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Lemu YK, Terfa YB, Inkosa LT, Mohammed AA, Yadeta GB, Tulu YT, Negari DH, Mamo Y, Mamo A. Women's Experiences on Injectable Contraceptive Preference Among Jimma Town Public Health Facilities, Southwest Ethiopia 2023. A Phenomenological Study Design. Open Access J Contracept 2024; 15:1-12. [PMID: 38404542 PMCID: PMC10886205 DOI: 10.2147/oajc.s443453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/10/2024] [Indexed: 02/27/2024] Open
Abstract
Background Contraception is the information, devices, and medications that enable individuals to decide whether and when to have children. It is a cost-effective method of limiting and spacing childbirth. In Ethiopia, the prevalence of modern contraceptives is increasing, and injection contraceptives represent a high prevalence. However, it is unclear why the women preferred injection contraception. Objective To explore Women's experiences on contraceptive preference among Jimma town public health facilities, southwest Ethiopia, 2023. Methods An interpretative phenomenological study design was employed. Women aged between 18 and 49 who have been using injectable contraceptives for more than one year were our study population. Data were collected through in-depth interviews using an open-ended, structured interview guide. The purposive sampling technique was used to select 12 participants from three randomly selected public health facilities in Jimma town. Audio data were transcribed verbatim into word files, and finally, Atlas.ti 7.0 software was used to facilitate coding and categorizing. Results Twelve women who have been using injectable contraceptives for the last year were involved in this study. Religious beliefs, fear of side effects, visiting Arab countries, and previous contraceptive experiences were the main reasons for respondents to prefer injectable contraceptive methods. This study revealed that women were experiencing positive and negative effects while using injection contraceptives. The majority of the respondents felt comfortable and pleased and had not encountered any health-related issues since beginning to use injection contraceptives. Conclusion The key factors influencing respondents' preference for injection methods of contraception included fear of side effects, religious convictions, travel to Arab nations, and prior contraceptive experiences. The majority of respondents felt at ease and pleased and reported no substantial health difficulties associated with injection contraception, despite a few women reporting minor adverse effects. Therefore, switching to long-acting methods of contraception necessitates increased women's understanding of contraceptives.
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Affiliation(s)
- Yohannes Kebede Lemu
- Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Yonas Biratu Terfa
- School of Nursing, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | | | - Ahmed Andiye Mohammed
- Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Geremu Bayissa Yadeta
- Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Yidnekachew Tafesse Tulu
- Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Desalegn Hundera Negari
- Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Yiftusira Mamo
- Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Abebe Mamo
- Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
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Demeke H, Legese N, Nigussie S. Modern contraceptive utilization and its associated factors in East Africa: Findings from multi-country demographic and health surveys. PLoS One 2024; 19:e0297018. [PMID: 38241359 PMCID: PMC10798634 DOI: 10.1371/journal.pone.0297018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/27/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The use of modern contraceptives has been low in most Sub-Saharan African countries despite high population growth and a sluggish economy. This study aimed to identify the prevalence and determinants of modern contraceptive use among married reproductive-age women in East Africa. METHODS For this study, the Demographic and health survey (DHS) data from nine countries in East Africa were analyzed, yielding a weighted sample of 32,925 married women. A multilevel mixed-effect logistic regression model was used to identify characteristics associated with the utilization of modern contraceptives at a p-value less than 0.05. For model comparison, we used the Akaike and Bayesian Information Criteria (AIC and BIC). For assessing variation (random effects), we used community-level variance with standard deviation and intra-cluster correlation coefficient (ICC). RESULTS The overall prevalence of modern contraceptive use was 45.68%, 95% CI (45.15, 46.21). Women's age, maternal education level, husband education level, media exposure, wealth status, occupation, religion, the total number of children ever born, distance to health facilities, history of termination of pregnancy, couple's desire for children, women's participation in decision making, living country and place of residence were significantly associated with modern contraceptive use in Eastern Africa. CONCLUSIONS Conferring to this study, utilization of modern contraceptives is low in East Africa. Interventions to improve the use of modern contraceptives should encompass disseminating awareness through mass media, enrolment of males in family planning, giving maternal education, building health facilities in remote areas, and encouraging family planning programs in rural areas.
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Affiliation(s)
- Henok Demeke
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Nanati Legese
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Shambel Nigussie
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
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Kumbeni MT, Alem JN, Ziba FA, Afaya A, Apanga PA. The practice of polygyny on the utilisation of reproductive health services among married women in Ghana. J Biosoc Sci 2024:1-12. [PMID: 38173346 DOI: 10.1017/s0021932023000299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
While the practice of polygyny is common in Ghana, little is known about its impact on the use of reproductive health services. The aim of this study was to assess the relationship between polygynous marriage and the utilisation of skilled antenatal care (ANC), assisted skilled birth, and modern contraceptive services among married women in Ghana. Secondary data from the 2017 Ghana Maternal Health Survey were used for this study. The study included a weighted sample of 9,098 married women aged 15-49 years. We used multivariable logistic regression models to assess the association between polygyny and each outcome variables. Sensitivity analysis was conducted to assess the dose-response relationship between polygyny and each outcome variable. The prevalence of eight or more ANC contacts, assisted skilled births, and use of modern contraception were 47.0%, 81.4%, and 25.4%, respectively. The prevalence of women in polygynous marriages was 15.3%. Compared to monogynous marriage, polygynous marriage was associated with 19% lower odds of having eight plus ANC contacts (adjusted odds ratio [aOR] 0.81, 95% CI: 0.69, 0.96), 25% lower odds of having assisted skilled birth (aOR 0.75, 95% CI: 0.63, 0.89), and 19% lower odds of modern contraceptive utilisation (aOR 0.81, 95% CI: 0.66, 0.99). Interventions on reproductive health may need to prioritise women in polygynous marriages in order to improve the utilisation of skilled ANC, assisted skilled birth, and modern contraceptive services.
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Affiliation(s)
- Maxwell Tii Kumbeni
- School of Public Health and Nutrition, College of Health, Oregon State University, Corvallis, USA
| | - John Ndebugri Alem
- Department of Peadiatric Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Florence Assibi Ziba
- Department of Peadiatric Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
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Odimegwu C, Phiri M, Tapera T, Simona S. Patterns and correlates of intention to use contraceptives among fecund sexually active women in developing countries. Glob Health Action 2023; 16:2255043. [PMID: 37681979 PMCID: PMC10494735 DOI: 10.1080/16549716.2023.2255043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Understanding a woman's future contraceptive needs and enhancing her chances of putting those needs into action depend heavily on her intentions to use contraceptive methods. However, there is little information about global perspectives of intention to utilise contraceptives among fecund sexually active women. OBJECTIVES This study examines the patterns and determinants of contraception intention of fecund sexually active women. METHODS The most recent Demographic and Health Surveys (DHS) from 59 countries were used for secondary data analysis. The DHSs applied a cross-sectional survey design to collect data from women between the ages of 15 and 49. The study comprises a sample of 697,590 fecund sexually active women in the reproductive ages. The desire to utilise contraceptive methods was examined using a multivariable binary logistic regression analysis. All analyses were weighted to allow for a complex survey design. RESULTS A pooled prevalence of intention to utilise contraception was 42.8% (95% CI: 42.5, 43.1) at the global level. Eastern and Southern Europe had the lowest prevalence, 17.3% (95% CI: 16.4, 18.2), and the highest prevalence was observed in countries from Latin America and the Caribbean, 68.0% (95% CI: 67.5, 69.9). Attaining secondary-level education (adjusted odds ratio (aOR) = 1.68; 95% CI: 1.62-1.72) or higher (aOR = 1.71; 95% CI: 1.63-1.80), working (aOR = 1.21; 95% CI: 1.18-1.24), experience of a pregnancy loss (aOR = 1.06; 95% CI: 1.03-1.09), or being exposed to media family planning messages (aOR = 1.51; 95% CI: 1.48-1.55) were factors associated with an increased likelihood of intent to use contraceptives. CONCLUSIONS The study has established that contraceptive use intention was low in many developing countries. Education, age, employment status, fertility preference, and exposure to family planning messages influenced contraceptive use intention. Health policy-makers ought to consider these factors when designing sexual and reproductive health strategies in developing countries.
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Affiliation(s)
- Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Million Phiri
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Talent Tapera
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Simona Simona
- Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Anyatonwu OP, Nwoku KA, Jonsson H, Namatovu F. The determinants of postpartum contraceptive use in Nigeria. Front Glob Womens Health 2023; 4:1284614. [PMID: 38148926 PMCID: PMC10749970 DOI: 10.3389/fgwh.2023.1284614] [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: 08/28/2023] [Accepted: 11/22/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Postpartum contraception is vital for maternal and child health, and reduces the risk of infant mortality. The Health Belief Model (HBM) is a widely accepted framework for exploring health behaviors, such as contraceptive use. Therefore, this study aimed to investigate the factors influencing postpartum contraceptive use in Nigeria and to contextualize the findings within the framework of the HBM. Methods This study was a secondary analysis of cross-sectional data collected from the Demographic Health Survey conducted in Nigeria (NDHS). In total, 28,041 women were included in this study. Self-reported contraceptive use was the outcome, while the explanatory variables included maternal age, place of residence, region of residence, religion, marital status, educational level, household wealth quintiles, knowledge of the ovulatory cycle, decision-maker for health care, and distance to health care facilities. Descriptive statistics and multivariate logistic regression were used to summarize and identify factors influencing postpartum contraceptive use. The HBM was used to discuss the main findings. Results The prevalence of postpartum contraceptive use in Nigeria is 27%. Our findings showed that the odds of using contraceptives during the postpartum period were higher among women who knew their ovulation cycles, lived in urban areas in the southern region, had no distance barriers to health care, and were 25-49 years old. Education, wealth, and marital status also increase the odds of contraceptive use. However, women who lived in the northeast and northwest regions or shared decision-making with their partners had lower odds. Conclusion This study highlights the need for region-specific and age-focused interventions to increase contraceptive use in Nigeria. Additionally, increasing accessibility and affordability of contraceptives for younger and economically disadvantaged women, along with promoting women's autonomy in decision-making, can further enhance contraceptive use across Nigeria.
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Affiliation(s)
| | - Kelechi Amy Nwoku
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Håkan Jonsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Fredinah Namatovu
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Centre for Demographic and Aging Research at Umeå University (CEDAR), Umeå University, Umeå, Sweden
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Kebede N, Kefale B, Yigezu M, Bogale EK, Zewdie A, Wasihun Y, Adane M. Individual and community level factors associated with modern contraceptive utilization among married women in the emerging region of Ethiopia: a multilevel mixed effects analysis of the 2019 Ethiopia Mini-Demographic and health survey. BMC Womens Health 2023; 23:652. [PMID: 38062400 PMCID: PMC10704797 DOI: 10.1186/s12905-023-02822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND A demonstrated technique to enhance reproductive health and economic progress is through ensuring that family planning services are accessible universally. Those studies that used Ethiopia Demographic and Health Survey (EDHS) data did not assess individual and community-level factors in contraceptive utilization. Thus, the study employs a multilevel mixed effects analysis approach, which allows for the examination of individual and community-level factors that influence contraceptive utilization. METHODS This study analyzed the 2019 Ethiopia Min Demographic and Health Survey datasets. A total of 1916 married women in the 2019 surveys were included in the analysis. The data were analyzed using Stata version 17.0. The data were analyzed using Multi-level mixed-effect logistic regression to identify the individual and community-level factors associated with modern contraceptive utilization. An adjusted odds ratio with a 95% confidence interval was used to. Show the strength and direction of the association and statistical significance was declared at a P value less than 0.05. RESULTS Factors significantly associated with modern contraceptive utilization were; Muslim and protestant followers [AOR = 0.31, 95% CI: (0.134, 0.714)] and [AOR = 0.35, 95% CI: (0.173, 0.691)] respectively, women with no education (OR = 0.46; 95% CI: 0.293, 0.710), those women who belong to the poor and middle wealth of household [AOR = 0.35, 95% CI: (0.237, 0.527)] and [AOR = 0.56, 95% CI: (0.347, 0.919)] respectively, women who had one to five and greater than or equal to six living children [AOR = 11.36, 95% CI:(2.119, 60.918)] and [AOR = 7.44, 95% CI:(1.437, 38.547)]respectively, Women in clusters poor wealth status [AOR = 0.40, 95% CI: (0.183, 0.875)] and women who belong to the Somali region [AOR = 0.20, 95% CI: (0.0.070, 0.506)]. CONCLUSION The study revealed that both individual and community-level factors determined modern contraceptive utilization. At the individual level, the religion of women, educational status, the wealth of the household, and the total number of living children were significantly associated with modern contraceptive utilization. At community-level factors, community wealth status and belonging to the Somali region were significantly associated with modern contraceptive utilization. The findings suggest that interventions aimed at increasing modern contraceptive utilization should target women with lower levels of education, those living in households with lower wealth, and those with larger families. Additionally, efforts should be made to improve access to modern contraceptives in communities with lower wealth status and in regions where traditional beliefs may hinder their use.
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Affiliation(s)
- Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Muluken Yigezu
- Department of Public Health College of Medicine & Health Science, Dire Dawa, Dire Dawa University, Dire Dawa, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion, College of Medicine Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite 07, Ethiopia
| | - Yitbarek Wasihun
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Kebede N, Kefale B, Yigezu M, Ayele K, Addisu E, Tsega Y, Kasaye MD, Wasihun Y. A multivariate decomposition analysis of modern contraceptive utilization among married women in the emerging region of Ethiopia (2000-2019). Sci Rep 2023; 13:20902. [PMID: 38017089 PMCID: PMC10684594 DOI: 10.1038/s41598-023-48176-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Abstract
Ensuring universal access to family planning services is a proven strategy to improve reproductive health as well as economic development. Assessing the trend and identifying the factors for the change in modern contraceptive utilization is crucial to design effective measures, but trend analysis was not conducted previously. Thus, this study aimed to assess the trend and determinants of modern contraceptive utilization change among married women in emerging regions of Ethiopia. This study used the 2000 Ethiopia Demographic and Health Survey and the 2019 Ethiopia Min Demographic and Health Survey datasets for analysis. A total of 2555 and 1916 married women in the 2000 and 2019 surveys were included in the analysis, respectively. The data were analyzed using Stata version 17.0. Logit-based decomposition analysis was executed to identify factors for modern contraceptive utilization change. Statistical significance was declared at a P value of less than 0.05. The trend of contraceptive utilization change increased from 6.26% in 2000 to 21.97% in 2019. About - 65.87% and 165.87% of the change in contraceptive utilization was due to changes in composition and behavior, respectively. The change in composition was due to the change in the composition of women according to religion, educational status, region, and the number of living children. The change in behaviors of not educated women, rural women, Muslim women, and those who resided in the afar region was the source of change in modern contraceptive utilization. Modern contraceptive utilization has increased in the last two decades. The change in modern contraceptive utilization is due to changes in population composition and behavior. Interventions targeting uneducated and rural women are vital to increasing contraceptive utilization. Strategic interventions are also required for the Somali regions of Ethiopia.
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Affiliation(s)
- Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia.
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Muluken Yigezu
- Department of Public Health College of Medicine & Health Science, Dire Dawa University, Dire Dawa City, Ethiopia
| | - Kokeb Ayele
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Elsabeth Addisu
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Yawkal Tsega
- Department of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Mulugeta Desalegn Kasaye
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Yitbarek Wasihun
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, 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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