27–0.53] were less likely to use modern contraceptives. Similarly, those who had low knowledge of modern contraception [aOR = 0.60, CI = 0.42–0.85] and whose ideal number of children was six or more [aOR = 0.66, CI = 0.43–0.99] were less likely to use modern contraceptives. However, those with four or more births were more likely to use modern contraceptives [aOR = 1.85, CI = 1.24–2.77]. Conclusion Modern contraceptive use among adolescent girls and young women in Mali has improved slightly relative to the prevalence of 2012, though the prevalence is still low, compared to the prevalence in other sub-Saharan African countries and the prevalence globally. Individual-level factors such as marital status, educational level, wealth quintile, parity, ethnicity and ideal number of children were associated with the use of modern contraceptive among adolescent girls and young women in Mali. Community knowledge of modern contraceptives was found as a community-level factor associated with modern contraceptive use among adolescent girls and young women. Therefore, Mali’s Ministry of Health and Public Hygiene's Health Promotion and Education unit should prioritise and intensify contraceptive education to increase coverage of modern contraceptive use and address disparities in the use of modern contraceptives. Such education should be done, taking into consideration factors at the individual and community-level of the target population.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
| | - Francis Appiah
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Collins Adu
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yaa Boahemaa Gyasi Aderoju
- Department of Adult Health Nursing, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Faustina Adoboi
- Cape Coast Nursing and Midwifery Training College, Cape Coast, Ghana
| | - Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health and Rights Unit, African Population and Health Research Center, Manga Close, Off Kirawa Road, Kitisuru, Nairobi, 00100 Kenya
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Apanga PA, Kumbeni MT, Ayamga EA, Ulanja MB, Akparibo R. Prevalence and factors associated with modern contraceptive use among women of reproductive age in 20 African countries: a large population-based study. BMJ Open 2020; 10:e041103. [PMID: 32978208 PMCID: PMC7520862 DOI: 10.1136/bmjopen-2020-041103] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the prevalence and factors associated with modern contraceptive (CP) use among women of the reproductive age. DESIGN Cross-sectional study. SETTING We used data from the Multiple Indicator Cluster Surveys (MICSs) from 20 African countries collected between 2013 and 2018. PARTICIPANTS Data on 1 177 459 women aged 15-49 years old. METHODS Multivariable logistic regression was used to identify factors associated with modern CP use, while controlling simultaneously for independent variables, and accounting for clustering, stratification and sample weights from the complex sampling design. We used random effects meta-analysis to pool adjusted estimates across the 20 countries. RESULTS The overall prevalence of modern CP use was 26% and ranged from 6% in Guinea to 62% in Zimbabwe. Overall, injectable (32%) was the most preferred method of CP, followed by oral pill (27%) and implants (16%). Women were more likely to use a modern CP if they: had a primary (adjusted prevalence odds ratios (aPORs): 1.68, 95% CI: 1.47 to 1.91)) or secondary/higher education (aPOR: 2.16, 95% CI: 1.80 to 2.59) compared with women with no formal education; had no delivery in the last 2 years (aPOR: 3.89, 95% CI: 2.76 to 5.47) compared with women who delivered in the last 2 years; were aged 25-34 years (aPOR: 1.33, 95% CI: 1.20 to 1.47) compared with women aged 15-24 years; were of middle-income status (aPOR: 1.25, 95% CI: 1.11 to 1.39) or rich (aPOR: 1.53, 95% CI: 1.27 to 1.84) compared with poor women and had two or more antenatal care visits compared with women without a visit. Perceived domestic violence was not associated with modern CP use (aPOR: 0.98, 95% CI: 0.92 to 1.05). CONCLUSION Our findings are relevant in a global context, particularly in the African region, and improve our understanding on relevant factors essential to increasing modern CP use.
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Affiliation(s)
| | - Maxwell Tii Kumbeni
- Nabdam District Health Directorate, Ghana Health Service, Nangodi, Upper East Region, Ghana
| | - Emmanuel Awine Ayamga
- Nabdam District Health Directorate, Ghana Health Service, Nangodi, Upper East Region, Ghana
| | - Mark B Ulanja
- School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Robert Akparibo
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
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Salifu MG, Mohammed K. Prevalence and Predictors of Contraceptives Use among Women Aged (15-49 years) with Induced Abortion History in Ghana. Adv Prev Med 2020; 2020:2630905. [PMID: 32908708 PMCID: PMC7474737 DOI: 10.1155/2020/2630905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/30/2020] [Accepted: 08/14/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The incidence of abortion in Ghana ranges from 27 per 1000 to 61 per 1000 women, causing gynecological complications and maternal mortality. The use of modern contraceptives and its associated factors among women aged 15-49 years have been documented. However, utilization of modern contraceptives specifically among women with induced abortion history is underreported. This study therefore aimed at determining the proportion and identifying predictors of contraceptives use in this underreported population. METHODS This study used secondary data from the 2017 Ghana Maternal Health Survey (GMHS) for the analysis. The analysis is on a weighted sample of 3,039 women aged (15-49 years) with a history of induced abortion. Both descriptive and inferential methods were employed. The chi-square test, univariate and multivariate logistic regression techniques were used to assess statistical associations between the outcome variable and the predictors. Statistical significance was set at 95% confidence interval and p values ≤0.05. RESULTS Out of the 3,039 participants, 37% (95% CI: 34.6, 38.84) used contraceptives. We identified women' age, union, place of residence, knowledge of fertile period, total pregnancy outcomes, and region as strong significant (95% CI, p ≤ 0.05) predictors of post induced abortion contraceptives use. CONCLUSION Contraceptives use among this vulnerable population is low. Therefore, there is a need to provide widespread access to postabortion contraception services and enhance efforts to efficiently integrate safe abortion practices law into health services in Ghana.
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Affiliation(s)
| | - Kamaldeen Mohammed
- Department of Geography, Western University, 1151 Richmond Street, N6A 3K7, London, Ontario, Canada
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Modern Contraceptive Use and Influencing Factors in Amhara Regional State: Further Analysis of Ethiopian Demographic Health Survey Data 2016. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/5817383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background. Ethiopia is one of the Sub-Saharan African countries with a high unmet need for contraceptives. Contraception is a good indicator of the extent to which couples have access to reproductive health services. A study on contraceptives can provide overall direction by helping to identify the obstacles in society and weaknesses in services that need to be overcome. However, little is known in Amhara region context. Therefore, this analysis was aimed to assess modern contraceptive use and influencing factors in the Amhara regional state of Ethiopia. Methods. We used secondary data analysis of the regional representative sample of women aged 15–49 years from the 2016 Ethiopian Demography and Health Survey (EDHS). A total of 2207 married reproductive-age women (15–49 years) selected using a two-stage stratified cluster sampling technique were included in this analysis. Both descriptive and logistic regression analyses were performed using STATA V.14. A 95% confidence interval was used to declare statistical significance. Results. Modern contraceptive use among married reproductive-age women was 51.3% (95% CI: 47.0–55.6). Being from households with rich wealth index (AOR = 1.6; 95% CI: 1.1–2.5), a secondary or higher level of education (AOR = 3.0; 95% CI: 1.4–6.2), and desire to space (AOR = 2.6; 95% CI: 1.9–3.7) or want no more child (AOR = 2.4; 95% CI: 1.6–3.5) were found positively associated with modern contraceptive use. On the other hand, modern contraceptive use was negatively associated with women aged 35–49 years (AOR = 0.7; 95% CI: 0.5–0.9). Conclusion. Modern contraceptive use was relatively high in the Amhara region. The odds of modern contraceptive use were higher among women with secondary or more educational levels. Women from households with rich wealth index and those who want to delay or avoid pregnancy had also more odds of using modern contraceptives. Therefore, strengthening women’s and community education could improve modern contraceptive use. Moreover, more emphasis should be given for income generation activities.
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Adampah T, Angwa LM, Demuyakor A, Achinkok D, Boah M. Contraceptive use among women with a history of induced abortion: findings from a national sample of sexually active, non-pregnant women in Ghana. EUR J CONTRACEP REPR 2020; 25:394-401. [PMID: 32684009 DOI: 10.1080/13625187.2020.1795117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of the study was to examine the relationship between a history of induced abortion and current use of contraception among reproductive-aged women in Ghana. METHODS The analysed data were a weighted sample of 6544 sexually active, non-pregnant women aged 15-49 years, obtained from the 2014 Ghana Demographic and Health Survey. Survey logistic regression analysis was used to estimate the odds of currently using any contraception and of using a modern method of contraception, given a history of induced abortion in the period 2009-2014. RESULTS A history of induced abortion between 2009 and 2014 was reported by 17.4% of women (95% CI 16.0%, 18.9%); 28.7% (95% CI 26.9%, 30.6%) were currently using a method of contraception and 23.0% (95% CI 21.4%, 24.7%) were currently using a modern method of contraception. The majority (80.1%) of current contraceptive users were using a modern method. The adjusted analysis revealed no statistically significant association between a history of induced abortion and current contraceptive behaviour. Other factors were associated with modern contraceptive use. CONCLUSION Overall, the use of contraception among sexually active women in Ghana was found to be low. Our findings showed that women's experience of induced abortion was unlikely to influence their current use of modern contraception.
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Affiliation(s)
- Timothy Adampah
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Center for Education, Culture and Health Opportunities (ECHO) Research Group International, Aflao, Ghana
| | - Linet Musungu Angwa
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Department of Clinical Medicine, Kabarak University, Nakuru, Kenya
| | - Abigail Demuyakor
- Key Laboratory of Myocardial Ischemia, Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, Harbin, China
| | - Dominic Achinkok
- School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana
| | - Michael Boah
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Ghana Health Service, Bolgatanga, Ghana
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Apambila RN, Owusu-Asubonteng G, Dassah ET. Contraceptive use among young women in northern Ghana: a community-based study. EUR J CONTRACEP REPR 2020; 25:339-344. [PMID: 32615045 DOI: 10.1080/13625187.2020.1783651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of the study was to assess factors influencing contraceptive uptake among young women aged 15-24 years in Bolgatanga Municipal District, northern Ghana. METHODS An analytical cross-sectional community-based study was conducted between December 2015 and April 2016. Participants (N = 580) were selected through multistage sampling and interviewed using a pretested structured questionnaire. RESULTS The mean age of the participants was 20.5 years (standard deviation 2.8 years). About a third were less than 20 years old. Contraceptive knowledge was nearly universal (99.7%). About 67% of sexually experienced young women had used contraceptives, but less than a quarter had used long-acting reversible contraception (LARC). Age was the only independent predictor of contraceptive use: women in their 20s were more than twice as likely as adolescents to use contraceptives (adjusted relative risk 2.75; 95% confidence interval 2.04, 3.71; p < 0.001). CONCLUSION Strategies to improve contraceptive uptake among young people in the municipality should encourage the use of LARC.
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Affiliation(s)
| | - Gerald Owusu-Asubonteng
- Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward T Dassah
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Thapa NR. Factors influencing the use of reproductive health services among young women in Nepal: analysis of the 2016 Nepal demographic and health survey. Reprod Health 2020; 17:102. [PMID: 32600458 PMCID: PMC7325020 DOI: 10.1186/s12978-020-00954-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background Utilization of reproductive health services is a key component for preventing young women from different sexual and reproductive health problems. Thus, the objective of this study is to determine the factors influencing the use of reproductive health services among young women in Nepal. Methods Data have been extracted from the 2016 Nepal Demographic and Health Survey (NDHS) datasets wherein the weighted sample population size was restricted for modern contraceptive use to 1593 whereas for the antenatal care and skilled birth attendants to1606. This study has selected three reproductive health indicators as outcome variables of reproductive health service utilization for the analysis viz, modern contraceptive use, at least four antenatal care visits, and use of skilled birth attendants. Likewise, all calculations are based on standard sample weight of NDHS. Results The study has found that 21% of young women used modern contraception, 71% attended at least four ANC visits, and 67% utilized a skilled birth attendant at delivery. Young Janajati women, women having 1–2, and 3 or more living children, women participating household decision-making, and the ones having exposure to media were more likely to use modern contraceptives, whereas the women who want more children were less likely to use them. Higher education attainments, higher wealth quintile, and lower birth order were associated with higher level of receiving at least four ANC visits and SBAs. However, the young women willing to have more children and having access to media have higher odds of receiving at least four ANC visits; and the women attending four and more ANC visits have higher odds of using SBAs. Conclusions In order to improve the use of reproductive health services among young women, efforts should be made to enrich the young women of lower educational level, lower economic status, higher birth order, and lower exposure to media. Further research is required to detect the causes that affect the use of reproductive health services.
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Affiliation(s)
- Naba Raj Thapa
- Department of Population Studies, Ratna Rajyalaxmi Campus, Tribhuvan University, Kathmandu, Nepal.
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Yussuf MH, Elewonibi BR, Rwabilimbo MM, Mboya IB, Mahande MJ. Trends and predictors of changes in modern contraceptive use among women aged 15-49 years in Tanzania from 2004-2016: Evidence from Tanzania Demographic and Health Surveys. PLoS One 2020; 15:e0234980. [PMID: 32598371 PMCID: PMC7323946 DOI: 10.1371/journal.pone.0234980] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 06/05/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Modern contraceptive use provides opportunities for women and couples to achieve optimal child spacing, achieve desired family size and reduce unsafe abortions. Despite these facts, modern contraceptive prevalence rate (mCPR) in Tanzania remains as low as 32%. This study aimed to determine trends and factors associated with changes in modern contraceptive use among women of reproductive age in Tanzania from 2004–2016. Methodology This was a cross-sectional study utilizing data from Tanzania Demographic and Health Surveys of 2004–2005, 2010 and 2015–2016. Data analysis was performed using Stata version 14. Analysis considered the complex survey design through application of weights, clustering and strata. Multivariable Poisson decomposition analysis was used to assess factors associated with changes in modern contraceptive use. Results were presented in the form of decomposition coefficients and percentages. Results Modern contraceptive use increased from 23.0% in 2004 to 34.3% in 2016. Differences in women’s characteristics contributed 12.5% of the increase in mCPR. These characteristics include partner’s education levels, recent sexual activity and being visited by a family planning worker. The difference in coefficients contributed 87.5% increase in mCPR. The most increase in modern contraceptive use was attributed to rural population (44.1%) and women who experienced a termination of pregnancy (7.1%). Conclusion Modern contraceptive use has steadily increased in Tanzania. Health policies and interventions need to target sexually active women, rural residents as well as less educated women and men to maintain and further accelerate the trends in mCPR. Interventions focusing on women who experienced a termination of pregnancy may also serve as an entry point to promote use of modern contraceptive methods.
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Affiliation(s)
- Mashavu H. Yussuf
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- * E-mail:
| | - Bilikisu R. Elewonibi
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Martin M. Rwabilimbo
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Innocent B. Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- School of Mathematics, Statistics & Computer Science, University of KwaZulu-Natal, Pietermaritzburg, Scottsville, South Africa
| | - Michael J. Mahande
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Abdulahi M, Kakaire O, Namusoke F. Determinants of modern contraceptive use among married Somali women living in Kampala; a cross sectional survey. Reprod Health 2020; 17:72. [PMID: 32448285 PMCID: PMC7247175 DOI: 10.1186/s12978-020-00922-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/14/2020] [Indexed: 12/04/2022] Open
Abstract
Background Low contraceptive uptake exposes women to unintended pregnancies and often the resultant obstetric complications. The immigrant communities especially from countries with low contraceptive use present a unique challenge. The main objective of the study was to describe modern contraceptive use and associated factors among married Somali women living in Kampala. Methods A community based cross sectional survey was conducted among Somali women living in Kampala from August to November 2016. Using consecutive sampling, 341 respondents were recruited after informed consent. Data was collected using interviewer administered questionnaires on contraceptives use and factors associated. Data was entered in Epidata 3.1 and analyzed using STATA 11.0. Logistic regression analysis was used to determine the factors associated with use of modern contraceptives. Results Majority of the participants were refugees 317/341(94%), with a mean age of 30.4 (±6.7) years and 136/341 (40%) had no formal education. More than 325/341 (95%) of respondents desired to have five or more children (Average 9 + 3) and 164/341 (45%) had five or more living children. Only 29% of women were using modern contraceptives, of which 51% used oral pills, 15% condoms and 15% injectables. Having tertiary education, one who had ever used modern contraceptives and desire for spacing of more than two years were independently associated with current of use modern contraceptives. Conclusions The Contraceptive prevalence rate among married Somali women in Kampala was (29%). A majority of the respondents were using short acting contraceptive methods. Attaining tertiary education, ever use of modern contraceptives, those whose source of contraceptive information was health worker and desire to space for more than two years were associated with current use of modern contraceptives. There is a need for improvement of girl child education, contraceptive awareness and male involvement to increase contraceptive uptake in this community. Research looking at attitude of this community towards use of long term contraception is recommended.
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Affiliation(s)
- Maryan Abdulahi
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University , 7062, Kampala, Uganda
| | - Othman Kakaire
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University , 7062, Kampala, Uganda
| | - Fatuma Namusoke
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University , 7062, Kampala, Uganda.
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Gebre MN, Edossa ZK. Modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia: evidence from 2016 Ethiopia demographic and health survey. BMC WOMENS HEALTH 2020; 20:61. [PMID: 32216823 PMCID: PMC7098091 DOI: 10.1186/s12905-020-00923-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/10/2020] [Indexed: 11/27/2022]
Abstract
Background Modern contraceptive methods enable couples to enjoy sexual intercourse without fear of the risk of pregnancy at any desired time. The evidence from different studies done in Ethiopia on modern contraceptive method utilization was highly varied and not conclusive. Therefore, the current study aims to study the magnitude of modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia based on 2016 EDHS data. Method A nationally representative 2016 EDHS data collected between January 18/ 2016 to June 27/2016 were used. Descriptive studies and logistic regression models were used to summarize descriptive data and measure statistical association respectively. Adjusted odds ratio and confidence interval were respectively used to measure association and its statistical significance. Finally, statistical significance was declared using a confidence interval. Result In the current study, the overall modern contraceptive utilization among reproductive-age women in Ethiopia was 3203 (20.42%). The injectable contraceptive method was the most commonly used modern contraceptive method, 1886(58.88%) followed by implant/Norplant, 779 (24.32%). The results of multivariable logistic regression showed that age, residence, region, woman’s occupation, number of living children, husband’s education, age at first sexual intercourse, husband’s desire for more children, wealth index and watching TV were independently associated to modern contraceptive utilization among reproductive-age women in Ethiopia. Conclusions The magnitude of modern contraceptive utilization among reproductive-age women in Ethiopia in the current study is unexpectedly low. Age, residence, region, woman’s occupation, number of living children, husband’s education, age at first sexual intercourse, husband’s desire for more children, wealth index and watching TV were independent predictors of modern contraceptive use among reproductive-age women in Ethiopia. Any intervention strategy that promotes modern contraceptive method utilization should consider these factors for its better success.
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Affiliation(s)
- Mamo Nigatu Gebre
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Zerihun Kura Edossa
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Gafar A, Suza DE, Efendi F, Has EMM, Pramono AP, Susanti IA. Determinants of contraceptive use among married women in Indonesia. F1000Res 2020; 9:193. [PMID: 32269768 PMCID: PMC7137393 DOI: 10.12688/f1000research.22482.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Contraceptives in family planning are used to control the timings between pregnancies. Although the number of those using family planning has increased, determinants of contraceptive use among married women in Indonesia remain insufficient. This research aimed to identify the factors associated with contraceptive use among married women in Indonesia. Methods: This study employed data from the Indonesian Demographic and Health Survey 2017. We selected 35,621 married women aged 15-49 years. Then, the determinants of contraceptive use among married women in Indonesia were examined by binary logistic regression. Results: Women's age (Adjusted Odds Ratio (AOR)=0.529; 95% CI=0.470-0.597), the number of living children (AOR=44.024; 95% CI=33.193-58.390), education level (adjusted odds ratio=2.800; 95% CI=2.181-3.594), wealth index (AOR=1.104; 95% CI=0.978-1.246), frequency of watching television (AOR=1.555; 95% CI=1.321-1.829), and frequency of using the Internet (AOR=0.856; 95% CI=0.794-0.924) were significantly associated with contraceptive use among married women. Conclusions: This study highlights the determinants of contraceptive use among married women in Indonesia. Women's age, the number of living children, education level, wealth index, and access to information may influence contraceptive use among these women. This study emphasizes that health education and promotion on the importance of using contraception should be initiated in innovative ways.
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Affiliation(s)
- Alfian Gafar
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | | | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- School of Nursing & Midwifery, La Trobe University, Melbourne, Australia
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Amissah J, Nakua EK, Badu E, Amissah AB, Lariba L. In search of universal health coverage: the hidden cost of family planning to women in Ghana. BMC Res Notes 2020; 13:58. [PMID: 32029007 PMCID: PMC7006161 DOI: 10.1186/s13104-020-4928-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/29/2020] [Indexed: 12/17/2022] Open
Abstract
Objective This study aims to estimate the cost of accessing FP services in Ghana. A cross-sectional design, involving quantitative methods were used to recruit 1194 women who accessed FP services in 336 primary health facilities, selected through a two-stage sampling. Descriptive statistics were used to estimate the cost, using STATA 13. Results The average age of the women was 29 ± 6.87. Most women had basic education. The sources of payment for FP services were self-finance, family and sponsorship. The average direct cost of accessing FP services was GHS 7.90 [US$ 1.76]. The cost of FP services was highest for consultation GHS 7.50 [US$ 1.67], Laboratory test/x-ray GHS 6.03 [US$ 1.34], Transportation GHS GHS5.50 [US$ 1.22], Contraceptive GHS 4.73 [US$ 1.05] and Client records Card GHS 3.30 [US$ 0.73]. The cost of FP services was higher for clients visiting private facilities, tertiary level as well as those in urban centers. Clients on average spent 54.21 min traveling at a distance of 3.49 km and wait averagely 18.11 min for each visit. Government stakeholders are encouraged to revise the existing maternal health policies, as well as increase the list of FP services within the exemption package of the NHIS policy.
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Affiliation(s)
- John Amissah
- Department of Health Policy Planning, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Emmanuel Kwaku Nakua
- Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Badu
- Department of Nursing, University of Newcastle, Callaghan, Australia
| | - Alexander Baba Amissah
- Institute of Continuous Education and Distance Learning, University of Ghana, Legon, Accra, Ghana
| | - Leticia Lariba
- Department of Pharmaceutics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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