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Geta TG, Abdiwali SA, Farah MM, Assefa DZ, Arusi TT. Multilevel analysis on prevalence and associated factors of modern contraceptive uptake in Somaliland: based on The Somaliland Health and Demographic Survey 2020. Reprod Health 2024; 21:67. [PMID: 38773601 PMCID: PMC11110236 DOI: 10.1186/s12978-024-01786-1] [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: 07/31/2023] [Accepted: 04/03/2024] [Indexed: 05/24/2024] Open
Abstract
INTRODUCTION Contraception is the deliberate prevention of unwanted pregnancy through various contraceptive methods. Its uptake is low in Sub-Saharan African countries, particularly in east Africa. This might be linked to the high prevalence of unwanted pregnancies and the high fertility rate in the area. Although studies reporting the prevalence and associated factors of modern contraceptive uptake are available in other African countries, no study has been conducted in Somaliland. Therefore, the current study aimed to assess its prevalence and associated factors in Somaliland using Somaliland Health and Demographic Survey (SLHDS) data. METHODS AND MATERIALS The study used Somaliland Demographic Health Survey (SLDHS) 2020 data. The survey was a national-level survey using a cross-sectional study design. A total of 3656 reproductive-age women were included in the current study. To determine independent predictors of modern contraceptive uptake, a multi-level multivariable logistic regression analysis was done. Random effect analysis, standard error (SE) and intra-cluster correlation (ICC) were computed. RESULTS The proportion of modern contraceptive uptake among reproductive age groups in Somaliland is 1%. Modern contraceptive uptake is significantly associated with the residence, educational level and wealth index of participants. Women from nomadic communities had lower odds (AOR: 0.25; 95% CI: 0.10, 0.66) of modern contraceptive uptake compared to those from urban areas. Being in the highest wealth quintiles (AOR: 17.22; 95% CI: 1.99, 155.92) and having a tertiary educational level (AOR: 2.11; 95% CI: 1.29, 9.11) had higher odds of using the modern contractive method compared to those with the lowest wealth quintiles and non-formal education, respectively. CONCLUSION The prevalence of modern contraceptive uptake in Somaliland was very low. It is associated with the level of education, wealth index and residence of the women.
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Affiliation(s)
- Teshome Gensa Geta
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
- Department of Public Health, College of Health Science and Medicine, Gollis University, Hargeisa, Somaliland.
| | - Saad Ahmed Abdiwali
- Department of Public Health, College of Health Science and Medicine, Gollis University, Hargeisa, Somaliland
| | - Mustafa Mohamoud Farah
- Department of Public Health, College of Health Science and Medicine, Gollis University, Hargeisa, Somaliland
| | - Dereje Zewdu Assefa
- Department of Anaesthesia, College of Health Science and Medicine, Wolkite University, Wolkite, Ethiopia
| | - Temesgen Tantu Arusi
- Department of Obstetrics and Gynaecology, College of Health Science and Medicine, Wolkite University, Wolkite, Ethiopia
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Feyisa BR, Shiferaw D, Yesse M, Shama AT, Duressa LT, Biru B. Time to first birth and its predictors among reproductive-age women in Ethiopia: multilevel analysis using shared frailty model. BMJ Open 2024; 14:e082356. [PMID: 38760052 PMCID: PMC11103229 DOI: 10.1136/bmjopen-2023-082356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/02/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE To determine the time to first birth and its predictors among reproductive-age women in Ethiopia. DESIGN, SETTING AND PARTICIPANTS Nationwide secondary data analysis using mini Ethiopian Demographic and Health Survey, 2019. A stratified, two-stage cluster sampling technique was used to select the sample. Among 9012 women of age 15-49 years, 8885 completed the interview yielding a response rate of 99%. MAIN OUTCOMES MEASURED Time to first birth was determined. Kaplan-Meier method was used to estimate the time to first birth. The lognormal inverse Gaussian shared frailty model was used to model the data at a 95% CI. CI and adjusted time ratio (ATR) were reported as effect size. Statistical significance was declared at p-value<0.05. RESULTS The overall median time to give first birth was 18 years (IQR: 15, 21). Age 20-29 (ATR=1.08; 95% CI, 1.05 to 1.12), Age>29 years (ATR=1.08; 95% CI, 1.05 to 1.11), northern regions (ATR=1.06; 95% CI, 1.03 to 1.08), rural residence (ATR=0.95; 95% CI, 0.93 to 0.98), never using contraceptive methods (ATR=0.98; 95% CI, 0.96 to 0.99), sex of household head (ATR=1.01; 95% CI, 1 to 1.03), poorest wealth index (ATR=1.04; 95% CI, 1.02 to 1.06) and richest wealth index (ATR=1.07; 95% CI, 1.04 to 1.1) were the significant predictors of time to first birth among reproductive-age women. CONCLUSION In Ethiopia, women often gave birth to their first child at a younger age than what is recommended. Explicitly, women aged 20-29 and over 29, living in the northern region, leading a household as females, and belonging to the poorest or wealthiest wealth index tended to have a slightly delayed first childbirth. On the other hand, women in rural areas and those who had never used contraception were more likely to have an early first birth. The findings indicated the necessity of implementing targeted measures for rural Ethiopian women, especially those lacking knowledge about contraception.
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Affiliation(s)
- Bikila Regassa Feyisa
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Desalegn Shiferaw
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- Department of Public Health, College of Medical and Health Science, Dambi Dollo University, Dambi Dollo, Ethiopia
| | - Mubarek Yesse
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- Department of Public Health, College of Medical and Health Science, Werabe University, Werabe, Ethiopia
| | - Adisu Tafari Shama
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | | | - Bayise Biru
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
- Department of Human Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Donkoh IE, Okyere J, Seidu A, Ahinkorah BO, Aboagye RG, Yaya S. Association between knowledge and use of contraceptive among women of reproductive age in sub-Saharan Africa. Health Sci Rep 2024; 7:e2028. [PMID: 38736479 PMCID: PMC11082086 DOI: 10.1002/hsr2.2028] [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: 05/20/2023] [Revised: 11/30/2023] [Accepted: 03/10/2024] [Indexed: 05/14/2024] Open
Abstract
Background and Aims The use of contraceptives has been considered relevant in reducing unintended pregnancies in sub-Saharan Africa (SSA). However, despite evidence of knowledge of contraceptives, their use remains low in SSA. This study examined the association between knowledge of contraceptive methods and the use of contraceptives in SSA. Methods Data for the study were extracted from the Demographic and Health Surveys of 21 countries in SSA spanning from 2015 to 2021. A weighted sample of 200,498 sexually active women of reproductive age were included in the final analysis. We presented the results on the utilization of contraceptives using percentages with their respective 95% confidence intervals (CI). We examined the association between knowledge of contraceptive methods and the use of contraceptives using multilevel binary logistic regression analysis. Results Overall, 24.32% (95% CI: 24.15-24.50) of women in SSA used contraceptives. Chad had the lowest prevalence of contraceptive use (5.07%) while Zimbabwe had the highest prevalence (66.81%). The odds of using any method of contraception were significantly higher for women with medium [Adjusted odds ratio (AOR) = 1.89; 95% CI = 1.80-1.98] and high [AOR = 2.22; 95% CI = 2.10-2.33] knowledge of contraceptive methods compared to those with low knowledge, after adjusting for all covariates. Conclusion Our study has shown that the use of contraceptives among women in SSA is low. Women's knowledge of any contraception method increases their likelihood of using contraceptives in SSA. To improve contraceptive use in SSA, targeted interventions and programmes should increase awareness creation and sensitization, which can improve women's knowledge on methods of contraception. Also, programmes implemented to address the low uptake of contraceptives should consider the factors identified in this study. In addition, specific subregional strategies could be implemented to narrow the subregional disparities.
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Affiliation(s)
- Irene Esi Donkoh
- Department of Medical Laboratory ScienceUniversity of Cape CoastCape CoastGhana
| | - Joshua Okyere
- Department of Population and HealthUniversity of Cape CoastCape CoastGhana
- School of Nursing and Midwifery, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Abdul‐Aziz Seidu
- Centre for Gender and AdvocacyTakoradi Technical UniversityTakoradiGhana
- College of Public Health, Medical and Veterinary SciencesJames Cook UniversityTownsvilleQueenslandAustralia
| | - Bright Opoku Ahinkorah
- School of Clinical MedicineUniversity of New South Wales SydneySydneyNew South WalesAustralia
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public HealthUniversity of Health and Allied SciencesHohoeGhana
| | - Sanni Yaya
- School of International Development and Global StudiesUniversity of OttawaOttawaOntarioCanada
- The George Institute for Global Health, Imperial College LondonLondonUK
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Mankelkl G, Kassaw AB, Kinfe B. Factors associated with modern contraceptive utilization among reproductive age women in Kenya; evidenced by the 2022 Kenyan demographic and health survey. Contracept Reprod Med 2024; 9:10. [PMID: 38491382 PMCID: PMC10941430 DOI: 10.1186/s40834-024-00271-1] [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: 11/30/2023] [Accepted: 02/25/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Globally, sexual and reproductive health is a significant public health issue for women of the reproductive age group. A modern contraceptive method enables individuals and families to manage fertility by reducing unintended pregnancies, abortions, pregnancy-related morbidity, and death. A modern contraceptive method is a drug or medical treatment that prevents sexual activity from leading to pregnancy. However, there is limited reliable and updated data on factors associated with modern contraceptive utilization among reproductive-age women at the national level in Kenya. So, the major goal of this study was to evaluate factors associated with modern contraceptive utilization among women of reproductive age in Kenya at the national level, as evidenced by the 2022 Kenyan demographic and health survey. METHODS The most recent datasets from the Kenyan Demographic and Health Survey were used for secondary data analysis. In all, 14,987 women of reproductive age participated in the investigation. Data for multivariable analysis on the factors influencing modern contraceptive utilization among Kenyan women of reproductive age can be obtained from the Kenyan Demographic and Health Survey. Finally, the odd ratio and percentages were presented along with their 95% confidence intervals. RESULT This study includes a total weighted sample of 14,987 reproductive-age women from the Kenyan demographic and health survey. Of the total contraceptive use, 90.1% of the study participants used modern contraceptives. Being married [AOR: 1.593, 95% CI (1.302, 1.948)], living in an urban area [AOR: 1.230, 95% CI (1.060, 1.428)], reading a magazine [1.002, 95% CI (0.921, 1.091)], listening to radio [AOR: 1.265, 95% CI (1.101, 1.454)], not breastfeeding [AOR: 1.296, 95% CI (1.114, 1.507), and having more than two children [AOR: 2.350, 95% CI (1.603, 3.445)] were the factors that promote modern contraceptive utilization. Conversely, having a history of terminated pregnancy [AOR: 0.767, 95% CI (0.657, 0.897), being Muslim [AOR: 0.566, 95% CI (0.418, 0.766)], and being in the 35-39 age range [AOR: 0.766, 95% CI (0.605, 0.971)] were all associated with a lower use of modern contraceptives. CONCLUSION Certain factors such as marriage, living in urban areas, having more than two children, having a female-led household, belonging to the middle class, reading magazines, listening to the radio, and not breastfeeding have a positive correlation with the use of modern contraceptives. Conversely, being a Muslim, aged between 35 and 39, and having a history of miscarriages are negatively correlated with the use of modern contraceptives. This indicates that addressing socioeconomic, geographic, and cultural barriers could improve the effectiveness of modern contraceptive.
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Affiliation(s)
- Gosa Mankelkl
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Altaseb Beyene Kassaw
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Beletu Kinfe
- Department of occupational Health and safety, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Osborne A, Bangura C. Proximal factors influencing the likelihood of married and cohabiting women in Sierra Leone to use contraceptives. A cross-sectional study. Contracept Reprod Med 2024; 9:7. [PMID: 38414059 PMCID: PMC10898058 DOI: 10.1186/s40834-024-00269-9] [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: 01/30/2024] [Accepted: 02/18/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND In the tapestry of reproductive health in Sierra Leone, where maternal mortality remains a poignant thread, understanding contraceptive use intentions among married and cohabiting women emerges as a vital motive. This study examines the intention to use contraceptives among married and cohabiting women in Sierra Leone. METHODS The study analysed the 2019 Sierra Leone Demographic and Health Survey data. A total of 7846 married and cohabiting women comprised the study. A multivariable binary regression analysis was used to examine the predictors of intention to use contraceptives. The regression results were presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CI). RESULTS The proportion of intention to use contraceptives among married and cohabiting women was 47% in Sierra Leone. Married and cohabiting women living in the eastern region (AOR = 1.65, 95% CI = 1.18, 2.30), southern region (AOR = 1.45, 95% CI = 1.04, 2.01), secondary education (AOR = 1.42, 95% CI = 1.00, 2.01), listen to the radio at least once a week (AOR = 1.30, 95% CI = 1.08, 1.55), and four or more births (AOR = 2.97, 95% CI = 2.23, 3.96) had higher odds of being associated with intention to use contraceptives. The propensity to utilise contraceptives among married and cohabiting women in Sierra Leone declined as their age increased, especially women aged 45-49 (AOR = 0.07, 95% CI = 0.04, 0.11) who had the least intention of using contraceptives. Married women (AOR = 0.53, 95% CI = 0.39, 0.72) and women who read magazines or newspapers at least once a week(AOR = 0.61, 95% CI = 0.36, 1.o4) had lower odds of contraceptive use intention. CONCLUSION The findings of this study indicate that there is a moderate yet encouraging intention to use contraception among married and cohabiting women in Sierra Leone. Factors like residing in the eastern and southern regions, having secondary education, having more children and regular radio listening are associated with higher contraceptive use intentions. Older women, especially those nearing the end of their childbearing years, have the lowest intention. Married women and regular magazine or newspaper readers were less likely to intend to use contraceptives. These findings call for targeted interventions focusing on rural areas, women with lower education, and older women.
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Affiliation(s)
- Augustus Osborne
- Department of Biological Sciences, School of Basic Sciences, Njala University, PMB, Freetown, Sierra Leone.
| | - Camilla Bangura
- Department of Biological Sciences, School of Basic Sciences, Njala University, PMB, Freetown, Sierra Leone
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Armah-Ansah EK, Bawa B, Igonya EK. Prevalence and factors associated with intention to use contraceptives among women of reproductive age: a multilevel analysis of the 2018 Guinea demographic and health survey. BMC Pregnancy Childbirth 2024; 24:8. [PMID: 38166935 PMCID: PMC10759447 DOI: 10.1186/s12884-023-06204-1] [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: 01/02/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Contraceptive use is a key indicator of improving the health and well-being of women, mothers and their families, preventing unwanted pregnancies, and reducing maternal and child mortalities. Despite a lot of investments from the Government of Guinea to improve contraceptive use, studies reveal that contraceptive use still remains low in Guinea. However, the intention to use contraceptives in Guinea has not been well examined. Therefore, this study seeks to examine the factors associated with the intention to use contraceptives among women of reproductive age in Guinea. METHODS The study made use of data from the Guinea Demographic and Health Survey (GNDHS) conducted in 2018. For this study, we included a weighted sample of 6,948 women who were either married or cohabiting and responded to all the variables of interest. The data were analyzed using Stata version 14.2. Descriptive and multilevel logistic regression were carried out to examine the factors associated with the intention to use contraceptives. The results of multilevel logistic regression were presented using adjusted odds ratios at 95% confidence intervals and p-value < 0.05 to determine the significant associations. RESULTS The prevalence of intention-to-use contraceptives among women was 19.8% (95% CI18.3%-21.5%). Women with secondary/higher educational levels [aOR = 1.58, 95% CI = 1.26-1.99], women whose partners had secondary/higher educational level [aOR = 1.26, 95% CI = 1.04-1.52], women who were cohabiting [aOR = 1.74, 95% CI = 1.13-2.68] and were exposed to mass media [aOR = 1.60, 95% CI = 1.35-1.89] were likely to have higher intentions to use contraceptives. Additionally, women from the Kankan Region [aOR = 4.26, 95% CI = 2.77-6.54] and women who belong to the richer wealth quintile [aOR = 1.36, 95% CI = 0.91-1.89] were likely to have higher odds of intentions to use contraceptives. However, women aged 45-49 years, those from the Peulh ethnic group, and those who lack the competence to make healthcare decisions alone had lower odds of intention to use contraceptives. CONCLUSION The study revealed a low prevalence of intention to use contraceptives among women of reproductive age in Guinea. The study has highlighted that both individual-level and household/community-level factors were significantly associated with the intention to use contraceptives. Therefore, policymakers and stakeholders need to consider these factors discussed in this paper when developing policies and interventions to promote and enhance intention-to-use contraceptives among women of reproductive age in Guinea. The findings call on the Government of Guinea and all stakeholders in Guinea to ensure that female education is promoted to help improve their social status, decision-making on fertility, and reduce fertility rates and maternal mortality.
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Affiliation(s)
- 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.
| | | | - Emmy Kageha Igonya
- Population Dynamics Sexual and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
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Hailegebreal S, Dileba Kale T, Gilano G, Haile Y, Endale Simegn A. Modern contraceptive use and associated factors among reproductive-age women in Ethiopia: multilevel analysis evidence from 2019 Ethiopia mini demographic and health survey. J Matern Fetal Neonatal Med 2023; 36:2234067. [PMID: 37433665 DOI: 10.1080/14767058.2023.2234067] [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: 03/04/2023] [Revised: 04/26/2023] [Accepted: 07/03/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Despite the high fertility and population growth rates, the use of modern contraceptives remains low in low- and middle-income countries. Different pocket-sized studies on the use of modern contraceptive methods conducted in various parts of Ethiopia have been extremely varied and ambiguous. Therefore, this study aimed to assess modern contraceptive use and its associated factors in women of reproductive age in Ethiopia. METHODS Cross-sectional data from the Ethiopia Interim Demographic Health Survey (EMDHS) 2019 in a stratified, two-stage, and cluster sampling study. Multilevel binary logistic regression analysis was used to fit the associated factors. The interclass correlation (ICC), median odds ratio (MOR), proportional change variance (PVC), and deviance were used for model comparison and fitness. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the significant factors of modern contraceptive use. RESULT The multilevel analysis demonstrated that Orthodox religion [AOR = 1.7; 95%CI: 1.4-2.10] protestant religion [AOR = 1.2; 95%CI: 0.93-1.62], married [AOR = 4.2; 95%CI: 1.93-9.07], primary education [AOR = 1.5; 95%CI: 1.26-1.76], secondary education [AOR = 1.36; 95%CI: 1.04-1.77 [AOR = 1.89; 95%CI: 1.37-2.61], middle [AOR = 1.4; 95%CI: 1.14-1.73], rich [AOR = 1.3; 95%CI: 1.06-2.68] were positively associated with modern contraceptive utilization, while the age group of 40-49 [AOR = 0.45, 95% CI: 0.34-0.58], and high community poverty [AOR = 0.62; 95%CI: 0.46-0.83] were negatively associated with modern contraceptive utilization. CONCLUSION The prevalence of modern contraception in Ethiopia remains low. Maternal age, religion, maternal education, marital status, wealth index, region, and community poverty were significant predictors of modern contraceptive utilization in Ethiopia. Governments and non-governmental organizations should expand their public health programs to poorer communities to increase the use of modern contraception in the country.
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Affiliation(s)
- Samuel Hailegebreal
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Temesgen Dileba Kale
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Gilano
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Yosef Haile
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Agrawal R, Mishra M, Rehman T, Surendran G, Sinha A, Kanungo S, Pati S. Utilization of modern temporary contraceptive methods and its predictors among reproductive-aged women in India: insights from NFHS-5 (2019-21). Front Glob Womens Health 2023; 4:1219003. [PMID: 38025983 PMCID: PMC10644831 DOI: 10.3389/fgwh.2023.1219003] [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: 05/19/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Evidence from various studies on modern contraceptive methods shows that the utilization varies greatly. The present study aimed to estimate the magnitude and determinants for temporary modern contraceptive utilization among reproductive-aged (15-49 years) women in India. We analysed National Family Health Survey-5 data using the "svyset" command in STATA software. Modern contraception utilization was estimated using the weighted prevalence, and its correlates were assessed by multivariable regression by reporting an adjusted prevalence ratio (aPR) with 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of different temporary modern contraceptives. The mean (SD) age of 359,825 respondents was 31.6 (8.5) years with 75.1% (n = 270,311) and 49.2% (n = 177,165) of them being from rural area and having completed education up to secondary school, respectively. The overall utilization of modern temporary contraception was 66.1% [95%CI: 65.90-66.35, n = 237,953]. Multigravida (vs. nulligravida) [aPR = 2.13 (1.98-2.30)], higher education of husband (vs. not educated) [aPR = 1.20 (1.14-1.27)], urban (vs. rural) [aPR = 1.06 (1.03-1.10)], watching television less than once a week (vs. not at all) [aPR = 1.04 (1.01-1.08)], divorced (vs. married) [aPR = 0.65 (0.45-0.94)], and Scheduled Tribe (ST) (vs. unreserved) [aPR = 0.92 (0.88-0.96)] were significant independent determinants. The highest utilization of male condoms, IUCDs, pills and injections were in Himachal Pradesh (86%), Nagaland (64%), Tripura (85%), and Ladakh (20%), respectively. Out of every ten reproductive-aged (15-49 years) women in India, six are using temporary modern contraceptive methods. More intervention strategies should be planned, considering factors like gravida, education, residence, health promotion and caste to attain replacement fertility level.
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Affiliation(s)
- Ritik Agrawal
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Manisha Mishra
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Tanveer Rehman
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Gayathri Surendran
- Department of Community Medicine, Christian Medical College, Vellore, India
| | - Abhinav Sinha
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Srikanta Kanungo
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Sanghamitra Pati
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
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Yeboah D, Issah AN, Kpordoxah MR, Akiti C, Boah M. Prevalence and factors associated with the intention to use contraception among women of reproductive age who are not already using a contraceptive method in Liberia: findings from a secondary analysis of the 2019-2020 Liberia Demographic Health Survey. BMJ Open 2023; 13:e072282. [PMID: 37802625 PMCID: PMC10565247 DOI: 10.1136/bmjopen-2023-072282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE Contraception constitutes a vital aspect of sexual and reproductive healthcare. However, the high prevalence of non-use has become a great public health concern globally. This study examined the intention to use contraceptives and its associated factors among women of reproductive age who were not using any method in Liberia. DESIGN AND SETTING A cross-sectional population-based study was conducted. We used data from the 2019-2020 Liberia Demographic and Health Survey. The research framework used the theory of planned behaviour to identify the factors that influence women's intention to use contraception. PARTICIPANTS The study analysed a weighted sample of 4504 women aged 15-49 who were not currently using any form of contraception. DATA ANALYSIS The outcome variable was the intention to use a contraceptive method. A binary logistic regression was used to identify factors associated with the intention to use contraceptives in Stata V.13.0. RESULTS Of the 4504 women, 39.42% intended to use contraception. Contraception intention was significantly lower in married women than in never married women (adjusted OR (aOR) 0.78; 95% CI 0.62 to 0.98). Additionally, women aged 25-34 (aOR 0.434; 95% CI 0.339 to 0.556) and 35-49 (aOR 0.120; 95% CI 0.088 to 0.163) had a reduced intent to use contraceptives than those aged 15-24. However, women with at least one child, those with prior contraception experience and those who had their first sexual encounter at the age of 13 or older were more likely to intend to use contraception. Notably, Muslim and wealthy women displayed a lower likelihood of intending to use contraception. CONCLUSION These findings highlight that attitudes, subjective norms and perceived behavioural control significantly influence women's intentions to use contraception. Understanding and addressing these factors are crucial for promoting effective contraceptive use among women, facilitating informed reproductive choices.
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Affiliation(s)
- Daudi Yeboah
- Department of Epidemiology, Biostatistics, and Disease Control, University for Development Studies, Tamale, Ghana
| | - Abdul-Nasir Issah
- Department of Health Services, Policy, Planning Management, and Economics, University for Development Studies, Tamale, Ghana
| | - Mary Rachael Kpordoxah
- Department of Global and International Health, University for Development Studies, Tamale, Ghana
| | - Caselia Akiti
- Department of Bilogical Sciences, University of Liberia, Monrovia, Liberia
- Monitoring and Evaluation Unit, Ministry of Health, Congo Town, Monrovia, Liberia
| | - Michael Boah
- Department of Epidemiology, Biostatistics, and Disease Control, University for Development Studies, Tamale, Ghana
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Belachew TB, Negash WD, Asmamaw DB, Fetene SM, Addis B, Baykeda TA, Kidie AA, Endawkie A, Zegeye AF, Tamir TT, Fentie EA, Wubante SM. Prevalence and predictors of post-abortion modern contraceptive utilization among reproductive age women in Ethiopia. Sci Rep 2023; 13:15932. [PMID: 37741903 PMCID: PMC10518002 DOI: 10.1038/s41598-023-42911-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 09/15/2023] [Indexed: 09/25/2023] Open
Abstract
The development of a post-abortion family plan is an integral part of comprehensive abortion care. In spite of this, it received insufficient attention as a means of breaking the cycle of repeated abortions, unintended pregnancies, and maternal deaths resulting from abortion. Therefore, this study examined post abortion modern contraceptive utilization among Ethiopian women as well as associated factors. The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1236 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of post abortion contraceptive use. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval. Overall prevalence of post abortion contraceptive use was observed to be 25.6% (95% CI: 23.24, 28.12). Women's age 15-24 (AOR = 2.34; 95% CI: 1.11, 4.93), and 25-34 (AOR = 1.94; 95% CI: 1.27, 2.98), married women (AOR = 2.6; 95% CI: 1.43, 4.96), women who had 1-4 (AOR = 4.13; 95% CI: 1.79, 9.57) and ≥ 5 number of children (AOR = 8.80; 95% CI: 3.30, 13.49), Being in metropolitan region (AOR = 9.14; 95% CI: 1.79, 12.48), women being in urban area (AOR = 1.85; 95% CI: 1.32, 2.24), and community media exposure (AOR = 1.75; 95% CI: 1.11, 3.56) were associated with post abortion modern contraceptive use. Post abortion modern contraceptive use in this study was low. Women age, current marital status, number of living children, residency, community media exposure, and region were significantly associated with post abortion modern contraceptive utilization. Therefore, it is better to provide ongoing health information about post-abortion family planning and its benefits, especially for people who live in rural and small peripheral regions, and public health policymakers should take both individual and community level factors into account when designing family planning programmes.
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Affiliation(s)
- Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia.
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Samrawit Mihret Fetene
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
| | - Banchlay Addis
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
| | - Tsegaw Amare Baykeda
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Atitegeb Abera Kidie
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abel Endawkie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Wollo, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sisay Maru Wubante
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Budu E, Okyere J, Osei MD, Seidu AA, Ahinkorah BO. Determinants of contraceptive continuation among women in sub-Saharan Africa. BMC Womens Health 2023; 23:447. [PMID: 37620922 PMCID: PMC10463526 DOI: 10.1186/s12905-023-02578-8] [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: 09/19/2022] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Contraceptive continuation is an important factor that has significant implications on total fertility rates and reproductive health outcomes, like unintended pregnancies. Therefore, it is imperative to understand the factors that influence women's decision to continue the use of contraceptives. The present study examined the determinants of contraceptive continuation among women in sub-Saharan Africa (SSA). METHODS Data for the study were extracted from the most recent Demographic and Health Surveys (DHS) of twenty-four (24) countries in SSA. Descriptive and multivariable binary logistic regression analysis were conducted. Frequencies, percentanges, and an adjusted odds ratio with 95% confidence intervals were used to present the results. RESULTS Compared to adolescents, adult women aged 45-49 years [aOR: 1.24; CI: 1.13-1.37] had higher odds of contraceptive continuation. The odds of contraceptive continuation were lower among those working [aOR: 0.96; CI: 0.93-0.98] compared to those not working. Also, the study shows that the likelihood of contraceptive continuation was lower among those exposed to family planning messages compared to those not exposed [aOR: 0.91; CI: 0.88-0.93]. Compared to women who used LARCs, women who used pills [aOR: 0.34; CI: 0.33-0.36], injectable [aOR: 0.42; CI: 0.40-0.43], other modern contraceptives [aOR: 0.72; CI: 0.68-0.75] or traditional methods [aOR: 0.50; CI: 0.478-0.523] were less likely to continue with their contraception. Women with one birth [aOR: 0.86; CI: 0.83-0.90] and those with 2 + births in the last five years [aOR: 0.54; CI: 0.512-0.56] reported lower odds of contraceptive continuation as compared to those with no births. Compared to women with no children living, those with 4 + children living had lower odds of contraceptive continuation [aOR: 0.62; CI: 0.57-0.67]. The study also found that the likelihood of contraceptive continuation was higher among those with secondary education [aOR: 1.08; CI: 1.04-1.12] as compared to those with no formal education. Contraceptive continuation was also higher among those who have information on choice [aOR: 3.91; CI: 3.82-4.01], and also higher among those who were undecided about having an additional child [aOR: 1.39; CI: 1.33-1.46]. Compared to West AfricaAngola, women from all other sub-regions were less likely to continue using contraceptives Comoros were more likely to continue with contraception [aOR: 1.49; CI: 1.24-1.78]. CONCLUSION To improve contraceptive continuation among women of reproductive age, countries in SSA must invest heavily in advocacy and dissemination of family planning messages, and information of choice. Also, much commitment should be directed towards enhancing the use of long-acting reversible contraceptive use.
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Affiliation(s)
- Eugene Budu
- Korle Bu Teaching Hospital, P. O. Box, 77, Accra, 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.
| | - Mary Dansoah Osei
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- Centre For Gender and Advocacy, Takoradi Technical University, P.O.Box 256, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Kitaw TA, Haile RN. Time to first childbirth and its predictors among reproductive-age women in Ethiopia: survival analysis of recent evidence from the EDHS 2019. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1165204. [PMID: 37519340 PMCID: PMC10382129 DOI: 10.3389/frph.2023.1165204] [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: 02/13/2023] [Accepted: 04/17/2023] [Indexed: 08/01/2023] Open
Abstract
Background Being a mother for the first time is the most significant event in a woman's life. "Age at first birth" refers to a mother's age in years when she gives birth to her first child. The age of first childbirth has physical, economic, and social implications. However, little is known about this issue in Ethiopia. Thus, this study sought to determine the time to first childbirth and its predictors at a national level. Methods Data were extracted from the 2019 Ethiopia Demographic and Health Survey using STATA version 17 software. A total of 8,885 weighted reproductive-age women (15-49 years) were included in this study. A Kaplan-Meier survivor curve was generated to estimate the time of first childbirth. A log-rank test was used to compare the difference in survival curves. Akaike information criteria and Bayesian information criteria were calculated to select the appropriate survival model for the data. The Weibull accelerated failure time model with no frailty distribution was used to identify significant predictors. Results The overall median survival time to first childbirth was 18 years. The significant predictors of time to first childbirth were the educational level of the mother [primary education (ϕ = 1.036, 95% CI: 1.011, 1.063), secondary and above education (ϕ = 1.154, 95% CI: 1.118, 1.191)], knowledge of any contraceptive method [know at least one (ϕ = 1.051, 95% CI: 1.006, 1.101)], and media exposure (ϕ = 1.048, 95% CI: 1.011, 1.086). Conclusion The median survival time to first childbirth was 18 years, which is lower than the optimal age for first childbirth (late 20 s and early 30 s). The timing of first childbirth in Ethiopia is mainly influenced by the educational level of women, knowledge of contraceptive methods, and exposure to media. Thus, exposing women to educational materials and other awareness-creation campaigns regarding the consequences of early first childbirth and strategies to improve women's knowledge of contraceptive methods is highly recommended.
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Gelagay AA, Negash WD, Belachew TB, Bitew DA, Fentie EA, Worku AG, Bashah DT, Tebeje NB, Gebrie MH, Yeshita HY, Cherkose EA, Ayana BA, Lakew AM, Asmamaw DB. Magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia. evidence from Dabat demographic health surveys. BMC Public Health 2023; 23:1123. [PMID: 37308903 DOI: 10.1186/s12889-023-16046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 06/03/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Due to additional roles and emotional changes that occur during postpartum period, women use contraceptives differs from other times in their life. However, there is limited information about the unmet need for family planning (FP) among women in the extended postpartum period in the study area. Therefore, this study aimed to assess magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia. METHODS A secondary data analysis was performed using the Dabat Demographic and Health Survey 2021. A total sample of 634 women during the extended postpartum period was included in this study. Stata version 14 statistical software was used for data analysis. Descriptive statistics were described using frequencies, percentages, mean, and standard deviation. Multicollinearity was tested using the variance inflation factor (VIF) and we computed Hosmer and Lemeshow goodness of fit. Both bivariable and multivariable logistic regression analyses were carried out to determine the association between independent variables and outcome variable. Statistical significance was declared at a p-value ≤ 0.05 with a corresponding 95% confidence interval. RESULTS The overall unmet need for FP during the extended postpartum women was 42.43% (95% CI: 38.62, 46.33), of which 33.44% was unmet need for spacing. Place of residence (AOR = 2.63, 95%CI: 1.61, 4.33), place of delivery (AOR = 2.09, 95%CI: 1.35, 3.24), and availability of radio and or TV (AOR = 1.58, 95% CI: 1.22, 2.13) were significantly associated with unmet need for family planning. CONCLUSION The magnitude of unmet need for family planning among women during the extended postpartum period in the study area was high when compared to the national average and the United Nations sphere standard of unmet need for family planning. Place of residence, place of delivery, and availability of radio and or TV were significantly associated with unmet need for family planning. Hence, the concerned bodies are recommended to promote intuitional delivery and give spatial attention to those who are residing in rural areas and to those who have had no media exposure in order to reduce the unmet need for family planning among postpartum women.
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Affiliation(s)
- Abebaw Addis Gelagay
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia
| | - Abebaw Gebeyehu Worku
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia
| | - Debrework Tesgera Bashah
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nigusie Birhan Tebeje
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia
| | - Mignote Hailu Gebrie
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hedija Yenus Yeshita
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia
| | - Endeshaw Adimasu Cherkose
- School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhanu Abera Ayana
- Department of Obstetrics and Gynecology, Zewuditu Memorial Hospital, Addis Ababa, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia.
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Merid MW, Kibret AA, Alem AZ, Asratie MH, Aragaw FM, Chilot D, Belay DG. Spatial variations and multi-level determinants of modern contraceptive utilization among young women (15-24 years) in Ethiopia: spatial and multi-level analysis of mini-EDHS 2019. Contracept Reprod Med 2023; 8:26. [PMID: 37038207 PMCID: PMC10084619 DOI: 10.1186/s40834-023-00224-0] [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: 01/13/2023] [Accepted: 03/29/2023] [Indexed: 04/12/2023] Open
Abstract
INTRODUCTION There is tremendous regional inequalities and low uptake of modern contraceptives particularly among young women (15-24 years), characterized by high fertility but high unmet need for contraceptives in Ethiopia. Hence, the present study aimed at exploring the spatial distribution and the multi-level determinants of modern contraceptive use among young women in Ethiopia. METHODS This study was conducted using the 2019 Ethiopian demographic and health survey data on a weighted sample of 3,379 young women. STATA version 14 for the multi-level, and ArcGIS 10.7 and Sat Scan 9.6 for the spatial analysis were used. Spatial analysis was done to identify the hotspot areas of modern contraceptive use in Ethiopia. Multi-variable multi-level logistic regression was used for identifying determinants of modern contraceptive use and variables with a p-value < 0.05 were considered to be significant determinants. RESULT The overall prevalence of modern contraceptive use among young women in Ethiopia was 17.23% (95% CI: 10.98, 23.47). The hotspots areas for modern contraceptive use were detected in the central and south-western Amhara, western and central Oromia, and western SNNPR regions. Whereas the Somali region, Dire dawa, and Harari cities were cold spot areas for modern contraceptive use. Being married (AOR = 18.5; 95% CI: 12.66, 27.27), parity (AOR = 4.82; 95% CI: 1.27, 18.32), having television (AOR = 2.39; 95%CI: 1.43, 3.99), having radio (AOR = 1.43; 95%CI: 1.05, 1.94) had higher odds of using modern contraceptives compared to their counterparts. Besides, family size of above five (AOR = 0.46; 95% CI: 0.34, 0.62) and living in Somali region (AOR = 0.05; 95% CI: 0.01, 0.32) were associated with decreased odds of using modern contraceptives among young women in Ethiopia. CONCLUSION The modern contraceptive use was low among young women and considerably varied across regions in Ethiopia. A remarkably low rate of modern contraceptive use (cold spot) area was detected in Somali region-Ethiopia. Taking in to account a geographic perspective and key factors identified in this study would be vital for efficient resource allocation, targeted interventions, and informed decision-making to enhance contraceptive uptake in Ethiopia.
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Affiliation(s)
- Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mankelkl G, Kinfe B. Spatial variations and multilevel mixed effect analysis on determinants factors of modern contraceptive utilization among reproductive age women in Ethiopia; proven by Ethiopian mini demographic health survey 2019. BMC Womens Health 2023; 23:77. [PMID: 36814235 PMCID: PMC9948416 DOI: 10.1186/s12905-022-02030-3] [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: 08/24/2022] [Accepted: 10/26/2022] [Indexed: 02/24/2023] Open
Abstract
INTRODUCTION Globally, in 2019, there are 1.9 billion women of reproductive age (15-49), of which 1.1 billion have a need for family planning. Of these, 842 million use contraceptives, and 270 million still have an unmet need for contraception. Ethiopia is a low-income country with inadequate access to family planning (FP), especially in the developing regions. The Ethiopian government was striving to increase the number of health facility in order to provide quality maternal care and services. Increasing the modern contraceptive prevalence rate is one of the goals of the government to reduce maternal and child mortality and morbidity. METHODS Secondary data analysis was conducted using data from mini-EDHS of 2019 demographic and health Survey datasets. The study comprised a total of 8885 reproductive-age women. Spatial variations and multilevel mixed effect analysis on determinants factors of modern contraceptive use among reproductive age women in Ethiopia; evidenced by mini-EDHS 2019. Finally, the percentage and odd ratio, its 95% confidence intervals, and the result of spatial analysis were reported. RESULT This study includes a total weighted sample of 8885 reproductive-age women from the 2019 mini-Ethiopian demographic and health survey. The prevalence of modern contraceptive use was 25.5% in Ethiopia. living in urban area [AOR = 2.13; 95% CI = (1.75, 2.61); P = 0.000], being married [AOR = 1.42; 95% CI = (1.19, 1.70); P = 0.000] were found positively associated with contraceptive use. In contrast to this, attending primary education [AOR = 0.91; 95% CI = (0.74, 1.12); P = 0.000]., being Muslim [AOR = 0.25; 95% CI = (0.22, 0.29); P = 0.000], being poorest [AOR = 0.54; 95% CI = (0.45, 0.66); P = 0.000] were found negatively associated with contraceptive use. CONCLUSION In this study Individual and community level factors were associated with modern contraceptive use and also there were spatial variations in modern contraceptive use across the region among reproductive-age women. Empowering women to have better educational status, improving the wealth index, promoting marriage, creating awareness among rural residences women and promoting education about modern contraceptives through religiously acceptable persons, and promoting modern contraceptive use in developing regions were the key factors to improve modern contraceptive use among reproductive age women in Ethiopia.
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Affiliation(s)
- Gosa Mankelkl
- College of Medicine and Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia.
| | - Beletu Kinfe
- College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Belachew TB, Negash WD, Bitew DA, Asmamaw DB. Modern contraceptive utilisation and its associated factors among reproductive age women in high fertility regions of Ethiopia: a multilevel analysis of Ethiopia Demographic and Health Survey. BMJ Open 2023; 13:e066432. [PMID: 36787981 PMCID: PMC9930559 DOI: 10.1136/bmjopen-2022-066432] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE This study is aimed to assess the magnitude of modern contraceptives utilisation and associated factors among reproductive age women in high fertility regions of Ethiopia. DESIGN Cross-sectional study. SETTING High fertility regions of Ethiopian. PARTICIPANTS A total weighted sample of 3822 married reproductive age women. METHODS In this study, data were obtained from the recent Ethiopian Demographic and Health Surveys. A total weighted sample of 3822 women of reproductive age was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of modern contraceptive utilisation. Statistical significance was determined using adjusted OR (AOR) with 95% CI. RESULTS The overall modern contraceptive utilisation was 29.75% (95% CI 28.2% to 31.2%). Among the factors associated with utilisation were women's age 25-34 years (AOR 1.3; 95% CI 1.01 to 1.66) and ≥35 (AOR 1.71; 95% CI 1.37 to 2.70), husband's occupation (AOR 1.49; 95% CI 1.03 to 1.99), number of alive children: 1-4 (AOR 2.20; 95% CI 1.47 to 3.30), 5-8 (AOR 1.74; 95% CI 1.09 to 2.77), husband's desired number of children (AOR 0.77; 95% CI 0.61 to 0 .96), residency (AOR 2.37; 95% CI 1.20 to 4.67), community media exposure (AOR 1.77; 95% CI 1.01 to 3.08), region (AOR 0.13; 95% CI 0.03 to 0.52) and religion (AOR 0.49; 95% CI 0.36 to 0.66) were significantly associated with modern contraceptive utilisation. CONCLUSION Modern contraceptives utilisation in high fertility regions of Ethiopia was low. Women age, husband occupation, number of living children, husband's desired number of children, residency, community media exposure, region and religion were significantly associated with modern contraceptive utilisation. Therefore, to improve the utilisation of modern contraceptives, public health policy makers should consider creating awareness through mass media, male involvement in family planning, as well as family planning programmes, should be encouraged in rural areas.
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Affiliation(s)
| | | | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Negash WD, Eshetu HB, Asmamaw DB. Predictors of modern contraceptive use among reproductive age women in high fertility countries in sub-Saharan Africa: evidence from demographic and health surveys. BMC Womens Health 2022; 22:520. [PMID: 36514075 PMCID: PMC9746200 DOI: 10.1186/s12905-022-02121-1] [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: 05/05/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The world's population has increased faster than expected due to high fertility rates, with sub-Saharan Africa accounting for most of the increase. Modern contraceptive use is the best option to reduce the high fertility rate. There is limited information on the prevalence of modern contraception and its predictors in sub-Saharan Africa's high-fertility countries. Therefore, this study aimed to assess the prevalence and predictors of modern contraception among reproductive-age women in high fertility countries in sub-Saharan Africa. METHODS We used Demographic and Health Survey data sets from the top 10 high fertility countries in sub-Saharan Africa. Stata version 16.0 software was used to analyze the data, and all statistical analyses were completed after the data had been weighted. Multilevel binary logistic regression was performed to identify factors associated with modern contraceptive use. Adjusted odds ratio with a 95% confidence interval, and a p value < 0.05 was used to declare statistical significance. RESULTS The prevalence of modern contraceptive use in all the countries considered in this study was 10.72% (95% CI 10.57, 10.87). In terms of the predictor variables, young aged women, those who had attended a primary or secondary level of formal education, women who received antenatal care follow up, women who reported distance to the health facility as not a big problem, and women from rich families were more likely to use modern contraceptives. CONCLUSION Only one in 10 women of reproductive age used modern contraceptive methods in high fertility countries in sub-Saharan Africa. To improve the use of modern contraceptives, governments and non-governmental organizations studied in the countries should intensify programs that focus on those women who are economically poor, those with no formal education, no media exposure, and those with no antenatal care follow up.
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Affiliation(s)
- Wubshet Debebe Negash
- grid.59547.3a0000 0000 8539 4635Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- grid.59547.3a0000 0000 8539 4635Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- grid.59547.3a0000 0000 8539 4635Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Díaz-Alvites AL, Yrala-Castillo G, Al-kassab-Córdova A, Munayco CV. Associated factors, inequalities, and spatial distribution of the use of modern contraceptive methods among women of reproductive age in Peru: a population-based cross-sectional study. BMC Public Health 2022; 22:2267. [PMID: 36471291 PMCID: PMC9720945 DOI: 10.1186/s12889-022-14629-0] [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: 06/15/2022] [Accepted: 10/07/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The use of contraceptive methods in Peru has remarkably increased in recent decades. Nevertheless, despite the completeness and accessibility of family planning methods, modern contraceptive methods utilization in Peru remains below the South American average. Thus, this study aimed to elucidate the factors associated with modern contraceptive use, as well as the presence of inequalities and the spatial distribution in Peruvian women aged 15-49 years in 2019. METHODS A secondary data analysis was conducted using information from the 2019 Peruvian Demographic and Health Survey. We performed descriptive statistics, bivariate analysis, and Poisson multiple regression. Inequalities were estimated through concentration curves and Erreygers' normalized concentration index. Spatial analysis included choropleth map, Global Moran's I, Kriging interpolation and Getis-Ord-Gi* statistic. RESULTS The prevalence of modern contraceptive use was 39.3% among Peruvian women of reproductive age. Modern contraceptive use was directly associated with youth (aPR 1.39), women having their first sexual intercourse before the age of 18 (aPR 1.41), and being married but not together (aPR 1.87). In addition, speaking Quechua or Aymara (aPR 0.87) and having no children (aPR 0.59) were inversely associated with utilization of modern contraceptives. We found the presence of inequalities in the use of contraceptive methods (pro-rich distribution), although the magnitude was low. Spatial analysis unveiled the presence of a clustered distribution pattern (Moran's Index = 0,009); however, there was inter-departmental and intra-departmental heterogeneity in the predicted prevalence of the use of modern contraceptives. In addition, significant hot and cold spots were found in Peru. CONCLUSION Two out of five Peruvian women of reproductive age used modern contraceptives. It was associated with younger women's age, younger age at first sexual intercourse, being married or cohabitant, among others. No substantial inequality was found in modern contraceptive use. The prevalence was heterogeneous at the intra- and inter-departmental level. Those departments located in the south, south-east, and north-east had the lowest prevalence. Therefore, nonfinancial barriers must be tackled through multi- and cross-sectoral efforts and continue to universally provide modern contraceptives.
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Affiliation(s)
- Ana Lucía Díaz-Alvites
- grid.441917.e0000 0001 2196 144XFaculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru ,grid.441917.e0000 0001 2196 144XSociedad Científica de Estudiantes de Medicina de La Universidad Peruana de Ciencias Aplicadas (SOCIEMUPC), Lima, Peru
| | - Gonzalo Yrala-Castillo
- grid.441917.e0000 0001 2196 144XFaculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru ,grid.441917.e0000 0001 2196 144XSociedad Científica de Estudiantes de Medicina de La Universidad Peruana de Ciencias Aplicadas (SOCIEMUPC), Lima, Peru
| | - Ali Al-kassab-Córdova
- grid.441908.00000 0001 1969 0652Center of Excellence in Economic and Social Research in Health, Universidad San Ignacio de Loyola, Lima, Peru
| | - César V. Munayco
- grid.441917.e0000 0001 2196 144XFaculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
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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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Mulugeta SS, Fenta SM, Fentaw KD, Biresaw HB. Factors associated with non-use of modern contraceptives among sexually active women in Ethiopia: a multi-level mixed effect analysis of 2016 Ethiopian Demographic and Health Survey. Arch Public Health 2022; 80:163. [PMID: 35794637 PMCID: PMC9258219 DOI: 10.1186/s13690-022-00922-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 06/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background Appropriate contraceptive use prevents unintended pregnancy, protects the health of mother and child, and promotes women’s well-being. Use of modern Family planning in Ethiopia was still very low. The purpose of this study was to assess the factors that are associated with non-use of modern family planning services among women of reproductive age. Method A nationally representative 2016 EDHS women data were used for analysis. A total of 15,683 women in the reproductive age group were included in this study. Descriptive and multilevel multivariable binary logistic regression models were used to summarize descriptive data and measure statistical association between the dependent and the individual and community level variable, respectively. Adjusted Odds Ratio (AOR) and confidence interval were respectively used to measure association and its statistical significance. Result Among women in the reproductive age group 79.49% (95% CI: 78.85%, 80.12%) did not use a modern contraceptive method. Women age between 25–34 years (AOR = 0.54, 95% CI: 0.47–0.61) and age between 34–49 year (AOR = 0.62, 95% CI: 0.55–0.71), having primary educated women (AOR = 0.0.77, 95% CI: 0.68–0.87),secondary and above educational (AOR = 0.88, CI: 0.75–1.03), Secondary and above-educated husband (AOR = 0.84, 95% CI: 0.72–0.96), rich women (AOR = 0.74,95%CI:0.65–0.85), health facility delivery (AOR = 0.84, 95%CI: 0.73–0.0.98), being watching TV (AOR = 0.74, 95% CI: 0.65–0.85), having 1–2 living children (AOR = 0.21, 95% CI: 0.19–0.23) are less likely to not use contraception were identified. Furthermore, Muslim women (AOR = 1.43, 95% CI: 1.23–1.62), women living in rural area (AOR = 3.43; 95% CI: 2.72–4.32), and ANC visit 1.25(1.07–1.47) were more likely to not use contraception. Further, Women in Afar, Somali, Gambela, Harari, and Dire Dawa were less likely to use modern contraception methods than women in Tigray, but Amhara region had a lower rate of non-use. Conclusion Family planning interventions should target younger women, women living in rural areas, the poor, and Muslim women. Moreover, initiatives to empower women associated to family planning programs would be beneficial in increasing contraceptive uptake among sexually active women in Ethiopia.
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Magnitude of unmet need for family planning and its predictors among reproductive age women in high fertility regions of Ethiopia: Evidence from Ethiopian Demographic and Health Survey. BMC Womens Health 2022; 22:408. [PMID: 36199076 PMCID: PMC9535900 DOI: 10.1186/s12905-022-01982-w] [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: 01/07/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Unmet need for family planning refers to fertile women who want to limit or space their delivery but are not using contraceptive methods. Despite multiple studies were conducted to address family planning in Ethiopia, there is limited information on unmet need in high fertility regions. Knowing the magnitude and predictors of unmet need in the study area helps as an impute for interventions. Therefore, this study aims to assess the magnitude and predictors of unmet need for family planning among reproductive age women in high fertility regions of Ethiopia. METHODS A secondary data analysis was performed using the Ethiopian Demographic and Health Survey 2016. A total sample weight of 4312 currently married reproductive age women were included in this study. A multilevel mixed-effect binary logistic regression model was fitted. Finally, the odds ratios along with the 95% confidence interval were generated to determine the individual and community level factors of unmet need for family planning. A p-value less than 0.05 was declared as statistical significance. RESULTS The overall unmet need for family planning among currently married reproductive-age women in high fertility regions of Ethiopia was 29.78% (95% CI: 28.26, 31.3). Women with no formal education (AOR: 1.65, 95% CI: 1.17, 2.15), women in the poor wealth quantile (AOR: 1.67, 95% CI: 1.34, 2.09), women with no media exposure (AOR: 1.32, 95% CI: 1.09, 1.58), multiparous women (AOR: 1.57, 95% CI: 1.15, 2.16), sex of household head (AOR: 1.39, 95% CI: 1.11, 1.77) and rural residency (AOR: 2.45, 95% CI: 1.12, 3.59) were predictors of unmet need for family planning. CONCLUSION The magnitude of unmet need for family planning among currently married reproductive-age women in high fertility regions of Ethiopia was high when compared to the national average and the United Nations sphere standard of unmet need for family planning. Education, wealth index, mass media, parity, sex of household head, and residence were independent predictors of unmet need for family planning among reproductive-age women in high fertility regions of Ethiopia. Any interventional strategies that reduce the unmet need for family planning should consider these factors to overcome the problems in the regions.
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Ayinmoro AD, Fayehun OA. Differentials in Contraceptive Use Among Selected Minority Ethnic Groups in Nigeria. Front Glob Womens Health 2022; 3:878779. [PMID: 35720812 PMCID: PMC9204047 DOI: 10.3389/fgwh.2022.878779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Ethnicity is one of the critical factors that shape contraceptive use in Nigeria. While there are growing disparities in contraceptive uptake among women of reproductive age in the three major ethnic groups (Hausa, Igbo and Yoruba), not much is known about differentials in contraceptive use among the minority ethnic groups. This study examined differentials in contraceptive use among a sample of 1,072 respondents comprising the Ebira (352), Igala (358) and Okun (361) ethnic groups in Nigeria. Questionnaire was administered to respondents proportionately in the selected minority ethnic groups with six key informant interviews and 12 focus group discussions to generate quantitative and qualitative data among ever-married women. Quantitative data were analyzed at bivariable and multivariable levels. The qualitative data were content-analyzed. Differentials in contraception are shaped by ethnic affiliations and socio-demographic characteristics of couples. The use of modern contraceptives was low among the Ebira (25.7%) and Igala (24.1%) ethnic groups, but high among Okun (67%) women of reproductive age. The odd of using a modern contraceptive is significantly higher among the Okun women (UOR = 5.618, 95% CI 4.068–7.759) than the Ebira and Igala. There is no significant difference between the Ebira and Igala minority ethnic groups on modern contraceptive use. Ethnicity as a factor is not a stand-alone predictor of the use of modern contraception among the study groups, other socio-economic variables such as residence, religion, income and marital status were significant predictors of modern contraceptive use among minority ethnic groups. We suggest introducing reproductive health intervention programmes targeted at sensitizing the minority ethnic groups on effective modern contraceptive use while addressing their specific modern contraceptive need in Nigeria.
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Mare KU, Aychiluhm SB, Tadesse AW, Mohammed OA. Individual and community-level determinants of non-use of contraceptive among women with no fertility desire in Ethiopia: a multilevel mixed-effect analysis. Emerg Themes Epidemiol 2022; 19:2. [PMID: 35366932 PMCID: PMC8976977 DOI: 10.1186/s12982-022-00112-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In Ethiopia, about two-third of women in the reproductive-age do not use any method of contraception. Moreover, evidence on non-use of contraceptives among women who do not have future fertility desires are limited. Therefore, this study intended to identify both individual and community-level determinants of non-use of contraceptives among this group in Ethiopia using a multilevel mixed effect analysis. METHODS Data retrieved from the demographic and health survey program official database website ( http://dhsprogram.com ) were used in this study. The suvey was conducting using a multistage cluster sampling technique and a weighted sample of 4398 reproductive-age women with no fertility desire was used in this study. Four models were fitted using a multilevel multivariable logistic regression to identify determinants of non-use of contraceptives and model with the lowest Akaike's Information Criterion was selected as a best fitted model. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. RESULTS Overall, 65.3% [95% CI (63.9%, 66.7%)] of women with no fertility desire were not using any contraceptive method. Living in large central [AOR (95% CI) 0.45 (0.31, 0.67)] and metropolitan regions [AOR (95% CI) 0.39 (0.22, 0.68)] and being from household with middle [AOR (95% CI) 0.65 (0.42, 0.93)] and rich wealth index [AOR (95% CI) 0.67 (0.44, 0.98)] were negatively associated with non-use of contraceptives. Besides, being from a community with high women illiteracy [AOR (95% CI) 1.38 (1.15, 1.67)], being Muslim [AOR (95% CI) 1.86 (1.22, 2.85)], having history of pregnancy termination [AOR (95% CI) 1.59 (1.10, 2.31)], having a husband who desire to have more children [AOR (95% CI) 1.46 (1.02, 2.09)] were the positive determinants of non-utilization of contraceptives. CONCLUSION Nearly two-third of reproductive-age women with no fertility desire in Ethiopia do not use any contraceptive method. Awareness creation interventions on the benefits of contraceptives targeting Muslim religion followers and improving women education and their economic empowerment at household level may decrease the proportion of non-use of contraceptives at a national level.
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Affiliation(s)
- Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
| | - Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Osman Ahmed Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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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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Tsehay CT. Factors associated with modern contraceptive demands satisfied among currently married/in-union women of reproductive age in Ethiopia: a multilevel analysis of the 2016 Demographic and Health Survey. BMJ Open 2022; 12:e049341. [PMID: 35110305 PMCID: PMC8811575 DOI: 10.1136/bmjopen-2021-049341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Regardless of the local and international initiatives, excluding exempting services, demand satisfied for contraceptives remains low in Ethiopia. This circumstance is supposed to be attributed to different level factors; however, most were not well addressed in the previous studies. Therefore, this study aimed at assessing the magnitude and individual, household and community-level factors associated with demand satisfied for modern contraceptive (DSFMC) methods among married/in-union women of reproductive age. DESIGN Cross-sectional study. SETTING A community-based study across the country. PARTICIPANTS Randomly selected 9126 married/in-union women had participated using a structured questionnaire. OUTCOME DSFMC methods among married/in-union women of reproductive age. RESULTS DSFMC methods in Ethiopia was 39.5% (95% CI 38.5% to 40.5%). Women aged 35-49 years (adjusted OR (AOR): 0.43, 95% CI 0.32 to 0.58), Muslim religion (AOR: 0.58, 95% CI0.43 to 0.78), husband lived elsewhere (AOR: 0.42, 95% CI 0.29 to 0.60), joint decision making to use (AOR: 1.30, 95% CI 1.04 to 1.62), good knowledge (AOR: 1.57, 95% CI 1.32 to 1.86) and wealth status of poorer (AOR: 1.56, 95% CI 1.17 to 2.06), middle (AOR: 1.77, 95% CI 1.33 to 2.35), richer (AOR: 1.96, 95% CI 1.49 to 2.59), and richest (AOR: 1.49, 95% CI 1.05 to 2.08), pastoralist regions (AOR: 0.28, 95% CI 0.18 to 0.42), and agrarian regions (AOR: 1.72, 95% CI 1.21 to 2.44) and rural residency (AOR: 0.56, 95% CI 0.37 to 0.82) were factors significantly associated. CONCLUSIONS Women's age, religion, the current living place of husbands and women's knowledge were individual-level factors. Household wealth status and mutual decision making to use were household-level factors. Region and residency were households and community-level factors associated with DSFMCs. Increasing the accessibility of modern contraceptive methods to women in rural areas and pastoralist regions, those living separately, engaging religious leaders and men in the programme, would increase their satisfying demand.
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Affiliation(s)
- Chalie Tadie Tsehay
- Department of Health Systems and Policy, University of Gondar, Gondar, Ethiopia
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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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Mare KU, Abrha E, Mohammed Yesuf E, Birara Aychiluhm S, Tadesse AW, Leyto SM, Sabo KG, Mulaw GF, Mohammed OA, Ebrahim OA. Factors affecting utilization of long-acting reversible contraceptives among sexually active reproductive-age women in the pastoral community of Northeast Ethiopia: A community-based cross-sectional study. WOMEN'S HEALTH 2022; 18:17455057221116514. [PMID: 35946956 PMCID: PMC9373132 DOI: 10.1177/17455057221116514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: In Ethiopia, only one in ten reproductive-age women use long-acting
reversible contraceptives. Evidence on the utilization of these methods and
associated factors among sexually active reproductive-age women in the
pastoral area of Northeast Ethiopia is limited. Thus, this study aimed to
assess the utilization of long-acting reversible contraceptives and
associated factors among sexually active reproductive-age women in the
pastoral community of Northeast Ethiopia. Methods: A community-based cross-sectional study was conducted from 1 to 30 April 2021
among 572 reproductive-age women selected by a systematic random sampling
method. Data were collected using a structured interviewer-administered
questionnaire and entered into Epi-info version 7 and then finally exported
to Stata version 16 for further analysis. Bivariable and multivariable
binary logistic regression analyses were done to identify factors affecting
the utilization of long-acting reversible contraceptives. Odds ratio with
the corresponding 95% confidence interval were computed and the statistical
significance of the explanatory variables was declared at
p-value < 0.05. Results: Overall, the utilization of long-acting reversible contraceptives was (24.3%;
95% confidence interval = 20.9%–28.0%). It was also revealed that being
Orthodox (adjusted odds ratio = 4.10; 95% confidence interval = 2.20–7.65)
and Protestant (adjusted odds ratio = 7.86; 95% confidence
interval = 1.26–18.97) religion followers, attending higher education
(adjusted odds ratio = 3.31; 95% confidence interval = 1.37–7.98), and
having a husband who attended higher education (adjusted odds ratio = 4.37;
95% confidence interval = 1.98–9.67) were associated with an increased odds
of using long-acting reversible contraceptive methods. Besides, having a
good (adjusted odds ratio = 6.69; 95% confidence interval = 2.64–16.95) and
moderate (adjusted odds ratio = 3.03; 95% confidence interval = 1.06–8.56)
knowledge, and positive attitude (adjusted odds ratio = 3.65; 95% confidence
interval = 1.90–7.01) toward long-acting reversible contraceptives were also
associated with the utilization of these methods. Conclusion: Less than one-fourth of sexually active reproductive-age women in the study
area were using long-acting reversible contraceptives. Thus, improving
women’s and husbands’ education and women’s knowledge and attitude toward
long-acting reversible contraceptives is important to scale up the uptake of
these contraceptive methods.
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Affiliation(s)
- Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Ezana Abrha
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Ebrahim Mohammed Yesuf
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Simeon Meskele Leyto
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | | | - Osman Ahmed Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Oumer Abdulkadir Ebrahim
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Girma Garo M, Garoma Abe S, Dugasa Girsha W, Daka DW. Unmet need for family planning and associated factors among currently married women of reproductive age in Bishoftu town, Eastern Ethiopia. PLoS One 2021; 16:e0260972. [PMID: 34871318 PMCID: PMC8648111 DOI: 10.1371/journal.pone.0260972] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Unmet family planning is one of the common causes for low contraceptive prevalence rates in developing countries, including Ethiopia. Rapid urbanization had profound effect on population health, however, little is known about the unmet need of family planning in settings where there was increased industrializations and internal migrations in Ethiopia. This study aims to determine the unmet need for family planning services among currently married women and identify factors associated with it in Bishoftu town, Eastern Ethiopia. Methods Community-based cross-sectional study was conducted from 1st January to 28th February, 2021 among 847 randomly sampled currently married women of the reproductive age group. Data were collected using semi structured interviewer administered questionnaire. Multivariate logistic regression was used to identify factors associated with the outcome variable and a 95% confidence interval was used to declare the presence of statistical significance associations. Results Eight hundred twenty-eight women were participated in the study. The prevalence of unmet need for family planning among currently married women was 26% [95% CI: 23,29]. Maternal age [AOR, 3.00, 95% CI:1.51–5.95], educational status [AOR, 2.49, 95% CI:1.22–5.07], occupational status of self-employee [AOR, 1.98, 95% CI:1.15–3.39] and housewife [AOR, 1.78, 95% CI:1.02–3.12], being visited by health care provider in the last 12 months [AOR, 1.81, 95% CI: 1.26–2.60] and desired number of children less than two [AOR, 1.53, 95% CI:1.01–2.30] were significantly associated with unmet need for family planning. Conclusions Unmet need for family planning was higher in the study area compared with the United Nations sphere standard of unmet need for family planning and the national average, and slightly lower than the regional average. Socio-demographic, economic, and health institution factors were determinants of the unmet need for family planning in the study area. Therefore, health education and behaviour change communication related to family planning services should be strengthened and access to family planning services should be improved.
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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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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: 27] [Impact Index Per Article: 6.8] [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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