Religious leaders' nuanced views on birth spacing and contraceptives in Sierra Leone - qualitative insights

BACKGROUND

Sierra Leone is a religiously diverse country, with Christianity and Islam being the dominant faiths. This religious landscape plays a significant role in shaping attitudes towards family planning and contraceptives. We examined religious leaders' knowledge of family planning and modern contraceptive methods.

METHODS

In September 2021, data was collected from 116 religious leaders in Sierra Leone, including 32 Muslims and 84 Christians from nine different denominations from sixteen districts, through 16 focus group discussions. The data was subjected to a thematic analysis using NVIVO 12 software.

RESULTS

The study found a spectrum of opinions among religious leaders, both between religions (Christianity vs. Islam) and within denominations of Christianity. There was a general acceptance of natural birth spacing methods, like abstinence during fertile periods, across both Christian and Muslim leaders. Views on modern contraceptives were more divided. Catholics generally opposed them, citing religious doctrines against interfering with procreation. Pentecostals and some Muslims, however, found them permissible under certain circumstances, like promoting family well-being or spacing births for health reasons.

CONCLUSION

The study reveals that religious leaders' views on family planning in Sierra Leone are multifaceted. Understanding these nuances is crucial for designing effective family planning programs. By working with denominations that are more accepting of modern methods and leveraging the support for natural birth spacing methods across religions, there's potential to improve reproductive health outcomes in Sierra Leone.

Knowledge, Attitude, and Practice of Family Planning Among Saudi Primary Health Care Attendees in Al-Ahsa, Kingdom of Saudi Arabia

BACKGROUND

 Assessing community awareness and practice of the significance and methods of family planning is critical for improving the effectiveness and quality of services, policies, and planning, which has a positive impact on the health and quality of life of women, children, families, and communities.

OBJECTIVE

 This study aims to determine Saudi population's knowledge, attitude, and practice of family planning in Al-Ahsa, Kingdom of Saudi Arabia.

METHODOLOGY

 A cross-sectional study was conducted in Al-Ahsa, Saudi Arabia. The study included randomly selected participants (male and female Saudi primary health care attendees). All adult Saudi individuals of both genders attending primary health care centers were eligible for inclusion in this study. Data were analyzed using IBM SPSS Statistics for Windows, Version 15 (Released 2006; IBM Corp., Armonk, New York, United States). Descriptive statistics for the prevalence and quantitative variables was used.  Results: The study included 672 participants; 78.6% of them were females and 21.4% were males. 23.8% of participants aged between 20 and 30 years old. 73.8% of participants heard of family planning before. The source of information about family planning was reported as 36.9% from the Internet, 27.4% from relatives, 21.4% from the doctor, and 14.3% from books. 21.4% think that long-term contraceptive use led to permanent infertility. 81.0% of the participants said that they tend to use family planning methods. 78.6% of the participants have used a family planning method before, where 25.8% of the participants used natural contraception methods, 21.2% used surgical contraception, 27.3% used condoms, and 12.1% used hormonal tablets, while 13.6% used nothing. However, 65.2% currently use contraceptives. 31.8% use the natural method of family planning currently, 21.2% use surgical methods, and 6.1% use condoms.

CONCLUSION

 In comparison to many studies previously mentioned, the rate of family planning utilization was average, as was the level of knowledge and attitude toward family planning. However, there were some mistaken beliefs among participants regarding contraceptives. Age, gender, the duration of a marriage, education level, working status, and monthly income were all found to be significantly associated with knowledge of family planning.

Knowledge, Attitude, and Practice of Contraception Use Among Childbearing Women in Makkah Region, Saudi Arabia

Introduction The rapid growth of the Saudi Arabian economy led to socio-demographic changes, with an increasing need for birth spacing and the use of contraceptives. This study evaluated the knowledge, attitude, and practice of contraception use in the Makkah region of Saudi Arabia. Methods This cross-sectional study used an online questionnaire involving women aged 18-49 in Makkah, Saudi Arabia. Descriptive analyses were performed and the Chi-squared test was used to compare variables. A p-value of < 0.05 was considered statistically significant. Results The study included 352 women aged 32±9.1 years with a response rate of 91%. Among them, 72.1% had a diploma or bachelor's degree, and two-thirds were married (63.4%). Nearly all respondents had heard of contraception before (96.9%). However, only 44.3% knew contraception is a method of family planning, and 23.9% knew it prevents unwanted pregnancy. During the period of conducting the research, 37.8% reported using some contraception. Oral contraceptive pills (OCP) (97.2%, 33.8%), intrauterine devices (IUD) (97.2%, 22.7%), and male condoms (92.9%, 16.9%) were the most known and popular contraception methods used. Respondents' primary sources of information regarding contraception were relatives or friends (38.3%) and websites (30.2%), and 61.9% needed education on family planning. We found that women with multiple children were significantly more likely to practice family planning (p=0.005). Conclusion We found that participants were aware of and had a good attitude toward family planning. However, they had poor knowledge and poor practice of family planning. Raising awareness and education are recommended to improve knowledge and practice of family planning.

Contraceptive Use and the Associated Factors among Women of Reproductive Age in Jazan City, Saudi Arabia: A Cross-Sectional Survey

The contraceptive use profile is poorly understood in some Gulf Arabian countries, including Saudi Arabia. The present study aimed to assess the knowledge, attitude, and practices related to contraceptive use among women of childbearing age in Jazan city, Saudi Arabia. An observational, analytical cross-sectional study was conducted among a random sample of 450 women in Jazan city. The data were obtained through personal interviews using a questionnaire that included questions on women's level of knowledge about contraception methods, their attitudes towards contraception methods, and their practices. Data were analyzed using descriptive and inferential statistics techniques using the SPSS program. The prevalence of ever having used contraceptives was significantly different according to age group, job status, children ever born, and the number of pregnancies (p < 0.05 for all). On the other hand, the prevalence of desire to use the contraceptives in the future was high, at 70.9%, with a 95% CI [66.5-74.9]. It differed significantly according to age group and job status (p < 0.05 for both). The most familiar and usable types of contraceptives were pills (36.3%) and intrauterine devices (24.4%). When asked their reasons for using contraceptives, 53.8% of participants cited child spacing and 21.8% improving child health. Logistic regression revealed that the use of contraception among women was more associated with the 20-34 age group [COR = 7.7, 95% CI = 4.4-13.5, p < 0.001] than the 15-24 age group. Having more than one pregnancy and having more than one child were also associated with increased use of contraceptive methods (p < 0.001 for both). These results indicate there is a high level of awareness about contraceptives, a positive attitude toward them, and good practices for the use of them among Saudi women in Jazan. More efforts are needed to improve women's awareness for better utilization of the available services.

Prevalence and determinants of contraceptive method use among Bangladeshi women of reproductive age: a multilevel multinomial analysis

BACKGROUND

Much scholarly debate has centered on Bangladesh's family planning program (FPP) in lowering the country's fertility rate. This study aimed to investigate the prevalence of using modern and traditional contraceptive methods and to determine the factors that explain the contraceptive methods use.

METHODS

The study used data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), which included 11,452 (weighted) women aged 15-49 years in the analysis. Multilevel multinomial logistic regression was used to identify the factors associated with the contraceptive method use.

RESULTS

The prevalence of using modern contraceptive methods was 72.16%, while 14.58% of women used traditional methods in Bangladesh. In comparison to women in the 15-24 years age group, older women (35-49 years) were more unwilling to use modern contraceptive methods (RRR: 0.28, 95% CI: 0.21-0.37). Women who had at least a living child were more likely to use both traditional and modern contraceptive methods (RRR: 4.37, 95% CI: 3.12-6.11). Similarly, given birth in the previous 5 years influenced women 2.41 times more to use modern method compared to those who had not given birth (RRR: 2.41, 95% CI: 1.65-3.52). Husbands'/partners' decision for using/not using contraception were positively associated with the use of both traditional (RRR: 4.49, 95% CI: 3.04-6.63) and modern methods (RRR: 3.01, 95% CI: 2.15-4.17) rather than using no method. This study suggests rural participants were 21% less likely to utilize modern methods than urban participants (RRR: 0.79, 95% CI: 0.67-0.94).

CONCLUSION

Bangladesh remains a focus for contraceptive use, as it is one of the most populous countries in South Asia. To lower the fertility rate, policymakers may design interventions to improve awareness especially targeting uneducated, and rural reproductive women in Bangladesh. The study also highlights the importance of male partners' decision-making regarding women's contraceptive use.

Ovarian cancer in Lebanese women: a 12-year comparative epidemiological study and trend analysis

Purpose

Over the last decade, Lebanon has experienced an increase in the rate of cancer patients. The aim of this study is to investigate the incidence rates of ovarian cancer in Lebanese women over a period of 12 years and to compare them to other countries.

Methods

Data were collected from the Lebanese National Cancer Registry for the time period 2005-2016 (inclusive). Data from other countries were retrieved from an online database 'Cancer Incidence in Five Continents'. The age-specific and age-standardised incidence rates (ASIR) were calculated and analysed using Joinpoint regression.

Results

Ovarian cancer ranked seventh among the commonest cancers in Lebanese women in the studied time frame. Approximately 189 new cases were reported every year, with an average age-standardised incidence rate of 7.88 (per 100,000 women). Ovarian cancer showed a significantly decreasing trend in the 12 years of study. Lebanon had one of the highest ASIR for ovarian cancer among regional countries and randomly selected countries.

Conclusion

Lebanon presented a high ASIR for ovarian cancer compared to regional countries, and was placed among the top ASIRs compared to countries worldwide. However, with the decreasing ovarian cancer trends, it is important to implement efficacious awareness in order to detect all OC cases.

Factors influencing the uptake of short-term contraceptives among women in Afghanistan

The aim of this study is to assess factors that influence the uptake of short-term contraceptives among married women aged between 15 and 49 years in Afghanistan. The cross-sectional Afghanistan 2015 Demographic and Health Survey provided the dataset for this analysis. We included 22,974 women and applied multivariable logistic regression to investigate the influencing factors for the uptake of short-term contraceptives. 92% of Afghan women knew at least one type of short-term contraception but only 17% were using short term contraceptives. Short term contraceptive use was most prevalent among women in the age group between 30 and 40 who were educated, employed, and rich. Most of the users were living in the western parts of Afghanistan and women from the Balooch and Pashtun ethnic groups were most likely to use short-term contraceptives. Media exposure and women empowerment were also positively associated with the use of short-term contraceptives. We did not find an association with living in urban or rural settings. Contraception promotion in Afghanistan requires multisectoral efforts, tailored to the needs of women from low and middle socioeconomic strata. Health promotion activities, empowering women, strengthening education, and training of service providers on effective counseling are options that should be considered to improve the current situation.

Individual and community-level determinants of non-use of contraceptive among women with no fertility desire in Ethiopia: a multilevel mixed-effect analysis

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.

Relationship between socio-economic characteristics of older adults' women and family planning use in Botswana

Older adults (50 years and over) are still sexually active and therefore vulnerable to unplanned pregnancy, infection of STIs and HIV, yet there are no programmes in place to cater for their family planning needs. The objective of the study is to show how some socio-economic characteristics of older adults influence their family planning (FP) use. The study used a stratified random sampling design where four health districts (two urban and two rural) were purposively selected and the sample size of 444 older adult women allocated to the districts using proportional allocation to size. Snowball technique was used in identifying respondents. The multinomial logistic regression analysis reveals that while age, marital status, educational qualification, employment status, menopausal status, district and desire for another child jointly significantly predict FP use, only menopausal status and desire for another child individually significantly (p < 0.01) predict FP use. Older adult women who desired another child were significantly (p < 0.01) 7.5 times more likely to use family planning (FP) methods than those who do not want another child. The postmenopausal older adult women were less likely to use FP methods than those in their premenopausal state (OR = 0.13). Women with no schooling were less likely to use FP methods than those with degree/professional qualifications. Single and married women were less likely to use FP methods than the divorced/widowed/separated. The study recommends the promotion of education and training on FP use among the older adult women that will take into consideration their menopausal status and desire for another child. The training should be home-based.

Modern Contraceptive Use and Influencing Factors in Amhara Regional State: Further Analysis of Ethiopian Demographic Health Survey Data 2016

Background. Ethiopia is one of the Sub-Saharan African countries with a high unmet need for contraceptives. Contraception is a good indicator of the extent to which couples have access to reproductive health services. A study on contraceptives can provide overall direction by helping to identify the obstacles in society and weaknesses in services that need to be overcome. However, little is known in Amhara region context. Therefore, this analysis was aimed to assess modern contraceptive use and influencing factors in the Amhara regional state of Ethiopia. Methods. We used secondary data analysis of the regional representative sample of women aged 15–49 years from the 2016 Ethiopian Demography and Health Survey (EDHS). A total of 2207 married reproductive-age women (15–49 years) selected using a two-stage stratified cluster sampling technique were included in this analysis. Both descriptive and logistic regression analyses were performed using STATA V.14. A 95% confidence interval was used to declare statistical significance. Results. Modern contraceptive use among married reproductive-age women was 51.3% (95% CI: 47.0–55.6). Being from households with rich wealth index (AOR = 1.6; 95% CI: 1.1–2.5), a secondary or higher level of education (AOR = 3.0; 95% CI: 1.4–6.2), and desire to space (AOR = 2.6; 95% CI: 1.9–3.7) or want no more child (AOR = 2.4; 95% CI: 1.6–3.5) were found positively associated with modern contraceptive use. On the other hand, modern contraceptive use was negatively associated with women aged 35–49 years (AOR = 0.7; 95% CI: 0.5–0.9). Conclusion. Modern contraceptive use was relatively high in the Amhara region. The odds of modern contraceptive use were higher among women with secondary or more educational levels. Women from households with rich wealth index and those who want to delay or avoid pregnancy had also more odds of using modern contraceptives. Therefore, strengthening women’s and community education could improve modern contraceptive use. Moreover, more emphasis should be given for income generation activities.

Prevalence, Correlates, and Barriers of Contraceptive Use among Women Attending Primary Health Centers in Aljouf Region, Saudi Arabia

(1) Backgrounds and Objectives: with the rapid alteration in the socio-demographic pattern of the Saudi community, particularly the changes concerned with women’s education and work force, contraceptive use must be a fundamental aspect in the life of women in reproductive age. The present study aimed to identify the prevalence and correlates of contraceptive use among women attending primary health centers in Aljouf region, Saudi Arabia, and to determine the perceived barriers of stopping or not using contraceptive methods in this population. (2) Methods: a primary health center-based cross-sectional study was conducted among 369 women of reproductive age. Data collection was done by using structured questionnaires distributed during face to face interviews with the participants. Data were analyzed using the SPSS program, version 24. (3) Results: most of the participants (n = 166; 45%) were current contraceptive users and 32.2% (n = 119) reported previous use of contraceptive methods. Pills were the most frequently used method (n = 203; 71.2%) and intrauterine devices (IUDs) came next (n = 67; 23.5%) while surgery was the least common method among the respondents (n = 3; 1.1%). Logistic regression analysis showed that the significant predictors of contraceptive use were: age > 35 years (odds ratio (OR): 4.52; confidence interval (CI): 1.56–15.42), Children number ≥ 4 (odds ratio (OR): 1.41; confidence interval (CI): 1.06–1.92) and monthly income ≥ 5000 Saudi Riyal (RS) (odds ratio (OR): 2.29; confidence interval (CI): 1.24–8.27). The most perceived barriers towards contraceptive utilization were cultural, demographic, medical, administrative, and barriers related to the method itself. The least reported barriers were psychosocial and physical. (4) Conclusions: the present study showed a high prevalence of contraceptive use among Saudi women in Aljouf region, Saudi Arabia. The study recommended sustained efforts to increase population awareness of the importance of family planning. Policymakers should discover the barriers that prevent contraceptive utilization by women.

Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia

OBJECTIVE

Zambia is among the world's top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women.

DESIGN

Cross-sectional study.

SETTING

Rural Zambia.

PARTICIPANTS

Secondary data of 4903 married or cohabiting rural women (15-49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson's χ² and descriptive statistics were performed to examine factors associated with modern contraceptive use.

RESULTS

Factors that were positively associated with contraceptive use were respondent's education (secondary adjusted ORs (AOR = 1.61, p≤0.002); higher (AOR = 2.39, p≤0.050)), wealth index (middle class, (AOR = 1.35, p≤0.005); rich (AOR = 2.04, p≤0.001) and richest (AOR = 1.95, p≤0.034)), high parity (1-2 (AOR = 5.31, p≤0.001); 3-4 (AOR = 7.06, p≤0.001); 5+ (AOR = 8.02, p≤0.001)), men older than women by <10 years (AOR = 1.50, p≤0.026) and women sensitised about family planning at health facility (AOR = 1.73, p≤0.001). However, old age (40-49 years (AOR = 0.49, p≤0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR = 0.77, p≤0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR = 0.78, p≤0.026) and women without knowledge of number of children husband desires (AOR = 0.71, p≤0.001) were negatively associated with contraceptive use.

CONCLUSION

Modern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.

Factors influencing sexual and reproductive health of Muslim women: a systematic review

BACKGROUND

In Islamic societies, issues related to sexual and reproductive health (SRH) are rarely discussed and considered sensitive subjects. This review aimed to identify any personal, religious, cultural, or structural barriers to SRH service and education among Muslim women worldwide.

METHODS

A search for qualitative and quantitative studies was conducted on seven electronic databases. A narrative synthesis using thematic analysis was conducted.

RESULTS

Fifty-nine studies were included from 22 countries: 19 qualitative, 38 quantitative and two mixed methods. Many Muslim women have poor SRH knowledge, and negative attitudes which influence their access to, and use of SRH services. Barriers to contraception use among Muslim women included a lack of basic reproductive knowledge, insufficient knowledge about contraception, misconceptions, and negative attitudes. Women had negative attitudes towards family planning for limiting the number of children but not for child spacing, which reflected religious views towards family planning. Religious and cultural beliefs were barriers to contraception use and access to SRH services and information. Family and the community have a significant impact on women's contraceptive use and access to SRH services. Husband and family opposition played a significant role in contraception access and use. Fear of stigmatization and being labelled as having pre-marital sexual relations among unmarried women acted as the main barrier to accessing contraception and seeking SRH information and services.

CONCLUSION

The findings reveal that there are multiple levels of factors that influence Muslim women's SRH. Poor SRH knowledge and practices among Muslim women is complex matter that is affected by personal, community, cultural, religious factors and existing policies and regulations. All these factors overlap and are affected by each other. There is an urgent need for interventions addressing modifiable barriers to SRH education and services to improve knowledge, informed choice and access to services to facilitate better sexual and reproductive wellbeing for Muslim women. It is important to note that while this review aimed to report findings on Muslim women, we acknowledge that significant variations exist within every culture and religion.

Reproductive health profile and circumcision of females in the Hali semi-urban region, Saudi Arabia: A community-based cross-sectional survey

BACKGROUND

Improving the reproductive health of females has be.come the focus of the developmental efforts of many nations.

OBJECTIVES

To identify the reproductive health style of married females, and to determine the prevalence and predictors of circumcision among girls aged less than or equal 18 years in Hali semi-urban region.

DESIGN

A cross-sectional household survey SETTING: Houses in Hali, Al-Qunfudhah governorate, western Saudi Arabia during 2017.

SUBJECTS AND METHODS

A multistage systematic cluster random sampling method was used to select participants. A validated questionnaire was used in interviewing the head of the selected houses.

MAIN OUTCOME MEASURES

Reproductive health profile of women, and circumcision of girls.

SAMPLE SIZE

365 households.

RESULTS

Reproductive life starts early in the Hali region as 41.4% of women are married at or before 18 years of age. Consanguinity was recorded in 57.0% of houses. The prevalence of grand multiparity (GMP) was 54.7%; it was significantly associated with current maternal age, age at marriage, low educational levels of both parents and husbands with non-professional jobs. Current use of birth control methods was reported by 28.9% of families, and oral contraceptives (OCs) were the commonest method. Contraceptive use was significantly associated with higher educational levels of both parents and with women having professional work. The prevalence of circumcision was 80.3%. Circumcision was most frequent (59.4%) at age 7 years or less, and almost always done by doctors (91.4%). Hemorrhage (2.9%) and fever (2.3%) were the minimal recorded complications. Girls with higher parental education, enough income, no parental consanguinity, and whose mothers married at an older age had slightly lower rates of circumcision, but the difference was without statistical significance.

CONCLUSION

The pattern of early female marriage, high consanguinity, GMP, low contraceptive use, and a high frequency of circumcision in girls was apparent in Hali. Public health education and legislative policies are needed.

LIMITATIONS

Recall bias may affect the reported frequency of circumcision, and related complications.

CONFLICTS OF INTEREST

None.

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study

BACKGROUND

Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district.

METHODS

A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted.

RESULTS

Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives.

CONCLUSION

While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

Awareness and utilization of modern contraceptives among street women in North-West Ethiopia

BACKGROUND

Contraception is a major component of reproductive health. Assessing the levels of contraceptive awareness and use helps to identify potential areas of intervention. Hence, this study was conducted to assess awareness, practice and associated factors of modern contraceptives among street women in North-West Ethiopia.

METHODS

A cross-sectional study was conducted on 204 street women from Gondar and Bahir Dar cities. Participants were recruited from "cluster" sites such as main road sides, isolated slum areas, around Churches and/or Mosques (in the mornings of Sundays and other religious feast days) and streets where street women usually reside and/or sleep. Data were collected using a pre-tested and structured interview questionnaire in local language (Amharic) after informed verbal consent. Data were then entered into SPSS version 16.0 for analysis. Binary logistic regression models were fit to assess associations and control confounding. Associations were measured by the Odds ratio and its 95% confidence interval.

RESULTS

The mean (± SD) age of participants was 30.9 (± 8.7) years. Majority (90.7%) had ever heard about modern contraceptives. Nearly half (47.1%) had ever used and a third (34.3%) were current users. Three quarter of the current users (74.3%) were using injectables while 10% were on long acting or permanent methods. Marital status (AOR=2.81), family size (AOR=2.67) and age of 25-34 years (AOR=3.45) were associated with modern contraceptive use.

CONCLUSIONS

Current contraceptive use among street women is satisfactory considering their life styles and living conditions. However, further research is required to explain perceptions and hidden barriers.