Determinants of modern contraceptive practice in Yaoundé-Cameroon: a community based cross sectional study

Childbearing intentions, fertility awareness knowledge and contraceptive use among female university students in Cameroon

OBJECTIVES

The primary objective of this study was to examine the association between fertility awareness knowledge, and contraceptive use among sexually active female university students (FUS) in Cameroon.

METHODS

This study was designed as a secondary data analysis of a cross-sectional survey that was conducted between July and August 2018. We extracted and analyzed relevant data (i.e., socio-demographic characteristics, sexual behavior, fertility-related characteristics, and contraceptive use) using a modified Poisson regression with a robust variance estimator. Prevalence Ratios (PR) and 95% confidence intervals were estimated, and statistical significance was set at P≤0.05.

RESULTS

The median age of the sexually active FUS was 23 years (IQR = 21-25) and 99.3% indicated that they wanted to have children. Only 49.3% knew their fertile period and 62.5% of the sexually active FUS were current contraceptive users. We found a statistically significant association between fertility awareness knowledge and period abstinence (PR = 1.57;95%CI: 1.02-2.44, p = 0.049). In multivariate adjusted models, there was a statistically significant association between fertility awareness knowledge and male condom use (APR = 1.29; 95% CI:1.02-1.64, p-value = 0.032) and the withdrawal method (APR = 1.40;95% CI:1.02-1.93, p = 0.038). We found a statistically significant effect modification of "preferred timing to have children" on the association between fertility awareness knowledge and withdrawal method use. There was no association between fertility awareness knowledge and the use of oral contraceptive pills.

CONCLUSION

Most of the female students intend to have children in the future, but their fertility awareness knowledge was suboptimal. There was a statistically significant relationship between fertility awareness knowledge, and the use of male condoms and the withdrawal method. The study underscores the need for FUS to be targeted with interventions to help them gain knowledge of their menstrual cycle to better plan or avoid unwanted pregnancy.

Four out of ten married women utilized modern contraceptive method in Ethiopia: A Multilevel analysis of the 2019 Ethiopia mini demographic and health survey

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.

Predictors of contraceptive method mix in the Cameroon development corporation plantation camps

INTRODUCTION

low socioeconomic status is a risk factor for maternal death and contraceptive use has been shown to reduce maternal deaths in those poor settings. Despite the tremendous benefits of contraceptives in the regulation of reproductive health indicators, its use in less developed countries continue to remain unacceptably low. The purpose of this study was primarily to assess the contraceptive method mix and then determine the predictors of contraceptive use in the Cameroon Development Corporation (CDC) plantation camps.

METHODS

mix sampling was used. Firstly, two CDC camp localities (Tiko and Pena Mboko) were purposively selected. Pre-existing clusters within these localities were then randomly selected and then eligible participants within the sampled clusters systematically selected. Using the main street junction as starting point, direction of sample collection was determined by spinning a plastic bottle. From the start of street junction and moving in direction of the bottle pointer, all households left to the principal investigator were visited in search of eligible participants which were sexually active women aged 15-49 years who gave consent/assent. One participant was selected per household. We used pretested interviewer-administered questionnaires that covered information on socio-demographic characteristics, reproductive health and contraceptive use. Statistical significance was set at p-value ≤ 0.05.

RESULTS

six hundred and thirty four (634) sexually active women aged 15-49 years were included in the study; majority were 25-35 years (246; 38.8%). The current contraceptive prevalence was 63.1% [59.3-66.8] (400); of which 312 participants (78%) used a single method while 88 (22%) participants used contraceptives in combination. The most common methods in use were rhythm (196; 49%), male condom (109; 27.2%) and implants (63; 15.8%). When adjusted, statistically significant determinants for contraceptive use were age range and marital status such that odds of using contraceptives was lower in women < 35 years and those cohabiting (AOR= 0.71 [0.50-1.00] and AOR=0.62 [0.44-0.87] respectively).

CONCLUSION

current contraceptive practice in the CDC plantation camps is geared toward less effective traditional methods than the more effective modern methods. More health education is needed to adjust this paradigm.

Modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia: evidence from 2016 Ethiopia demographic and health survey

Background

Modern contraceptive methods enable couples to enjoy sexual intercourse without fear of the risk of pregnancy at any desired time. The evidence from different studies done in Ethiopia on modern contraceptive method utilization was highly varied and not conclusive. Therefore, the current study aims to study the magnitude of modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia based on 2016 EDHS data.

Method

A nationally representative 2016 EDHS data collected between January 18/ 2016 to June 27/2016 were used. Descriptive studies and logistic regression models were used to summarize descriptive data and measure statistical association respectively. Adjusted odds ratio and confidence interval were respectively used to measure association and its statistical significance. Finally, statistical significance was declared using a confidence interval.

Result

In the current study, the overall modern contraceptive utilization among reproductive-age women in Ethiopia was 3203 (20.42%). The injectable contraceptive method was the most commonly used modern contraceptive method, 1886(58.88%) followed by implant/Norplant, 779 (24.32%). The results of multivariable logistic regression showed that age, residence, region, woman’s occupation, number of living children, husband’s education, age at first sexual intercourse, husband’s desire for more children, wealth index and watching TV were independently associated to modern contraceptive utilization among reproductive-age women in Ethiopia.

Conclusions

The magnitude of modern contraceptive utilization among reproductive-age women in Ethiopia in the current study is unexpectedly low. Age, residence, region, woman’s occupation, number of living children, husband’s education, age at first sexual intercourse, husband’s desire for more children, wealth index and watching TV were independent predictors of modern contraceptive use among reproductive-age women in Ethiopia. Any intervention strategy that promotes modern contraceptive method utilization should consider these factors for its better success.

HIV Status and Contraceptive Utilization among Women in Cameroon

OBJECTIVE

We examined patterns of contraceptive utilization by HIV status among women in Cameroon, hypothesizing that women living with HIV would utilize contraception at higher rates than their HIV-negative peers.

METHODS

Deidentified, clinical data from the Cameroon Baptist Convention Health Services (2007-2013) were analyzed (N = 8995). Frequencies compared outcomes between women living with HIV (15.1%) and uninfected women. Multivariate analyses examined associates of contraceptive utilization and desire to become pregnant.

RESULTS

Contraceptive utilization was associated with higher education, living with HIV, monogamy, and higher parity ( P < .001). Women living with HIV had 66% higher odds of using contraceptives than their negative peers (odds ratio [OR]: 1.66, confidence interval [CI]: 1.45-1.91, P < .001). Polygamous women had 37% lower odds of using contraceptives compared to monogamous women (OR: 0.63, 95% CI: 0.52-0.75, P < .001).

CONCLUSION

Increasing contraceptive utilization in resource-constrained settings should be a priority for clinicians and researchers. Doing so could improve population health by reducing HIV transmission between partners and from mother to child.

Trends and patterns of family planning methods used among women attending family planning clinic in a rural setting in sub-Sahara Africa: the case of Mbalmayo District Hospital, Cameroon

Objective

Family planning enables women to prevent unwanted pregnancies and control family sizes. Provision of family planning services is an essential human right. This study aimed to describe the trends and patterns of contraceptive use in a family planning clinic in a rural district hospital setting.

Results

A total 313 participants who used contraceptives between March 2016 and August 2017 were included this study given a. Their mean age was 32.4 ± 1.8 years with an age range of 18–48 years. The index study estimates the rate of contraceptive use at 17.4 contraceptives per month. The most commonly used contraceptive methods were implants and IUD in 29.4 and 28.4% of the participants respectively while the least used was condoms in 8.3% of the participants. Contraceptive used are highest among those 21–40 years (83.1%) and least among adolescents less than 20 years (6.7%).

Determinants of unmet need for family planning among married women of reproductive age in Burundi: a cross-sectional study

Background

High unmet need for family planning (32.4%) characterized Burundi in 2010. However, there has not been any study examining the relationship between unmet need and associated factors in Burundi. The present study aims at determining the demographic, socioeconomic and other factors underlying the unmet need for contraception among married women aged 15-49 in Burundi.

Methods

This study used data from the 2010 Burundi Demographic and Health Survey. Total unmet need, unmet need for spacing and for limiting were used as outcomes and demographic, socioeconomic and other factors as independent variables. After a descriptive analysis of the study population (n = 5421), the association between the three outcomes and the independent variables were analysed using logistic regression. Odds ratios with their 95% confidence intervals were calculated with statistical significance at p < 0.05.

Results

This study showed that the likelihood of total unmet need decreased with age after 35+, with an adjusted Odds Ratio = 0.586 and 95% CI = 0.423-0.811, compared to women aged 15-24. Women with 4-5 and 6+ living children had higher odds [aOR = 1.850 (1.322-2.590) and 2.390 (1.616-3.534) respectively]. Odds of unmet need were lower among women with primary [aOR = 0.741 (0.618-0.888)] and secondary education [aOR = 0.555 (0.399-0.771)]. Women whose husband desired more children than them [aOR = 1.824 (1.411-2.358)] and those ignoring the husband's desired children [aOR = 2.700 (2.176-3.350)] had higher odds than those desiring the same number as the husband. Women who had experienced the death of 1+ sons had higher odds [aOR = 1.285 (1.038-1.591)]. Middle [aOR = 0.670 (0.530-0.846)] and rich [aOR = 0.664 (0.541-0.817)] compared to poor, women living in the North [aOR = 0.611 (0.412-0.904)] compared to those from Bujumbura, had lower odds. Rural women had higher odds [aOR = 1.373 (1.018-1.852)] and those who had visited a health facility [aOR = 0.765 (0.608-0.961)] or had access to TV [aOR = 0.562 (0.375-0.843)] had lower odds.

Conclusion

Tackling the unmet need for FP in Burundi requires scaling-up male involvement, promoting spousal communication, client-centred services, greater use of media, women's education, child survival, and pro-poor policies.

Eliminating the high abortion related complications and deaths in Cameroon: the restrictive legal atmosphere on abortions is no acceptable excuse

BACKGROUND

The abortion law in Cameroon is highly restrictive. The law permits induced abortions only when the woman's life is at risk, to preserve her physical and mental health, and on grounds of rape or incest. Unsafe abortions remain rampant with however rare reported cases of persecution, even when these abortions are proven to have been carried out illegally.

DISCUSSION

Available public health interventions are cheap and feasible (Misoprostol and Manual Vacuum Aspiration in post abortion care, modern contraception, post-abortion counseling), and must be implemented to reduce unacceptably high maternal mortality rates in the country which still stand at as high as 596/100.000. Changes in the legal status of abortions might take a long time to come by. Albeit, advocacy efforts must be reinforced to render the law more liberal to permit women to seek safe abortion services. The frequency of abortions, generally clandestine, in this restrictive legal atmosphere has adverse economic, health and social justice implications.

CONCLUSION

We argue that a non-optimal or restrictive legal atmosphere is not an acceptable excuse to justify these high maternal deaths resulting from unsafe abortions, especially in Cameroon where unsafe abortions remain rampant. Implementing currently available, cheap and effective evidence based practice guidelines are possible in the country. Expansion and use of Manual Vacuum Aspiration kits in health care facilities, post-abortion misoprostol and carefully considering the content of post abortion counseling packages deserve keen attention. More large scale qualitative and quantitative studies nationwide to identify and act on context specific barriers to contraception use and abortion related stigma are urgently needed.