Effects of reproduction norms on contraception practice among Muslim women in Amman, Jordan

Determinants of modern family planning methods in Ethiopia: A community-based, cross-section mixed methods study

In 2019, Ethiopia had a total fertility rate of 4.2 births per woman with the rates varying significantly across regions. The Federal Ministry of Health of Ethiopia announced "Ethiopia FP 2020" to address the high fertility rate, aiming to reduce it to 3.0 by 2020. This study aimed to identify the determinants of the use of modern family planning services in the Amhara, Oromia, and Somali regions. A community-based, cross-sectional mixed methods study was conducted, using quantitative and qualitative surveys. The quantitative survey data were subjected to binary logistic regression analyses. Participants included over 4117 married men and women aged 15-65 years old. This study found that participants in Oromia were 8.673 times more likely to have modern family planning methods than those in Somali. Participants in Amhara were 5.183 times more likely to have modern family planning methods than their Somali counterparts. Women, married respondents, and recipients of media messages were more likely to have family planning experience. Family planning discussions with health extension workers and health professionals played a significant role in modern family planning. These findings show that establishing a family planning strategy that considers the sociocultural characteristics of each region help address regional contexts. Everyone in Somali-especially husbands and religious leaders-must be educated in family planning and funds be made available to deploy advanced measures for the same.

Sexual and reproductive health of women living with HIV in Muslim-majority countries: a systematic mixed studies review

Background

The number of women living with the human immunodeficiency virus (WLHIV) in Muslim-majority countries has increased significantly in the last decade. These women are often marginalized and face insecure sexual and reproductive health (SRH) needs and rights. However, little is known about the multi-faceted factors influencing these women’s fertility, contraceptive, and perinatal decisions and sexual life. This systematic mixed studies review aimed to synthesize the empirical evidence on social, cultural, and structural factors influencing the SRH of WLHIV in Muslim-majority countries.

Methods

This review provides a synthesis of quantitative, qualitative and mixed-method research findings searched from PubMed, EMBASE, Scopus, CINAHL and Cochrane databases. We screened 3452 SRH studies involving WLHIV. The studies, published in English between 2008 and 2017, were from 20 Muslim-majority countries with increased numbers of WLHIV. The quality of eligible studies was appraised using a mixed-methods appraisal tool (MMAT) version 2011. Findings were thematically analysed by a hybrid deductive-inductive approach. Two independent reviewers were involved in the study selection, data extraction, quality appraisal, and data synthesis.

Results

We included 13 SRH-related studies involving 1748 WLHIV in eight Muslim-majority countries. Most of these studies explored fertility desire and sexual health, while only a small proportion related to contraceptive use and the perinatal-care experience. We identified that WLHIV faced neglect of their SRH rights. These rights were predominantly affected by the socio-cultural, religious and health-services context of the women’s lives, which directed them to unsafe sex practices and stressful perinatal experiences.

Conclusions

This study points to the need for SRH laws, policies, and interventions which stop WLHIV experiencing SRH discrimination violence and achieving their SRH rights.

Misconceptions and current use of contraception among women of reproductive age in six major cities in Nigeria

OBJECTIVES

The aims of this study were to assess the determinants of family planning misconceptions and modern contraceptive use, and the influence of misconceptions on the use of modern contraceptive methods.

METHODS

We reviewed and analysed data collected between October 2010 and March 2011 among a representative household sample of 13,575 women of reproductive age (15-49 years) in six urban cities in Nigeria. Multiple linear and logistic regression models were used to examine the predictors of misconceptions and current use of contraception and the association between misconceptions and modern contraceptive use.

RESULTS

Catholic women were significantly more likely to have misconceptions compared with Muslim women (β = 1.09; 95% confidence interval [CI] 0.58, 1.60; p < .001); women with higher education were significantly less likely to have misconceptions about contraception compared with women with no formal education (β= -0.06; 95% CI -0.96, -0.29; p < .001). Unmarried women living with a partner were not significantly different from those who were not cohabiting (single, separated or widowed) in their current contraceptive use (adjusted odds ratio [OR] 0.91; 95% CI 0.79, 1.04; p > .05). Women with lower misconception scores were significantly more likely to adopt and use modern contraception compared with those with high misconception scores (adjusted OR 0.93; 95% CI 0.92, 0.94; p < .001).

CONCLUSION

These findings suggest that programmatic efforts should be geared towards dispelling misconceptions by providing simple factual information related to the benefits of contraception and family planning.

Impact of a pharmacist-provided information booklet on knowledge and attitudes towards oral contraception among Jordanian women: an interventional study

OBJECTIVES

Jordan has high rate of unintended pregnancy, which is largely attributed to limited knowledge and misconceptions about contraceptive methods, namely oral contraceptive pills (OCPs). The aim of this study was to examine the effect of a pharmacist-provided information booklet on increasing the knowledge of Jordanian women about safe and effective OCP use.

METHODS

This was a randomised interventional study. One hundred and sixty women who had used OCPs at least once in their lifetime were randomised to receive conventional counselling (control group) or a pharmacist-provided booklet (intervention group). Knowledge about and attitude towards OCP use were assessed before and immediately after the intervention, and at three-month follow-up.

RESULTS

The mean knowledge score (out of 5) of women in the intervention group improved significantly from 1.76 at baseline (standard deviation [SD] 1.25) to 5.00 (p < .000) directly after the intervention, which then slightly decreased to 4.93 (SD 0.31; p = .033) at follow-up. The baseline mean knowledge score of the control group was 1.29 (SD 1.12) and did not significantly increase over time. It was also considerably lower than that of the intervention group both immediately after the intervention and at follow-up. As regards mean attitude score (out of 6), the control group demonstrated no changes from baseline, whereas the intervention group improved significantly from 5.15 (SD 1.63) to 5.50 (SD 1.36; p = .014).

CONCLUSIONS

Provision of an information booklet by pharmacists to women in Jordan using OCPs is highly recommended. Studies with a larger sample size and from different regions of Jordan are recommended.

Religion and family planning

Religion is embedded in the culture of all societies. It influences matters of morality, ideology and decision making, which concern every human being at some point in their life. Although the different religions often lack a united view on matters such contraception and abortion, there is sometimes some dogmatic overlap when general religious principles are subject to the influence of local customs. Immigration and population flow add further complexities to societal views on reproductive issues. For example, present day Europe has recently faced a dramatic increase in refugee influx, which raises questions about the health care of immigrants and the effects of cultural and religious differences on reproductive health. Religious beliefs on family planning in, for example, Christianity, Judaism, Islam and Hinduism have grown from different backgrounds and perspectives. Understanding these differences may result in more culturally competent delivery of care by health care providers. This paper presents the teachings of the most widespread religions in Europe with regard to contraception and reproduction.

Uptake and predictors of contraceptive use in Afghan women

Background

Afghanistan has one of the world’s highest fertility rates and, related to this, an infant mortality rate far higher than its South Asian neighbors. Contraception enhances family spacing, improves women’s safety in child birth and, as a result, reduces infant and child mortality. Until recently, there has been a paucity of information on the comparative rates of contraceptive practices in the country and socioeconomic correlates of uptake. We aimed to elucidate the factors influencing the use of contraception in Afghanistan using recent, robust national data.

Methods

Using Afghanistan Mortality Survey (AMS) 2010 data, the distribution of Contraceptive Prevalence Rate (CPR) and correlates of contraceptive use among currently married women aged 15–49 years were explored. We initially summarised descriptive data on 25,743 married women and then derived predictors of the use of any form of contraception using a multiple logistic regression model.

Results

The prevalence of self-reported current use of any contraceptive method was 21.8% (95% CI: 20.4-23.4) at the national level though there was a wide variation in practice between provinces. Herat province in the West region had a highest contraceptive prevalence rate of 49.4% while Paktika in the Southeast region had the lowest CPR of 2%. Multiple logistic regression analysis showed that a family size of greater than 6 living children strongly predicted contraceptive use (AOR 7.4 (95% CI:6.1-9.0)). Other independent predictors included: secondary or high level of education (AOR 2.1 (95% CI: 1.8-2.5)) and being in the wealthiest stratum (OR 2.1 (95% CI 1.5-3.0)). Rural residence predicted a lower use of contraception (AOR, 0.72; 95% CI: 0.56-0.92).

Conclusion

Contraceptive uptake rate was low overall with wide inter provincial variation. Strengthening female education, targeting married women in rural area and women with no education may enhance the effectiveness of National Family planning program in Afghanistan.

Friday sermons, family planning and gender equity attitudes and actions: evidence from Jordan

BACKGROUND

To assess the effects of a communication intervention designed to enhance Jordanian religious leaders' (RLs) communication about family health.

METHODS

Programmatic effects on RLs were evaluated with a panel study design; 245 male and 145 female RLs participated in both baseline and end-line surveys in 2011. To assess effects on mosque attendees, a nonequivalent, post-intervention only with control group design was utilized; 431 intervention and 426 control respondents were interviewed in 2012.

RESULTS

Although RLs in the intervention site reported higher levels of preaching and teaching about the family health topics at end line than at baseline, their congregants were no more likely than control congregants to report having heard such messages over the previous 6-month period, contrary to the anticipated outcome. Yet, intervention congregants compared with controls were more likely to take action related to the topics to which they were exposed.

CONCLUSIONS

Despite the mixed findings, intervention mosque goers who recalled messages were more likely to report taking relevant actions. These findings suggest that trained RLs compared with their counterparts were more effective in message dissemination. Thus, the findings support broader implementation of this type of intervention once the programmatic changes recommended in this article are made.

Religious leaders gain ground in the Jordanian family-planning movement

OBJECTIVE

To assess the effect of a training program designed to enhance the role of Muslim religious leaders (RLs) in promoting family welfare, including reproductive health generally and family planning more specifically.

METHODS

A panel study design was utilized; 136 and 115 RLs completed the self-administered questionnaires at baseline (pre-training) and endline (6 months post-training), respectively. Scales were generated to assess RLs' knowledge of the number of family-planning methods deemed to be acceptable according to Islamic teachings (9 methods, Cronbach α=0.85), attitudes toward family planning (7 statements, Cronbach α=0.67), and preaching and/or counseling on family-planning topics (7 topics, Cronbach α=0.85).

RESULTS

Linear regressions controlling for sex, age, and educational attainment showed that, on average, RLs cited more methods deemed acceptable according to Islamic teachings (β=1.381; P<0.001), expressed more positive attitudes toward family planning (β=0.514; P<0.05), and preached and/or counseled on family-planning topics more frequently at endline compared with baseline (β=0.965; P<0.01).

CONCLUSION

Culturally appropriate training for RLs can lead to a deeper understanding of, and appreciation for, reproductive health and family planning, with the effects manifesting as increased preaching and/or counseling about these important topics.

Empowerment in family planning as viewed by Iranian women: a qualitative study

Women carry the primary responsibility for family planning in most parts of the world, and should be afforded the power of decision-making and control over their fertility. This study seeks to gain insight into Iranian women's perception of the meaning of empowerment in family planning. Using a qualitative study, seven focus group discussions and five individual interviews were conducted with 35 married Iranian women of reproductive age. The data were analysed using a conventional content analysis approach, in which themes and categories were explored to reveal women's experiences of empowerment in family planning. The results demonstrated four main categories: control over fertility plan, participative family planning, maintaining health and access to optimal family planning services. They viewed knowledge of family planning and autonomy of decision-making in fertility issues as essential elements for control of their fertility plan. Participants felt more empowered when joint family planning decisions were made with their partners in an atmosphere of agreement. Therefore, family planning policymakers should plan services with new approaches that focus on women's health and empowerment.

Significant effects of Fatwa-based perception on contraceptive practice among Muslim women in south Jordan under the early stage of fertility transition

An interview survey of 450 Muslim women in a rural village of south Jordan under the early stage of fertility transition was conducted to explore major causes of contraceptive use, taking both their sociodemographic attributes and fatwa (Islamic jurisprudence)-based perception into account. Discriminant analysis, which was performed for the subject women divided into 15- to 29-, 30- to 39-, and 40- to 49-year age groups, revealed that "the number of living children" in the former and "to do contraception for good care of children" in the latter played significant roles in discrimination into contraceptive user and nonuser groups for any age groups. To cope with demographically and socioeconmically vulnerable situations, contraceptive prevalence rate should be increased by means of government-led family planning programs in cooperation with the imam (Muslim religious leaders and priests) through fatwa, in which special attention is paid to traditional norms, represented by good childcare.