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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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Adeoye YR, Esan DT, Onasoga OA, Afolayan JA, Bello CB, Olawade DB. Determinants of Contraceptive Options among Postpartum Women Attending Selected Health Care Facilities in Nigeria: A Cross-Sectional Study. SAGE Open Nurs 2024; 10:23779608231226089. [PMID: 38268949 PMCID: PMC10807311 DOI: 10.1177/23779608231226089] [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: 07/03/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Differences in availability and choices of contraceptive methods among postpartum women have been found to influence their quality of life as the fertility rate is very high, and the contraceptive usage rate persistently remains low in Nigeria. Objectives This study assessed the determinants of contraceptive options among postpartum women in Nigeria. Methods Two Local Governments were randomly selected from the four Local Governments. Within these two local governments, five health facilities were selected. A multistage sampling technique was used to select the 240 respondents, while a structured questionnaire was used to collect data. Results Findings from the study indicated that 81.7% of the respondents have planned to have their current baby, and about 65.4% of the women have resumed sexual activities since delivery. Of those who have resumed sexual activities, the majority, 91.1% did so 6 weeks after delivery. Some form of contraceptive usage was prominent among 59.2% of the respondents, as the most common contraceptive method used was withdrawal (24.8%). Contraceptive prevalence was slightly lower for urban respondents than rural respondents, although the relationship was not significant. Also, there was a statistically significant relationship between the current use of contraceptives and resumption of sexual activities since delivery (p = .001), resumption of menstruation (p = .001), and information received about postpartum family planning (p = 0.013). Conclusion Findings from this study emphasize the urgent need for enhanced accessibility and availability of contraceptive methods, with a parallel emphasis on targeted interventions and effective communication strategies to promote contraceptive uptake and family planning. Addressing these determinants is vital in improving postpartum women's overall quality of life in the study area.
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Affiliation(s)
- Yetunde Romoke Adeoye
- Department of Clinical Nursing, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
- Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Deborah Tolulope Esan
- Faculty of Nursing Sciences, College of Health Sciences, Bowen University, Iwo, Nigeria
| | | | | | - Cecilia Bukola Bello
- Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - David Bamidele Olawade
- Department of Allied and Public Health, School of Health, Sport and Bioscience, University of East London, London, UK
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Agula C, Henry EG, Asuming PO, Obeng-Dwamena A, Toprah T, Agyekum MW, Shah I, Bawah AA. Postpartum contraceptive initiation and use: Evidence from Accra, Ghana. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221141290. [PMID: 36476194 PMCID: PMC9742708 DOI: 10.1177/17455057221141290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Postpartum contraceptive use reduces unintended pregnancies and results in better health outcomes for children and women. However, there is a dearth of knowledge on postpartum contraceptive use in Ghana, particularly among women in low-income urban settings. To shed light on strategies that might enhance access to postpartum family planning services in low-income urban settings, we examined contraceptive use among postpartum women in Accra, Ghana, at 1, 3, 6, and 12 months following the birth and the methods used. The predictors of modern contraceptive use in the 12-month postpartum period were also examined. METHODS Data come from a cross-sectional survey conducted in 2018 among 624 women aged 16-44 years who reported giving birth in the past 13-31 months prior to the interview. We generated descriptive statistics to examine the prevalence of contraceptive use among postpartum women at 1, 3, 6, and 12 months after birth. We further estimated a binary logistic regression to examine the predictors of modern contraceptive use at 12 months postpartum. RESULTS Forty percent of postpartum women never used any contraceptive method during 1 year after birth and of those who used a method, 40% relied on traditional methods. Moreover, 29% of women started using a method the immediate 1 month post-birth. Results further show that postpartum modern contraceptive uptake was positively associated with higher education, having more live births, and being currently in a union. CONCLUSIONS Findings highlight that there may be opportunities to improve the quality of counseling during antenatal and postnatal care visits by clients to ensure fully informed choices regarding postpartum contraception. Community outreach by health providers/promoters or similar models should be promoted in low-income population settings to educate postpartum women on modern contraceptive use. Women who plan to use traditional methods should be provided with information on the consistent and correct use of these methods.
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Affiliation(s)
- Caesar Agula
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Elizabeth G Henry
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Patrick O Asuming
- University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Akua Obeng-Dwamena
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | - Theophilus Toprah
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | | | - Iqbal Shah
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ayaga A Bawah
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana,Ayaga A Bawah, Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Accra, Ghana.
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Mruts KB, Tessema GA, Gebremedhin AT, Scott J, Pereira G. The effect of family planning counselling on postpartum modern contraceptive uptake in sub-Saharan Africa: a systematic review. Public Health 2022; 206:46-56. [PMID: 35366579 DOI: 10.1016/j.puhe.2022.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Family planning counselling at different contact points of maternal health services has been recommended for increasing the uptake of modern contraceptive methods. However, studies from sub-Saharan Africa (SSA) demonstrated inconsistent findings. The aim of this systematic review was to synthesise the available current evidence for the association between family planning counselling and postpartum modern contraceptive uptake in SSA. STUDY DESIGN This is a systematic review of the SSA literature. METHODS On 11 February 2021, we searched six electronic databases for studies published in English. We included quantitative observational and interventional studies that assessed the effects of family planning counselling on contraceptive uptake among women who gave birth in the first 12 months. We used Joanna Briggs Institute critical appraisal tools to evaluate study quality. The protocol for this systematic review was registered in PROSPERO (CRD42021234785). RESULTS Twenty-seven studies with 26,814 participants comprising 18 observational and nine interventional studies were included. Family planning counselling during antenatal care, delivery, postnatal care, and antenatal and postnatal care was associated with postpartum contraceptive uptake. Moreover, the newly implemented family planning counselling interventions improved postpartum modern contraceptive uptake. CONCLUSION Overall, the evidence suggests that family planning counselling during the different maternal health service delivery points enhances contraceptive uptake among postpartum women. SSA countries should promote and strengthen family planning counselling integrated with maternal health services, which will play a significant role in combating unintended and closely spaced pregnancies.
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Affiliation(s)
- K B Mruts
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; School of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
| | - G A Tessema
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - A T Gebremedhin
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccine and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia
| | - J Scott
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - G Pereira
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway; enAble Institute, Curtin University, Perth, Western Australia
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Mesfin Yesgat Y, Gultie Ketema T, Abebe Dessalegn S, Wallelign Bayabil A, Argaw Enyew M, Habte Dagnaw E. Extended post-partum modern contraceptive utilization and associated factors among women in Arba Minch town, Southern Ethiopia. PLoS One 2022; 17:e0265163. [PMID: 35294469 PMCID: PMC8926256 DOI: 10.1371/journal.pone.0265163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/24/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Post-partum family planning is a novel strategy to reduce maternal and neonatal mortality by preventing unwanted pregnancy and unsafe abortion. However, little was done on community-based design to assess modern contraceptive use during an extended postpartum period in southern Ethiopia. Therefore, this study aimed to assess modern contraceptive use during extended postpartum period and factors associated among women who gave birth in the previous twelve months in southern Ethiopia. METHODS A community-based cross-sectional study was conducted among 416 women in Arba Minch town. A systematic random sampling technique was employed to select the enrolled women. Data were collected using a structured and pretested questionnaire. The data were entered into Epi-Data version 4.6 then exported to statically package of social science (SPSS) version 25 for data analysis. RESULT Among enrolled postpartum women, 64.7% were used modern contraceptives for the last 12 months. Women were more likely to use a modern contraceptive during the extended period of postpartum if they resumed sexual intercourse (AOR:7.4 [4.08, 13.23]), received post-partum family planning counseling (AOR: 3.2 [1.95, 5.28]), and if they resumed menses (AOR: 5.3 [3.12, 9.15]) than the counterpart. Being young age women (AOR: 3.2 [1.05, 9.82]) compared to age above 35 years and married (AOR:3.2 [1.17-10.28]) compared to currently unmarried were significantly associated factors for modern contraceptive use during the extended period of postpartum. CONCLUSION The level of modern contraceptive utilization during the extended postpartum period was satisfactory. Therefore, in light of this finding, there is a need to improve the strengthening and scale-up antenatal and postnatal counseling of contraceptive use during the extended postpartum period, advice on preceding the return of menses, and give better attention for older age and unmarried women education on family planning.
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Affiliation(s)
- Yibeltal Mesfin Yesgat
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tekilemariam Gultie Ketema
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Samuel Abebe Dessalegn
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abraham Wallelign Bayabil
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Muche Argaw Enyew
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Eyaya Habte Dagnaw
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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