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Alam MB, Rana MS, Kabir MA, Khanam SJ, Khan MN. Pattern of contraceptive use among reproductive-aged women with disabilities in Bangladesh: Evidence from multiple indicator cluster survey 2019. Disabil Health J 2024:101651. [PMID: 38866623 DOI: 10.1016/j.dhjo.2024.101651] [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: 08/31/2023] [Revised: 04/16/2024] [Accepted: 06/06/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Contraception is crucial for reproductive-aged women with disabilities, empowering them to manage reproductive choices and enhancing overall health, autonomy, and well-being. OBJECTIVE The objective of this study was to examine the usage patterns of contraceptive methods among reproductive-aged women with disabilities in Bangladesh. METHODS We analyzed data from 47,465 reproductive-aged women from the 2019 Bangladesh Multiple Indicator Cluster Survey. Outcome variables included contraceptive usage patterns, grouped into any contraceptive methods, any modern contraceptive methods, and any traditional contraceptive methods. The primary explanatory variable considered was disabilities level (women with no disabilities, women with moderate disabilities, and women with severe disabilities), along with types of disabilities. A multilevel mixed-effects logistic regression model was used to assess associations between outcomes and explanatory variables while accounting for confounding. RESULTS The prevalence of any contraceptive methods use was 66.4 %, declining to 54 % among women with severe disabilities. The odd of modern contraception use was 31 % lower (aOR, 0.69, 95 % CI, 0.65-0.73) among women with moderate disabilities and 47 % lower (aOR, 0.53, 95 % CI, 0.47-0.60) among those with severe disabilities, compared to women with no disabilities. Within the individual domains of disabilities, those with vision, walking, cognitive, and self-care-related disabilities reported lower odds of modern contraception uptake than those with no disabilities. CONCLUSIONS The study highlights that women with disabilities use contraceptives less often, increasing vulnerability to unintended and short interval pregnancies and unsafe abortion. Strengthening family planning and prioritizing women with disabilities for modern contraceptives are vital.
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Affiliation(s)
- Md Badsha Alam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
| | - Md Shohel Rana
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
| | - Md Awal Kabir
- Department of Social Work, Pabna University of Science and Technology, Pabna, Bangladesh
| | - Shimlin Jahan Khanam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh.
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Kigongo E, Tumwesigye R, Anyolitho MK, Musinguzi M, Kwizera G, Achan E, Nabasirye CK, Udho S, Kabunga A, Omech B. Access to family planning services and associated factors among young people in Lira city northern Uganda. BMC Public Health 2024; 24:1146. [PMID: 38658880 PMCID: PMC11044454 DOI: 10.1186/s12889-024-18605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Access to family planning services among young people is crucial for reproductive health. This study explores the access and associated factors among young people in Lira City, Northern Uganda. METHODS AND MATERIALS A mixed-methods study was conducted in March to April 2022. Quantitative data were collected using a structured questionnaire from 553 participants aged 15-24 years. Qualitative data were obtained through in-depth interviews and focus group discussions. Data analysis included univariate, bivariate, and multivariate analyses for quantitative data, while interpretative phenomenological analysis was used for qualitative data. RESULTS Overall, 31.7% of the respondents had a good perceived access to family planning services, with 64.6% reporting perceived availability of FP methods. Challenges included lack of privacy (57.7%), fear of mistreatment (77.2%), and decision-making difficulties (66.2%). Among females, good perceived access to FP services was less likely among urban residents (AOR: 0.22, 95% CI: 0.09-0.53), Christian respondents (AOR: 0.51, 95% CI: 0.01-0.36), Muslim respondents (AOR: 0.07, 95% CI: 0.01-0.55) and respondents with poor attitude to FP services (AOR: 0.39, 95% CI: 0.24-0.64), but more likely among respondents with a sexual a partner (AOR: 4.48, 95% CI: 2.60-7.75). Among males, good perceived access to FP services was less likely among respondents living with parents (AOR: 0.19, 95% CI: 0.05-0.67) but more likely among respondents with good knowledge of FP services (AOR: 2.28, 95% CI: 1.02-5.32). Qualitative findings showed that three themes emerged; knowledge of family planning methods, beliefs about youth contraception and, friendliness of family planning services. CONCLUSION The study revealed a substantial gap in perceived access to family planning services among young people in Lira City. Barriers include privacy concerns, fear of mistreatment, and decision-making difficulties. Tailored interventions addressing urban access, religious beliefs for females, and knowledge enhancement for males are essential. Positive aspects like diverse FP methods and physical accessibility provide a foundation for targeted interventions. Youth-friendly services, comprehensive sexual education, and further research are emphasized for a nuanced understanding and effective interventions in Northern Uganda.
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Affiliation(s)
- Eustes Kigongo
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda.
| | - Raymond Tumwesigye
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
| | | | - Marvin Musinguzi
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
| | - Gad Kwizera
- Faculty of Education, Lira University, Lira, Uganda
| | - Everlyne Achan
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
| | | | - Samson Udho
- Faculty of Nursing , Mbarara University of Science and Technology, Mbarara, Uganda
| | - Amir Kabunga
- Faculty of Medicine, Lira University, Lira, Uganda
| | - Bernard Omech
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
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Anshebo AA, Markos Y, Behera S, Gopalan N. Contraceptive dynamics among women with disabilities of reproductive age in Ethiopia: systematic review. Syst Rev 2024; 13:42. [PMID: 38279168 PMCID: PMC10811808 DOI: 10.1186/s13643-024-02456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/08/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND In low-income countries, women with disabilities have limited access to essential sexual and reproductive health services and are disadvantaged socioeconomically. Even though some studies have been conducted previously, there are scanty findings on contraceptive use and associated factors among women with disabilities. Thus, this systematic review aimed to assess contraceptive use and associated factors among women with disabilities of reproductive age in Ethiopia. METHODS The Preferred Reporting Item for Systematic Review and Meta-Analyses [PRISMA] guidance is used to conduct this systematic review. Data were searched from electronic databases: PubMed/Medline, Scopus, Google Scholar, and other relevant sources. Studies screening was done using Rayyan software. The findings were narratively synthesized using a socio-ecological framework for health promotion. RESULT Ten cross-sectional studies and 4436 women with disabilities of reproductive age were included in this review. According to this review, women with disabilities are less likely to use contraceptives, with a prevalence of 21.7% in Gondor City and 44.4% in Addis Ababa. The associated factors were identified and themed at individual, interpersonal, community, and institutional levels. CONCLUSION Overall, the review findings revealed that women with disabilities continue to encounter challenges ranging from individual level to disability-unfriendly health facility infrastructure or institutional level. Therefore, health professionals and other relevant stakeholders should draw attention to creating awareness towards contraceptive use at individual and interpersonal levels, ensuring accessible contraceptive services and disability-friendly health facilities.
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Affiliation(s)
- Abebe Alemu Anshebo
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India.
- Deparment of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia.
| | - Yilma Markos
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Sujit Behera
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Natarajan Gopalan
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
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Seidu AA, Malau-Aduli BS, McBain-Rigg K, Malau-Aduli AEO, Emeto TI. "God is my only health insurance": a mixed-methods study on the experiences of persons with disability in accessing sexual and reproductive health services in Ghana. Front Public Health 2023; 11:1232046. [PMID: 37546318 PMCID: PMC10398390 DOI: 10.3389/fpubh.2023.1232046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/29/2023] [Indexed: 08/08/2023] Open
Abstract
Background Access to sexual and reproductive health (SRH) services is a fundamental human right, but people with disabilities (PwDs) in low-and middle-income countries often face multiple barriers to utilisation. This study aimed to assess the level of SRH services utilisation and the enabling and inhibiting factors among PwDs in Ghana's Ashanti region. Methods A sequential explanatory mixed-methods study design was employed, involving quantitative (n = 402) and qualitative (n = 37) data collection from PwDs. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed using inductive thematic analysis. Results The study found that only 33.8% of the PwDs had ever used SRH services. Utilisation was associated with sex, marital status and travel duration to health facility. The qualitative data revealed that factors at the individual, family/community and health facility levels influenced utilisation of SRH services, acting as both enablers and barriers. Conclusion PwDs had relatively low utilisation of SRH services in Ghana's Ashanti region. To increase utilisation, it is recommended to address the stigma and discrimination towards PwDs, provide more training for healthcare providers, improve the accessibility of healthcare facilities, and strengthen the national health insurance scheme. Further research could explore PwDs' SRH outcomes and strategies to improve these outcomes in Ghana.
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Affiliation(s)
- Abdul-Aziz Seidu
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Bunmi S. Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Kristin McBain-Rigg
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Aduli E. O. Malau-Aduli
- School of Environmental and Life Sciences, University of Newcastle, Newcastle, NSW, Australia
| | - Theophilus I. Emeto
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, QLD, Australia
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Shehu EY, Kumar P, Yimam W, Anteneh S. Youths with disabilities: Utilization and predictors of Youths Friendly Reproductive Health Services in Dessie City Administration, North East Ethiopia, 2021: A cross-sectional study. Health Sci Rep 2023; 6:e1386. [PMID: 37415674 PMCID: PMC10319967 DOI: 10.1002/hsr2.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 07/08/2023] Open
Abstract
Background and Aims Younger generations with disabilities are more likely to be affected and have severe difficulties receiving specific services. Ethiopia is no exception to the global trend of poverty-stricken countries with a higher frequency of illness or disability. This study aimed to assess the utilization of Youths Friendly Reproductive Health Services (YFRHS) and predictors among youths with disabilities in Dessie City, North East, Ethiopia, 2021. Methods A community-based, cross-sectional study was conducted. Data were collected from the literature using questionnaires. Bivariable analysis was performed for each independent variable with a p < 0.25 on the data imported to multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) at a 5% level of significance has measured the strength of association between utilization of youth-friendly reproductive services among disabilities and independent variables. Results Of 423 participants, 91% responded. About 42% of participants had used YFRHS. Youths in the age group of 20-24 years were 2.8 times more likely to use such services than 15-19-year-olds (AOR = 2.8, 95% CI: [1.04, 7.44]). Disabled youths living alone were 3.6 times more likely to use the services than those with parents (AOR = 3.6, 95% CI: [1.36, 9.35]). Youths with a visual impairment were 80% less likely to use the services than youths with hearing impairments (AOR = 0.2, 95% CI: [0.18, 0.30]), and disabled youths with poor knowledge were 90% less likely to use the services than participants with good knowledge (AOR = 0.1, 95% CI: [0.01, 0.61]) were statistically significant. Conclusion The utilization of YFRHS among youths with disabilities in Dessie Town was low. Participants aged 20-24 years, who lived alone, had visual impairment, and had poor knowledge, were found to be significantly associated.
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Affiliation(s)
- Eshetu Y. Shehu
- Department of Adult Health (N), College of Medicine & Health SciencesWollo UniversityDessieEthiopia
| | - Prem Kumar
- Department of Adult Health (N), College of Medicine & Health SciencesWollo UniversityDessieEthiopia
| | - Wondwossen Yimam
- Department of Comprehensive (N)College of Medicine & Health Sciences, Wollo UniversityDessieEthiopia
| | - Samuel Anteneh
- Department of Adult Health (N), College of Medicine & Health SciencesWollo UniversityDessieEthiopia
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