1
|
Sani J, Ahmed MM. Regional disparities and sociodemographic determinants of intention to use contraceptives among Somali women: a cross-sectional analysis of the 2020 SDHS. Contracept Reprod Med 2025; 10:31. [PMID: 40241228 PMCID: PMC12001640 DOI: 10.1186/s40834-025-00365-4] [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: 12/11/2024] [Accepted: 04/04/2025] [Indexed: 04/18/2025] Open
Abstract
BACKGROUND Contraceptive use is vital to improve maternal and child health, promote economic stability, and empower women. Despite global progress in family planning, Somalia faces unique challenges due to cultural, economic, and infrastructural barriers, resulting in low contraceptive use. This study investigated the prevalence and determinants of the intention to use contraceptives among women of reproductive age in Somali. METHODS Using data from the 2020 Somali Demographic and Health Survey (SDHS), this study analyzed a sample of 7,967 women aged 15-49. Contraceptive intention was categorized as "intent to use" versus "no intent to use." The SDHS questionnaire assesses intention to use contraceptives in the next 12 months, which aligns with standard DHS definitions. Bivariate and multivariable logistic regression analyses were conducted to assess the association between contraceptive intention and sociodemographic factors. Choropleth maps and bar charts illustrate regional disparities. RESULTS Overall, only 7.6% of the women intended to use contraception, with substantial regional variation. Woqooyi Galbeed reported the highest prevalence of contraceptive intention at 18.4%, while Gedo had the lowest at 1.1%. Significant predictors of contraceptive intention included higher education (AOR: 2.34, 95% CI: 1.21-4.56), secondary education (AOR: 1.91, 95% CI: 1.12-3.26). Women residing in nomadic communities had significantly lower odds of intending to use contraception (AOR: 0.40, 95% CI: 0.23-0.68). Since nomadic residence often implies reduced healthcare access, this finding suggests logistical and cultural barriers to contraceptive intentions. Cultural and geographic factors significantly influence contraceptive intentions. CONCLUSION Regional, educational, and socioeconomic variations affect contraceptive intentions in Somalia. Addressing these disparities through targeted educational and healthcare access interventions could improve family planning and utilization, ultimately enhancing maternal and child health outcomes.
Collapse
Affiliation(s)
- Jamilu Sani
- Department of Demography and Social Statistics, Federal University Birnin Kebbi, Birnin Kebbi, Kebbi State, Nigeria
| | | |
Collapse
|
2
|
Ngole BE, Joho AA. Factors Influencing Modern Family Planning Utilization and Barriers in Women of Reproductive Age in the Iringa Region, Tanzania: A Mixed-Methods Study. SAGE Open Nurs 2025; 11:23779608251313897. [PMID: 39830805 PMCID: PMC11742162 DOI: 10.1177/23779608251313897] [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: 11/16/2023] [Revised: 12/04/2024] [Accepted: 12/26/2024] [Indexed: 01/22/2025] Open
Abstract
Background Preventing unwanted pregnancies, achieving optimal child spacing, and improving quality of life are benefits of modern family planning (FP). This study aimed to assess modern FP use, identify the factors influencing its use and determine the barriers to FP use among women of reproductive age. Methods A mixed-methods approach was conducted in the Iringa Region between March and July 2022. Conveniently, 368 women of reproductive age were included in the quantitative study, and 48 were purposively selected for the qualitative study based on reported barriers to using modern FP. Interviewer-administered questionnaires and interview guides were used for data collection. The factors of modern FP use were determined using multivariable logistic regression analysis. The p < 0.05 was considered to be significant. For qualitative data, all interviews were recorded and transcribed. Data were analyzed manually through thematic analysis. Results The prevalence of modern FP use was 181 (49%). Being married (adjusted odds ratio [AOR] = 5.44, 95% confidence interval [CI] = 1.77-16.73, p = .003), parity of 6 and more (AOR = 2.43, 95% CI = 1.99-5.95, p = .052), availability of modern FP methods (AOR = 1.71, 95% CI = 1.03-2.85, p = .038), and women with primary education level (AOR = 2.99, 95% CI = 1.03-3.25, p = .001), women with secondary and higher education (AOR = 3.53, 95% CI = 1.41-4.38, p = .001), were predictors for modern FP utilization. Four main themes merged (1) individual barriers, (2) hospital barriers, (3) cultural barriers, and (4) knowledge of modern FP methods. Conclusion The use of modern FP increases with women's education. There is a need for the government to invest in women's education and raise awareness and knowledge of the benefits of modern FP methods.
Collapse
Affiliation(s)
- Besha E. Ngole
- Department of Clinical Nursing, School of Nursing and Public Health, the University of Dodoma, Dodoma, Tanzania
| | - Angelina A. Joho
- Department of Clinical Nursing, School of Nursing and Public Health, the University of Dodoma, Dodoma, Tanzania
| |
Collapse
|
3
|
Sen S, Banerjee A, Ali A, Chakma N. Modern contraceptive use among currently married non-pregnant women (aged 15-49 years) in West Bengal, India: a reflection from NFHS-5. Contracept Reprod Med 2024; 9:63. [PMID: 39614320 DOI: 10.1186/s40834-024-00322-7] [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: 07/06/2024] [Accepted: 11/10/2024] [Indexed: 12/01/2024] Open
Abstract
BACKGROUND There is a dearth of research on modern family planning practices in high focus states like West Bengal in India with diverse population groups and distinct health needs. Thus, this study aims to investigate the latest picture of modern contraceptive use and its associated socio-demographic factors among currently married non-pregnant of reproductive aged (15-49 years) women in West Bengal. METHODS The study is based on secondary data, collected from the fifth round of the National Family Health Survey (NFHS-5; 2019-20). A total of 15,841 currently married non-pregnant women were included into this study. With the overarching goal of understanding the determinants and patterns of modern contraceptive use, the study employed a combination of bi-variate and multivariate analyses, including logistic regression. RESULTS The results reveal that female sterilization is the most common modern contraceptive method across the state. Contraceptive use varies by district, from 43% in Puruliya to 77.3% in Birbhum. Women aged 30-34 were significantly more likely to use contraception (OR = 1.47), while those aged 45-49 were less likely to use it (OR = 0.74). Women with mixed gender composition of living children (OR = 1.48) were more likely to use contraception, compared to women with no children (OR = 0.21) or daughters only (OR = 0.80). SC women (OR = 1.63) and Christians (OR = 2.17) showed higher usage. Wealthier women (OR = 1.26) and urban residents also reported higher use. Moreover, son preference continues and women married after 18 are less likely to adopt modern methods. These findings highlight the need to improve reproductive health outcomes and overcome barriers to increasing contraceptive uptake. CONCLUSION Targeted interventions focusing on education, awareness-building, and improving access to diverse contraceptive options are recommended to empower women in making informed reproductive choices and advancing reproductive rights and health equity. Also, effective modern contraceptive services must overcome legal policy, social, cultural and structural barriers to benefit more women.
Collapse
Affiliation(s)
- Susanta Sen
- Department of Geography, The University of Burdwan, 713104, Burdwan, West Bengal, India
| | - Amit Banerjee
- Department of Geography, The University of Burdwan, 713104, Burdwan, West Bengal, India.
| | - Asif Ali
- Department of Geography, The University of Burdwan, 713104, Burdwan, West Bengal, India
| | - Namita Chakma
- Department of Geography, The University of Burdwan, 713104, Burdwan, West Bengal, India
| |
Collapse
|
4
|
Hailu S, Heluf H, Ayana GM, Negash B. Contraceptive use and determinants among sexually active unmarried adolescents and young women (aged 15-24 years) in East Africa: insights from Demographic and Health Survey data. Int Health 2024:ihae079. [PMID: 39513274 DOI: 10.1093/inthealth/ihae079] [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: 02/29/2024] [Revised: 08/17/2024] [Accepted: 10/18/2024] [Indexed: 11/15/2024] Open
Abstract
BACKGROUND Low contraception usage among adolescents is a significant public health issue, leading to a rise in unintended pregnancies and adolescent childbearing in sub-Saharan Africa. Despite global efforts to improve access to contraception, sexually active adolescents and young women in East Africa are often overlooked, exposing them to substantial health risks. This study explored the factors influencing contraceptive use among unmarried and sexually active adolescents and young women in East African countries. METHODS National representative data from the 2016 Demographic and Health Survey for eight East African countries were used in the analysis. Data processing and analysis were performed using STATA 17 software. A multilevel mixed-effect logistic regression was used to identify determinants of contraceptive use at p<0.05. RESULTS A total of 7813 sexually active unmarried adolescents and young women were considered for the final analysis. Among these young women, 24.9% were using a contraceptive method. Age, place of residence, knowledge of contraceptive methods, employment status and educational attainment were identified as significant determining factors of contraceptive use among sexually active unmarried adolescents and young women (aged 15-24 y) in East Africa. CONCLUSIONS Contraceptive utilization among sexually active unmarried adolescents and young women was relatively low in East African countries. Addressing the existing inequalities in access to contraceptive services for rural adolescents and young women in East African countries is crucial. Prioritizing policies that implement comprehensive sexual education is essential to enhance their knowledge of contraceptives and empower them to make informed decisions.
Collapse
Affiliation(s)
- Saba Hailu
- School of Public Health, College of Health and Medical Science, Haramaya University, Ethiopia, P.O. BOX: 235
| | - Helina Heluf
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Ethiopia, P.O. BOX: 235
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Science, Haramaya University, Ethiopia, P.O. BOX: 235
| | - Belay Negash
- School of Public Health, College of Health and Medical Science, Haramaya University, Ethiopia, P.O. BOX: 235
| |
Collapse
|
5
|
Chipako I, Singhal S, Hollingsworth B. Factors associated with long-acting reversible contraceptives usage among sexually active adolescent girls and young women in Zimbabwe. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003551. [PMID: 39163319 PMCID: PMC11335097 DOI: 10.1371/journal.pgph.0003551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 07/12/2024] [Indexed: 08/22/2024]
Abstract
Despite the benefits of long-acting reversible contraceptives (LARCs), they are not being utilized in Zimbabwe as much as the short-acting reversible contraceptives (SARCs). The aim of the study was to explore factors associated with LARC usage among Zimbabwean adolescent girls and young women, using data from the 2015 Zimbabwe Demographic and Health Survey. Cross tabulations and chi-square tests were used initially to describe associations. Odd ratios were then used to measure the strength of association between LARCs usage and the independent variables using stepwise multinomial logistic regression. From the 2132 sexually active females included in the study 9.1% were LARCs users and 42% were SARCs users at the time of the survey. Secondary and primary education had increased odds of not using any method (OR: 5.032, 95% CI: 2.136-11.8512 and OR: 5.799, 95% CI: 2.327-14.453 respectively) compared to tertiary education. Women with no living children had increased odds of not using any method (OR 66.543, 95% CI: 25.784-171.7381). Being not married was associated with decreased odds of SARCs usage (OR 0.399, 95% CI: 0.285-0.558). Desire for no more children was associated with reduced odds of SARCs usage (OR: 0.448, 95% CI: 0.304-0.66). Being a member of the Apostolic Faith church was associated with increased odds of not using any method (OR 1.423517, 95% CI: 1.018-1.990309). In conclusion, acquiring a tertiary education, having children, a desire to cease bearing children altogether, being unmarried and belonging to the highest wealth class were generally associated with an increased likelihood of using LARCs. Being a member of the Apostolic Faith church was associated with a decreased likelihood of LARCs usage. Findings from the study are relevant in the Zimbabwean context and highlights the relevant factors essential to focus on, when carrying out interventions aimed at increasing LARCs uptake in the country.
Collapse
Affiliation(s)
- Isaac Chipako
- Health Economics and Policy Division of Health Research Graduate College, Lancaster University, Lancaster, United Kingdom
| | - Saurabh Singhal
- Economics Department, Lancaster University, Lancaster, United Kingdom
| | - Bruce Hollingsworth
- Health Economics and Policy Division of Health Research Graduate College, Lancaster University, Lancaster, United Kingdom
| |
Collapse
|
6
|
Abdu Yesuf K. Modern contraceptive utilization and associated factors among younger and older married youth women in Ethiopia: Evidence from Ethiopia Mini Demographic and Health Survey 2019. PLoS One 2024; 19:e0300151. [PMID: 38805520 PMCID: PMC11132471 DOI: 10.1371/journal.pone.0300151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/22/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION Utilization of modern contraceptives increases over time but it was still low and varies across ages among married youth woman. This study revealed the prevalence of modern contraceptives and its associated factors among younger and older married youth women. METHODS A cross-sectional study design was applied to the sample of EMDHS 2019. Multilevel logistic regressions were carried out using STATA version 16 to identify the individual and community-level factors of modern contraceptive utilization. Adjusted odds ratios with a 95% confidence interval and variables with a p-value < 0.05 were considered to be significant determinants of modern contraceptive utilization. RESULT In the EMDHS 2019, a total of 3290 married women between ages 15 and 34 were included. Among these 1210 (36.7%) and 2080 (63%) women, they were age groups of 15-24 and 25-34 years, respectively. Modern contraceptive utilization among women aged 15-24 and 25-34 years was 54.23% and 52.6%, respectively. Injection is a commonly used modern contraceptive method. In this study, factors associated with modern contraceptive utilization among women aged 15-24 years include women who had primary education [AOR = 2.22; 95% CI: 1.02-4.83], who had three or more children in the household [AOR = 14.29; 95% CI: 1.61-126.25], Protestants [AOR = 0.29; 95% CI: 0.14-0.61], five to seven households [AOR = 0.34; 95% CI: 0.17-0.69], and region [AOR = 6.98; 95%:2.30-21.16]. On other hand, factors associated with modern contraceptive utilization among women aged 25-34 were women who had one or two under-five children in the household [AOR = 1.66; 95% CI: 1.03-2.68] and region [AOR = 3.54; 95%CI: 1.79-6.97]. CONCLUSIONS More than 50% of participants used modern contraceptives in both age groups and, the associated factor of modern contraceptive utilization varied among this age group. Health managers and policymakers need to consider age group, region, educational status, religion, and fertility level in planning of family planning program.
Collapse
Affiliation(s)
- Kedir Abdu Yesuf
- Department of Health informatics, Dessie Health Science College, Dessie, Ethiopia
| |
Collapse
|
7
|
Mankelkl G, Kassaw AB, Kinfe B. Factors associated with modern contraceptive utilization among reproductive age women in Kenya; evidenced by the 2022 Kenyan demographic and health survey. Contracept Reprod Med 2024; 9:10. [PMID: 38491382 PMCID: PMC10941430 DOI: 10.1186/s40834-024-00271-1] [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: 11/30/2023] [Accepted: 02/25/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Globally, sexual and reproductive health is a significant public health issue for women of the reproductive age group. A modern contraceptive method enables individuals and families to manage fertility by reducing unintended pregnancies, abortions, pregnancy-related morbidity, and death. A modern contraceptive method is a drug or medical treatment that prevents sexual activity from leading to pregnancy. However, there is limited reliable and updated data on factors associated with modern contraceptive utilization among reproductive-age women at the national level in Kenya. So, the major goal of this study was to evaluate factors associated with modern contraceptive utilization among women of reproductive age in Kenya at the national level, as evidenced by the 2022 Kenyan demographic and health survey. METHODS The most recent datasets from the Kenyan Demographic and Health Survey were used for secondary data analysis. In all, 14,987 women of reproductive age participated in the investigation. Data for multivariable analysis on the factors influencing modern contraceptive utilization among Kenyan women of reproductive age can be obtained from the Kenyan Demographic and Health Survey. Finally, the odd ratio and percentages were presented along with their 95% confidence intervals. RESULT This study includes a total weighted sample of 14,987 reproductive-age women from the Kenyan demographic and health survey. Of the total contraceptive use, 90.1% of the study participants used modern contraceptives. Being married [AOR: 1.593, 95% CI (1.302, 1.948)], living in an urban area [AOR: 1.230, 95% CI (1.060, 1.428)], reading a magazine [1.002, 95% CI (0.921, 1.091)], listening to radio [AOR: 1.265, 95% CI (1.101, 1.454)], not breastfeeding [AOR: 1.296, 95% CI (1.114, 1.507), and having more than two children [AOR: 2.350, 95% CI (1.603, 3.445)] were the factors that promote modern contraceptive utilization. Conversely, having a history of terminated pregnancy [AOR: 0.767, 95% CI (0.657, 0.897), being Muslim [AOR: 0.566, 95% CI (0.418, 0.766)], and being in the 35-39 age range [AOR: 0.766, 95% CI (0.605, 0.971)] were all associated with a lower use of modern contraceptives. CONCLUSION Certain factors such as marriage, living in urban areas, having more than two children, having a female-led household, belonging to the middle class, reading magazines, listening to the radio, and not breastfeeding have a positive correlation with the use of modern contraceptives. Conversely, being a Muslim, aged between 35 and 39, and having a history of miscarriages are negatively correlated with the use of modern contraceptives. This indicates that addressing socioeconomic, geographic, and cultural barriers could improve the effectiveness of modern contraceptive.
Collapse
Affiliation(s)
- Gosa Mankelkl
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Altaseb Beyene Kassaw
- Department of Biomedical Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Beletu Kinfe
- Department of occupational Health and safety, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| |
Collapse
|
8
|
Demeke H, Legese N, Nigussie S. Modern contraceptive utilization and its associated factors in East Africa: Findings from multi-country demographic and health surveys. PLoS One 2024; 19:e0297018. [PMID: 38241359 PMCID: PMC10798634 DOI: 10.1371/journal.pone.0297018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/27/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The use of modern contraceptives has been low in most Sub-Saharan African countries despite high population growth and a sluggish economy. This study aimed to identify the prevalence and determinants of modern contraceptive use among married reproductive-age women in East Africa. METHODS For this study, the Demographic and health survey (DHS) data from nine countries in East Africa were analyzed, yielding a weighted sample of 32,925 married women. A multilevel mixed-effect logistic regression model was used to identify characteristics associated with the utilization of modern contraceptives at a p-value less than 0.05. For model comparison, we used the Akaike and Bayesian Information Criteria (AIC and BIC). For assessing variation (random effects), we used community-level variance with standard deviation and intra-cluster correlation coefficient (ICC). RESULTS The overall prevalence of modern contraceptive use was 45.68%, 95% CI (45.15, 46.21). Women's age, maternal education level, husband education level, media exposure, wealth status, occupation, religion, the total number of children ever born, distance to health facilities, history of termination of pregnancy, couple's desire for children, women's participation in decision making, living country and place of residence were significantly associated with modern contraceptive use in Eastern Africa. CONCLUSIONS Conferring to this study, utilization of modern contraceptives is low in East Africa. Interventions to improve the use of modern contraceptives should encompass disseminating awareness through mass media, enrolment of males in family planning, giving maternal education, building health facilities in remote areas, and encouraging family planning programs in rural areas.
Collapse
Affiliation(s)
- Henok Demeke
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Nanati Legese
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Shambel Nigussie
- College of Health and Medical Science, School of Pharmacy, Haramaya University, Harar, Ethiopia
| |
Collapse
|
9
|
Mugoro EA, Mekango DE, Lule TA, Jena BH, Turuse EA. Time to initiation of modern contraceptive method use after childbirth and its predictors in Southern Ethiopia: a retrospective follow-up study. BMC Womens Health 2023; 23:658. [PMID: 38066584 PMCID: PMC10704612 DOI: 10.1186/s12905-023-02809-y] [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: 01/22/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Timely initiation of modern contraceptive use is vital to prevent unintended pregnancy and its related morbidities and mortalities. However, there is a scarcity of evidence about the duration of time elapsing from childbirth to initiating modern contraceptive use following childbirth and its associated factors in the study area for evidence-based interventions. Therefore, we aimed to assess the time to initiation of modern contraceptive method use and its predictors in Hossana town, southern Ethiopia. METHODS A retrospective follow-up study was conducted at public health facilities in Hosanna town. A total of 503 study participants were included in the study using a systematic random sampling technique. The Box and Whisker plot was used to estimate the time to initiation of modern contraceptive use. A Weibull regression model was applied to identify predictors of time to initiation of modern contraceptive use. Adjusted Hazard Ratio (AHR) with a 95% confidence interval (CI) was used to interpret the strength of the association. RESULTS The median time to initiation of modern contraceptive use was 6 months, with an interquartile range of 3 months. Husband/partner attending higher education [AHR = 1.64, 95% CI: 1.04, 2.57], women who had parity of more than two [AHR = 1.93, 95% CI: 1.01, 3.67], and women who had communicated with their husband/partner about modern contraceptive methods [AHR = 3.03, 95% CI: 1.41, 6.67] were more likely to initiate modern contraceptive method use within six months after childbirth. In contrast, women with an older age of greater than or equal to 30 years [AHR = 0.32, 95% CI: 0.13, 0.82] and who did not resume sexual intercourse after childbirth [AHR = 0.02, 95% CI: 0.01, 0.03] were less likely to initiate modern contraceptive method use within six months after childbirth. CONCLUSIONS The median time to initiation of modern contraceptive method use after childbirth in the postpartum period was delayed from the World Health Organization recommendation of at most 6 weeks. Emphasis should be given to older women, women with lower parity, and men's participation in contraceptive communication to improve timing for initiation of modern contraceptive use after childbirth and to curb the five-month lag periods.
Collapse
Affiliation(s)
- Erjabo Adinew Mugoro
- Department of public health, school of public health, college of medicine and health sciences, Wachemo University, Hossana, Ethiopia
| | - Dejene Ermias Mekango
- Department of reproductive health, school of public health, college of medicine and health sciences, Wachemo University, Hossana, Ethiopia
| | - Tigist Alebachew Lule
- Maternal and child health care unit, Wachemo University Nigist Eleni Mohammed Memorial Hospital, Wachemo University, Hossana, Ethiopia
| | - Belayneh Hamdela Jena
- Department of epidemiology and biostatistics, school of public health, college of medicine and health sciences, Wachemo University, Hossana, Ethiopia.
| | - Ermias Abera Turuse
- Department of epidemiology and biostatistics, school of public health, college of medicine and health sciences, Wachemo University, Hossana, Ethiopia
| |
Collapse
|
10
|
Kebede N, Kefale B, Yigezu M, Bogale EK, Zewdie A, Wasihun Y, Adane M. Individual and community level factors associated with modern contraceptive utilization among married women in the emerging region of Ethiopia: a multilevel mixed effects analysis of the 2019 Ethiopia Mini-Demographic and health survey. BMC Womens Health 2023; 23:652. [PMID: 38062400 PMCID: PMC10704797 DOI: 10.1186/s12905-023-02822-1] [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: 04/24/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND A demonstrated technique to enhance reproductive health and economic progress is through ensuring that family planning services are accessible universally. Those studies that used Ethiopia Demographic and Health Survey (EDHS) data did not assess individual and community-level factors in contraceptive utilization. Thus, the study employs a multilevel mixed effects analysis approach, which allows for the examination of individual and community-level factors that influence contraceptive utilization. METHODS This study analyzed the 2019 Ethiopia Min Demographic and Health Survey datasets. A total of 1916 married women in the 2019 surveys were included in the analysis. The data were analyzed using Stata version 17.0. The data were analyzed using Multi-level mixed-effect logistic regression to identify the individual and community-level factors associated with modern contraceptive utilization. An adjusted odds ratio with a 95% confidence interval was used to. Show the strength and direction of the association and statistical significance was declared at a P value less than 0.05. RESULTS Factors significantly associated with modern contraceptive utilization were; Muslim and protestant followers [AOR = 0.31, 95% CI: (0.134, 0.714)] and [AOR = 0.35, 95% CI: (0.173, 0.691)] respectively, women with no education (OR = 0.46; 95% CI: 0.293, 0.710), those women who belong to the poor and middle wealth of household [AOR = 0.35, 95% CI: (0.237, 0.527)] and [AOR = 0.56, 95% CI: (0.347, 0.919)] respectively, women who had one to five and greater than or equal to six living children [AOR = 11.36, 95% CI:(2.119, 60.918)] and [AOR = 7.44, 95% CI:(1.437, 38.547)]respectively, Women in clusters poor wealth status [AOR = 0.40, 95% CI: (0.183, 0.875)] and women who belong to the Somali region [AOR = 0.20, 95% CI: (0.0.070, 0.506)]. CONCLUSION The study revealed that both individual and community-level factors determined modern contraceptive utilization. At the individual level, the religion of women, educational status, the wealth of the household, and the total number of living children were significantly associated with modern contraceptive utilization. At community-level factors, community wealth status and belonging to the Somali region were significantly associated with modern contraceptive utilization. The findings suggest that interventions aimed at increasing modern contraceptive utilization should target women with lower levels of education, those living in households with lower wealth, and those with larger families. Additionally, efforts should be made to improve access to modern contraceptives in communities with lower wealth status and in regions where traditional beliefs may hinder their use.
Collapse
Affiliation(s)
- Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Muluken Yigezu
- Department of Public Health College of Medicine & Health Science, Dire Dawa, Dire Dawa University, Dire Dawa, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion, College of Medicine Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite 07, Ethiopia
| | - Yitbarek Wasihun
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
11
|
Kebede N, Kefale B, Yigezu M, Ayele K, Addisu E, Tsega Y, Kasaye MD, Wasihun Y. A multivariate decomposition analysis of modern contraceptive utilization among married women in the emerging region of Ethiopia (2000-2019). Sci Rep 2023; 13:20902. [PMID: 38017089 PMCID: PMC10684594 DOI: 10.1038/s41598-023-48176-4] [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: 04/20/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Abstract
Ensuring universal access to family planning services is a proven strategy to improve reproductive health as well as economic development. Assessing the trend and identifying the factors for the change in modern contraceptive utilization is crucial to design effective measures, but trend analysis was not conducted previously. Thus, this study aimed to assess the trend and determinants of modern contraceptive utilization change among married women in emerging regions of Ethiopia. This study used the 2000 Ethiopia Demographic and Health Survey and the 2019 Ethiopia Min Demographic and Health Survey datasets for analysis. A total of 2555 and 1916 married women in the 2000 and 2019 surveys were included in the analysis, respectively. The data were analyzed using Stata version 17.0. Logit-based decomposition analysis was executed to identify factors for modern contraceptive utilization change. Statistical significance was declared at a P value of less than 0.05. The trend of contraceptive utilization change increased from 6.26% in 2000 to 21.97% in 2019. About - 65.87% and 165.87% of the change in contraceptive utilization was due to changes in composition and behavior, respectively. The change in composition was due to the change in the composition of women according to religion, educational status, region, and the number of living children. The change in behaviors of not educated women, rural women, Muslim women, and those who resided in the afar region was the source of change in modern contraceptive utilization. Modern contraceptive utilization has increased in the last two decades. The change in modern contraceptive utilization is due to changes in population composition and behavior. Interventions targeting uneducated and rural women are vital to increasing contraceptive utilization. Strategic interventions are also required for the Somali regions of Ethiopia.
Collapse
Affiliation(s)
- Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia.
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Muluken Yigezu
- Department of Public Health College of Medicine & Health Science, Dire Dawa University, Dire Dawa City, Ethiopia
| | - Kokeb Ayele
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Elsabeth Addisu
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Yawkal Tsega
- Department of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Mulugeta Desalegn Kasaye
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| | - Yitbarek Wasihun
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia
| |
Collapse
|
12
|
Agrawal R, Mishra M, Rehman T, Surendran G, Sinha A, Kanungo S, Pati S. Utilization of modern temporary contraceptive methods and its predictors among reproductive-aged women in India: insights from NFHS-5 (2019-21). Front Glob Womens Health 2023; 4:1219003. [PMID: 38025983 PMCID: PMC10644831 DOI: 10.3389/fgwh.2023.1219003] [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: 05/19/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Evidence from various studies on modern contraceptive methods shows that the utilization varies greatly. The present study aimed to estimate the magnitude and determinants for temporary modern contraceptive utilization among reproductive-aged (15-49 years) women in India. We analysed National Family Health Survey-5 data using the "svyset" command in STATA software. Modern contraception utilization was estimated using the weighted prevalence, and its correlates were assessed by multivariable regression by reporting an adjusted prevalence ratio (aPR) with 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of different temporary modern contraceptives. The mean (SD) age of 359,825 respondents was 31.6 (8.5) years with 75.1% (n = 270,311) and 49.2% (n = 177,165) of them being from rural area and having completed education up to secondary school, respectively. The overall utilization of modern temporary contraception was 66.1% [95%CI: 65.90-66.35, n = 237,953]. Multigravida (vs. nulligravida) [aPR = 2.13 (1.98-2.30)], higher education of husband (vs. not educated) [aPR = 1.20 (1.14-1.27)], urban (vs. rural) [aPR = 1.06 (1.03-1.10)], watching television less than once a week (vs. not at all) [aPR = 1.04 (1.01-1.08)], divorced (vs. married) [aPR = 0.65 (0.45-0.94)], and Scheduled Tribe (ST) (vs. unreserved) [aPR = 0.92 (0.88-0.96)] were significant independent determinants. The highest utilization of male condoms, IUCDs, pills and injections were in Himachal Pradesh (86%), Nagaland (64%), Tripura (85%), and Ladakh (20%), respectively. Out of every ten reproductive-aged (15-49 years) women in India, six are using temporary modern contraceptive methods. More intervention strategies should be planned, considering factors like gravida, education, residence, health promotion and caste to attain replacement fertility level.
Collapse
Affiliation(s)
- Ritik Agrawal
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Manisha Mishra
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Tanveer Rehman
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Gayathri Surendran
- Department of Community Medicine, Christian Medical College, Vellore, India
| | - Abhinav Sinha
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Srikanta Kanungo
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| | - Sanghamitra Pati
- Department of Health Research, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, India
| |
Collapse
|
13
|
Yeboah D, Issah AN, Kpordoxah MR, Akiti C, Boah M. Prevalence and factors associated with the intention to use contraception among women of reproductive age who are not already using a contraceptive method in Liberia: findings from a secondary analysis of the 2019-2020 Liberia Demographic Health Survey. BMJ Open 2023; 13:e072282. [PMID: 37802625 PMCID: PMC10565247 DOI: 10.1136/bmjopen-2023-072282] [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: 01/27/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE Contraception constitutes a vital aspect of sexual and reproductive healthcare. However, the high prevalence of non-use has become a great public health concern globally. This study examined the intention to use contraceptives and its associated factors among women of reproductive age who were not using any method in Liberia. DESIGN AND SETTING A cross-sectional population-based study was conducted. We used data from the 2019-2020 Liberia Demographic and Health Survey. The research framework used the theory of planned behaviour to identify the factors that influence women's intention to use contraception. PARTICIPANTS The study analysed a weighted sample of 4504 women aged 15-49 who were not currently using any form of contraception. DATA ANALYSIS The outcome variable was the intention to use a contraceptive method. A binary logistic regression was used to identify factors associated with the intention to use contraceptives in Stata V.13.0. RESULTS Of the 4504 women, 39.42% intended to use contraception. Contraception intention was significantly lower in married women than in never married women (adjusted OR (aOR) 0.78; 95% CI 0.62 to 0.98). Additionally, women aged 25-34 (aOR 0.434; 95% CI 0.339 to 0.556) and 35-49 (aOR 0.120; 95% CI 0.088 to 0.163) had a reduced intent to use contraceptives than those aged 15-24. However, women with at least one child, those with prior contraception experience and those who had their first sexual encounter at the age of 13 or older were more likely to intend to use contraception. Notably, Muslim and wealthy women displayed a lower likelihood of intending to use contraception. CONCLUSION These findings highlight that attitudes, subjective norms and perceived behavioural control significantly influence women's intentions to use contraception. Understanding and addressing these factors are crucial for promoting effective contraceptive use among women, facilitating informed reproductive choices.
Collapse
Affiliation(s)
- Daudi Yeboah
- Department of Epidemiology, Biostatistics, and Disease Control, University for Development Studies, Tamale, Ghana
| | - Abdul-Nasir Issah
- Department of Health Services, Policy, Planning Management, and Economics, University for Development Studies, Tamale, Ghana
| | - Mary Rachael Kpordoxah
- Department of Global and International Health, University for Development Studies, Tamale, Ghana
| | - Caselia Akiti
- Department of Bilogical Sciences, University of Liberia, Monrovia, Liberia
- Monitoring and Evaluation Unit, Ministry of Health, Congo Town, Monrovia, Liberia
| | - Michael Boah
- Department of Epidemiology, Biostatistics, and Disease Control, University for Development Studies, Tamale, Ghana
| |
Collapse
|
14
|
Belachew TB, Negash WD, Bitew DA, Asmamaw DB. Prevalence of married women's decision-making autonomy on contraceptive use and its associated factors in high fertility regions of Ethiopia: a multilevel analysis using EDHS 2016 data. BMC Public Health 2023; 23:83. [PMID: 36631790 PMCID: PMC9832646 DOI: 10.1186/s12889-023-15009-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Women's independence in reproductive health is crucial to the health of mothers and children. Couples are, however, restricted from discussing their relationship openly. Regarding this, information about women's decision-making autonomy is low in developing countries including Ethiopia. Therefore, this study was aimed to assess married women's decision-making autonomy on contraceptive use in high fertility regions of Ethiopia. METHODS The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1157 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of decision making autonomy on contraceptive use. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval. RESULTS Overall prevalence of decision making autonomy on contraceptive use was observed to be 17.2% (15.1, 19.5). Women's age 25-34 (AOR = 3.19; 95% CI:1.55, 6.54), and 35-49 (AOR = 3.59; 95% CI: 1.5, 8.36), secondary and above educational level (AOR = 3.38; 95% CI: 1.07, 10.67), being married before 18 years (AOR = 0.42; 95% CI:0.26, 0.68), being Muslim in religion (AOR = 0.47; 95% CI: 0.23, 0.98), women being in urban area (AOR = 2.73; 95% CI: 1.97, 6.35), and community media exposure (AOR = 1.85; 95% CI: 1.15, 2.48) were associated with decision making autonomy on contraceptive use. CONCLUSION Women's decision-making autonomy on contraceptive use in this study was low. Age of mothers, educational status of mothers, age at first marriage, residence, religion, and community media exposure were significant factors. Therefore, the government should promote women's autonomy on contraceptive use as an essential component of reproductive health rights through mass media, educating, with particular attention for, youth women, and women living in rural settings.
Collapse
Affiliation(s)
- Tadele Biresaw Belachew
- grid.59547.3a0000 0000 8539 4635Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O.Box: 196, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- grid.59547.3a0000 0000 8539 4635Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O.Box: 196, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- grid.59547.3a0000 0000 8539 4635Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- grid.59547.3a0000 0000 8539 4635Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|