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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.
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Affiliation(s)
- Kedir Abdu Yesuf
- Department of Health informatics, Dessie Health Science College, Dessie, Ethiopia
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Adane B, Kefale B, Damtie Y, Arefaynie M, Addisu E, Dewau R, Mitiku K, Tsega TD, Andualem AA, Awoke M, Asfaw T, Wasihun Y, Yalew M. Male involvement in family planning and its association with knowledge and spouse discussion in Ethiopia: a systematic review and meta-analysis. BMJ Open 2024; 14:e082094. [PMID: 38670601 PMCID: PMC11057261 DOI: 10.1136/bmjopen-2023-082094] [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: 12/11/2023] [Accepted: 03/24/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE This study aimed to estimate the pooled prevalence of male involvement in family planning (FP) and its association with knowledge and spouse discussion in Ethiopia. DESIGN Systematic review and meta-analysis using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. DATA SOURCES The study was conducted by the articles searched from different databases: (PubMed, Cochrane Library, PsycINFO, HINARI and Google Scholar). ELIGIBILITY CRITERIA FOR SELECTING STUDIES This research encompassed investigations carried out within married couples in Ethiopia, specifically focusing on studies where male involvement in FP was the primary outcome. The inclusion criteria comprised studies with an observational study design, encompassing both published and unpublished works, conducted in the English language, with no restrictions on data collection and publication year. DATA EXTRACTION AND SYNTHESIS Following a systematic search of the articles, two independent authors assessed the quality of the studies, and data extraction was conducted using Microsoft Excel. The data analysis was performed by using STATA V.17. The overall level of male involvement in FP in Ethiopia was calculated using DerSimonian and Liard's random-effect model, with a significance level set at a p<0.05. Heterogeneity was examined using the I2 test, and Egger's test was employed to assess publication bias. RESULTS The pooled prevalence of male involvement in FP in Ethiopia was 59.71% (95% CI (47.68% to 71.73%)). Good knowledge regarding FP (AOR 6.63, 95% CI (2.58 to 17.03)) and spouse discussion on FP (AOR 4.36, 95% CI (2.50 to 7.59)) were significantly associated with male involvement in FP. CONCLUSIONS The prevalence of male involvement in FP in Ethiopia was low as compared with other literature conducted outside Ethiopia. Both good knowledge and spouse discussion regarding FP were significantly associated with male involvement in FP. So, the government and healthcare providers should focus on interventions that could increase their knowledge through different media. In addition, encouraging couples to have a discussion regarding FP could be a recalled intervention for healthcare providers.
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Affiliation(s)
- Bezawit Adane
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- Department of Reproductive and Family Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kefale Mitiku
- Department of Physiology, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tilahun Degu Tsega
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Amare Agmas Andualem
- Department of Anesthesia, College of Medicine and Health Sciences, injibara University, Injibara, Ethiopia
| | - Mahider Awoke
- Department of Public health Nutrition, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tezera Asfaw
- Department of Anatomy, College of Medicine and Health Sciences, Wollo university, Desssie, Ethiopia
| | - Yitbarek Wasihun
- Department of Health Promotion, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Yalew
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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Bwalya BB, Kasonde ME, Mulenga JN, Mapoma CC, Wamunyima N, Siamianze B, Onukogu O. The association between contraceptive use and desired number of children among sexually active men in Zambia. BMC Public Health 2023; 23:1833. [PMID: 37730599 PMCID: PMC10512645 DOI: 10.1186/s12889-023-16750-0] [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: 10/10/2022] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Contraceptive methods have been used to space births, but also to limit a couple's desired number of children. Efforts of family planning programmes have mainly concentrated on females, even though males tend to have large say on the desired number of children a couple should have. In our study, we sought to determine linkages between contraceptive use and desired number of children, as well as associated demographic and socio-economic characteristics, among sexually active males in Zambia. METHODS The main outcome variable of interest was desired number of children as measured by ideal number of children which is a count variable. Data for this paper was the male dataset from the 2018 Zambia Demographic and Health Survey, a cross-sectional national survey. Binary logistic regression was performed to determine odds ratios of contraceptive use by selected characteristics of sexually active males. Multivariate Poisson Regression Model was used to establish factors associated with desired number of children. RESULTS Age of men (20-29, 30-39 and 40-49 years), residence in rural areas, wealth quintile, Protestant or Muslim religious affiliation, media exposure, and having discussed family planning with a health worker in the last few months prior to the survey were associated with contraceptive use. Sexually active males who reported using any contraception method reported 3% less desired number of children compared to those who were not using any method. Older males (age group 30-49 years), resident in rural areas, with primary education, married, employed, Protestant religion, and those labelling women who use contraceptives "as promiscuous" had more desired number of children. CONCLUSIONS There were minimal differences in the desired number of children among males who reported using and not using any contraceptive method. Strategies aimed at encouraging contraception use should cover all categories of males to achieve universal involvement of men in family planning in Zambia. Future research may consider combining both qualitative and quantitative methods to look holistically at the demographic, socio-economic and cultural factors associated with non-contraception use and desired number of children among sexually active men in Zambia.
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Affiliation(s)
- Bwalya Bupe Bwalya
- Mulungushi University, Kabwe, Zambia.
- Department of Economics, School of Social Science, Mulungushi University, Kabwe, Zambia.
| | - Mwewa E Kasonde
- Department of Population Studies, School of Humanities and Social Sciences, The University of Zambia, Lusaka, Zambia
| | - James Nilesh Mulenga
- Department of Economics, School of Social Science, Mulungushi University, Kabwe, Zambia
| | - Chabila Christopher Mapoma
- Department of Population Studies, School of Humanities and Social Sciences, The University of Zambia, Lusaka, Zambia
| | - Nayunda Wamunyima
- Department of Political and Administrative Studies, School of Humanities and Social Sciences, The University of Zambia, Lusaka, Zambia
| | - Billy Siamianze
- Department of Economics, School of Social Science, Mulungushi University, Kabwe, Zambia
| | - Obinna Onukogu
- Department of Social Development Studies, School of Social Science, Mulungushi University, Kabwe, Zambia
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Kwawukume SAK, Laar AS, Abdulai T. Assessment of men involvement in family planning services use and associated factors in rural Ghana. Arch Public Health 2022; 80:63. [PMID: 35189959 PMCID: PMC8862224 DOI: 10.1186/s13690-022-00822-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background In low-and-middle income countries (LMICs) less attention is paid to men’s involvement in Family Planning (FP) programs where public health officials have advocated the involvement of men as a strategy for addressing the dismal performance of FP programs. The study assessed the involvement of men in FP use and the factors which promote or hinder the uptake of FP services among partners in a rural setting of northern Ghana. Methods A cross-sectional descriptive study was used to collect data from 200 respondents. Study respondents were selected through random cluster sampling. Results The findings showed that male partners’ knowledge (95.5%) and approval (72.8%) of FP services were high. About 48% of men were involved in FP service utilization. Having living children (aOR; 1.71(1.27, 2.15)) and being knowledgeable (aOR; 6.14(1.38, 10.90)) about FP were positively associated men’s involvement in FP service utilization. The findings also indicated that men had a higher propensity (X2 = 4.5534, p = 0.033) of supporting a FP method use. Women who reported that their spouse supported FP method use were more likely to use a contraceptive method (X2 = 9.5223, P = 0.002) if their spouse supported FP method use (X2 = 9.5223, P = 0.002) and if their partners had some education (X2 = 14.1133, P = 0.000). Reasons for low contraceptive use were health risks, side effects, and socio-cultural norms. Conclusion Family planning programs need to include men at all levels of health promotion and education of FP programs to help reduce misconceptions about contraceptive methods to increase acceptance and use among partners in rural settings of Ghana.
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Affiliation(s)
| | - Alexander Suuk Laar
- REJ Institute, Research and ICT Consultancy Services, Tamale, Northern Region, Ghana.
| | - Tanko Abdulai
- Department of Community Health and Family Medicine, SMHS University for Development Studies, Tamale, Northern Region, Ghana
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Tetui M, Ssekamatte T, Akilimali P, Sirike J, Fonseca-Rodríguez O, Atuyambe L, Makumbi FE. Geospatial Distribution of Family Planning Services in Kira Municipality, Wakiso District, Uganda. Front Glob Womens Health 2021; 1:599774. [PMID: 34816171 PMCID: PMC8593998 DOI: 10.3389/fgwh.2020.599774] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Access to family planning (FP) services remains a challenge, particularly in informal urban settlements. The unmet need for FP in these settings is high, with a correspondingly high prevalence of unintended pregnancies that may lead to unsafe abortions. However, there is a paucity of quality data on the distribution of FP services in such settings in Uganda. This paper described the geospatial distribution of FP services in Kira Municipality, Wakiso District, Uganda. Methods: This was a cross-sectional study in which we determined the availability and distribution of FP services in Kira Municipality. Community mapping and analysis were conducted using ArcGIS (version 10.1) and ArcGIS Online. Stata version 13.1 was used for data analysis. Chi-square test was used to compare the contraceptive provision and availability among facilities from informal and formal settlements. Results: Of the 176 healthcare facilities surveyed, only 42% (n = 74) offered contraceptives in informal settlements. The majority of the facilities were privately owned small clinics (95%). At least 80% of the facilities provided three or more modern contraceptive methods, with no difference (p = 0.107) between facilities in informal and formal settlements. Only 30.7% (p = 0.001) of the facilities provided at least one long-acting contraceptive. Similarly, 20 and 12% (p = 0.001) of the facilities had implants and intrauterine devices (IUDs) on the day of the survey. Almost 25% of the facilities did not offer contraceptive services (counseling and commodities) to unmarried adolescents. Conclusions: Most facilities were small privately-owned clinics, offering at least three modern contraceptive methods. The unavailability of long-acting reversible methods in the informal settings may affect the quality of FP services due to limited choice. The inequity in service provision that disfavors the unmarried adolescent may increase unwanted/unintended pregnancies. We recommend that local governments and partners work toward filling the existing commodities gap and addressing the discrimination against unmarried adolescents in such settings.
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Affiliation(s)
- Moses Tetui
- School of Pharmacy, Waterloo University, Waterloo, ON, Canada.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Department of Health Policy, Planning and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Pierre Akilimali
- Department of Nutrition Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Judith Sirike
- Division of Social Development, Intergovernmental Authority on Development, Kampala, Uganda
| | - Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - Lynn Atuyambe
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
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Women’s Autonomy Decision Making Power on Postpartum Modern Contraceptive Use and Associated Factors in North West Ethiopia. ADVANCES IN PUBLIC HEALTH 2019. [DOI: 10.1155/2019/1861570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Most postpartum women (95%) do not want pregnancy within 24 months after birth, however, 70% of them do not use modern contraceptives. In Ethiopia postpartum modern contraceptive use is low. Evidences show that women’s autonomy within the household is the most important thing in modern contraceptive use. Yet, there is dearth of information in Ethiopian context. Therefore, this study was aimed to assess women’s autonomy on modern contraceptive use and its associated factors among women who attended their children immunization service. Methods. Facility-based cross-sectional study was carried out from May 5 to Jone15, 2017 in sekota town and its surroundings among 415 women who attended immunization service for their children. Participants were selected by using a systematic sampling technique. The data were collected through face-to-face interviews using pre-tested structured questionnaires. The data were entered into epi.info version7 and analyzed using SPSS version 23. Both descriptive and logistic regression analyses were performed. A P-value less than or equal to 0.05 at 95% confidence interval was set to test statistical significance. Result. The proportion of women’s decision making power on postpartum modern contraceptive use was 77.3%. Being counseled on postpartum family planning (2.29, 95% CI: 1.27, 5.71), discussed on postpartum family planning with their husbands (AOR = 14.62, 95% CI: 6.52, 32.75), and had the index child within one year after previous birth (AOR = 7.98, 95% CI: 2.52, 30.65) were found positively associated with women’s autonomous decision making power on postpartum modern contraceptive use. In addition, those women who knew that pregnancy could happen during the postpartum period (AOR = 6.53, 95% CI: 3.2, 14.12) were more autonomous in decision to use postpartum contraception. Conclusion. The proportion of women’s autonomous decision making power on postpartum modern contraceptive use was low. Those women who were counseled on postpartum family planning, discussed with partners, and those who knew that pregnancy could happen during the postpartum period had higher odds of autonomous decision making power. Therefore, strengthening counseling, educating on postpartum family planning, and encouraging women to discuss postpartum family planning with their husbands may improve women’s power.
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What has reproductive health decision-making capacity got to do with unintended pregnancy? Evidence from the 2014 Ghana Demographic and Health Survey. PLoS One 2019; 14:e0223389. [PMID: 31600265 PMCID: PMC6786643 DOI: 10.1371/journal.pone.0223389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 09/19/2019] [Indexed: 12/25/2022] Open
Abstract
Introduction Women’s reproductive health decision-making is indispensable for improving their reproductive health and achieving Sustainable Development Goal three. This study explored the association between reproductive health decision-making capacity and unintended pregnancy among women in Ghana. Materials and methods We used data from the 2014 version of the Ghana Demographic and Health Survey. The unit of analysis for this study was pregnant women at the time of the survey (679). Bivariate and multivariable analyses were conducted using Pearson chi-square tests and binary logistic regression respectively. Results We found that women who had the capacity to make reproductive health decision [AOR = 0.61; CI = 0.51–0.89] were less likely to experience unintended pregnancies, compared to those who did not have the capacity. Age was found to have a statistically significant influence on unintended pregnancy, with women aged 25–29 years [AOR = 0.29; CI = 0.13–0.63], 30–34 years [AOR = 0.18; CI = 0.08–0.45], and 35–39 years [AOR = 0.26; CI = 0.10–0.68] being less likely to experience unintended pregnancy compared to those aged 15–19 years. Women with primary level of education were more likely to have unintended pregnancies, compared to those with no education [AOR = 2.07; CI = 1.12–3.84]. Conclusion This study has filled the gap in the already existing literature on the association between reproductive health decision making capacity and unintended pregnancy in Ghana and has created a room for specific interventions geared towards reducing unintended pregnancies, especially among women who are not capable of making reproductive health decisions, women aged 15–19 years, those with primary education, Traditionalists and unmarried women.
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Contraceptive method choice and spousal communication: Examining the effect of family planning method using an instrumental variable approach. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 22:100458. [PMID: 31473591 DOI: 10.1016/j.srhc.2019.100458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Spousal communication is an important factor in reproductive health outcomes, including family size, contraceptive use and conflict. A purported advantage of traditional contraception is that it increases communication about family planning, since both partners need to be involved in contraceptive practice. However, there is likely to be some degree of endogeneity due to selection: couples who communicate better are more likely to select methods requiring higher degrees of communication. METHOD This paper uses an instrumental variable approach to assess the causal effect of method choice on spousal communication in 7 countries in Sub-Saharan Africa. Religion is used as an instrument since this is correlated with method but not communication. RESULTS Results indicate that both traditional and modern methods are associated with greater discussion of family planning, and this is robust to the introduction of controls. However, when using the instrumental variable to account for selection effect, many of the significant results for traditional methods disappear although they persist for modern methods. CONCLUSIONS These findings indicate that the effect of traditional methods in improving communication is due to selection, rather than causation. While traditional methods still have a role to play in the contraceptive method mix, enthusiasm for side benefits such as family planning communication should be tempered.
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Ndagurwa P, Odimegwu C. Decomposition of Zimbabwe’s stalled fertility change: a two-sex approach to estimating education and employment effects. JOURNAL OF POPULATION RESEARCH 2019. [DOI: 10.1007/s12546-019-09219-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Thummalachetty N, Mathur S, Mullinax M, DeCosta K, Nakyanjo N, Lutalo T, Brahmbhatt H, Santelli JS. Contraceptive knowledge, perceptions, and concerns among men in Uganda. BMC Public Health 2017; 17:792. [PMID: 29017539 PMCID: PMC5633881 DOI: 10.1186/s12889-017-4815-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 10/03/2017] [Indexed: 11/10/2022] Open
Abstract
Background Low contraceptive uptake and high unmet need for contraception remain significant issues in Uganda compared to neighboring countries such as Kenya, Ethiopia, and Rwanda. Although prior research on contraceptive uptake has indicated that male partners strongly influence women’s decisions around contraceptive use, there is limited in-depth qualitative research on knowledge and concerns regarding modern contraceptive methods among Ugandan men. Methods Using in-depth interviews (N = 41), this qualitative study investigated major sources of knowledge about contraception and perceptions of contraceptive side effects among married Ugandan men. RESULTS: Men primarily reported knowledge of contraceptives based on partner’s experience of side effects, partner’s knowledge from health providers and mass media campaigns, and partner’s knowledge from her peers. Men were less likely to report contraceptive knowledge from health care providers, mass media campaigns, or peers. Men’s concerns about various contraceptive methods were broadly associated with failure of the method to work properly, adverse health effects on women, and severe adverse health effects on children. Own or partner’s human immunodeficiency virus (HIV) status did not impact on contraceptive knowledge. Conclusions Overall, we found limited accurate knowledge about contraceptive methods among men in Uganda. Moreover, fears about the side effects of modern contraceptive methods appeared to be common among men. Family planning services in Uganda could be significantly strengthened by renewed efforts to focus on men’s knowledge, fears, and misconceptions.
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Affiliation(s)
- Nityanjali Thummalachetty
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, 60 Haven Ave., B-2, New York, NY, 10032, USA
| | - Sanyukta Mathur
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, 60 Haven Ave., B-2, New York, NY, 10032, USA
| | - Margo Mullinax
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Kelsea DeCosta
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, 60 Haven Ave., B-2, New York, NY, 10032, USA
| | | | - Tom Lutalo
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - Heena Brahmbhatt
- Department of Population, Family and Reproductive Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John S Santelli
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, 60 Haven Ave., B-2, New York, NY, 10032, USA.
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Eshete A, Adissu Y. Women's Joint Decision on Contraceptive Use in Gedeo Zone, Southern Ethiopia: A Community Based Comparative Cross-Sectional Study. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2017; 2017:9389072. [PMID: 28367329 PMCID: PMC5359446 DOI: 10.1155/2017/9389072] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/02/2016] [Accepted: 01/30/2017] [Indexed: 06/07/2023]
Abstract
A community based comparative cross-sectional study design was employed to assess the mutual consent of women about family planning use in urban and rural villages of Gedeo zone. Two-thirds (67.4%) of women made joint decision on contraceptive use, varying between urban (70.9%) and rural (63.4%) settings. This difference was statistically significant where women in urban setup had a 41% (AOR, 1.41; 95% CI (1.15, 2.01) added chance of making joint decision than the rural counterpart. In both settings, attitude towards contraceptive method was an independent predictor of joint contraceptive decision (AOR = 2.85) in urban and (AOR = 2.81) rural women. Contrarily, different factors were found to be associated with joint contraceptive decision in either setup. In urban, having better knowledge about contraceptive methods (AOR = 2.9) and having lower age difference (AOR = 2.2) were found to be strong predictors of joint decision on contraceptive use, while having too many children (AOR = 2.2) and paternal support (AOR = 7.1) in rural setups. Lower level of joint decision making on contraceptive use was reported in both setups. Factors associated with joint decision varied between the two setups, except for attitude towards contraceptive methods. Future family planning program should address sociocultural, knowledge and attitude factors.
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Affiliation(s)
- Akine Eshete
- Department of Public Health, College of Medicine and Health Sciences, Dilla University, P.O. Box 419, Dilla, Ethiopia
| | - Yohannes Adissu
- Department of Public Health, College of Medicine and Health Sciences, Dilla University, P.O. Box 419, Dilla, Ethiopia
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Agyei-Baffour P, Boahemaa MY, Addy EA. Contraceptive preferences and use among auto artisanal workers in the informal sector of Kumasi, Ghana: a discrete choice experiment. Reprod Health 2015; 12:32. [PMID: 25890234 PMCID: PMC4427994 DOI: 10.1186/s12978-015-0022-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Contraceptive uptake in Ghana, especially in the Ashanti region remains low. This may be partly due to products' characteristics and choice which are influenced by attribute utility trade-offs by consumers in determining which method offers the optimal combinations, given the needs and desires of the individuals making the choice. The study sought to determine how specific attributes of contraceptives influence artisanal auto mechanics' stated preferences for a hypothetical contraceptive use in the Tafo-Suame industrial area of Kumasi, Ghana. METHODS A discrete choice experiment was conducted with artisanal auto mechanics in the study area from May to September 2011. Based on the summary of the attributes from the focus group discussion and in-depth interviews preceded administration of structured questionnaire, a discrete choice experiment (DCE) was created. The attributes used were; side effects, reversibility, ease of use, ability to prevent both pregnancy and sexually transmitted infection (STI's), price and privacy in acquiring and attractiveness of the method. A total of 340 consented respondents aged 15 to 49 years participated in the study. Data were entered in Access and Sawtooth software SSI Web CAPi module and then exported to Stata for analysis. RESULTS The study showed a universal (99.4%) knowledge on contraception, ever used 87% and currently using a method, 58%. The study revealed that methods' reversibility (β = 21.74; 95% CI: 20.17, 23.3), minimal allergic reaction (β = 13.93; 95% CI: 12.8, 15.05) and no effect on blood pressure (β = 12.71; 95% CI: 11.62, 13.79), were strongly associated with contraceptive preference and use. While contraceptives' ability to prevent "only pregnancy", (β = -15.13: 95% CI: -16.2, -14.02; "only STI's") (β = -11.65; 95% CI: -11.84, -11.46); and interrupt during sexual activity (β = -4.26; 95% CI: -5.19, -3.34), had large negative influence on contraceptive preference and use. CONCLUSION The study has documented the magnitude of the effects of contraceptive attributes on informed choice, use, preference. It revealed that reversibility, side effects and ability to prevent both pregnancy and STI's are the major important attributes that. The findings have implications on contraceptive development, uptake and the implementation of other family planning programmes.
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Affiliation(s)
- Peter Agyei-Baffour
- Department of Community Health, Kwame Nkrumah University of Science and Technology (KNUST), College of Health Sciences, School of Medical Sciences, Kumasi, Ashanti, Ghana.
| | - Mary Yaa Boahemaa
- Department of Community Health, Kwame Nkrumah University of Science and Technology (KNUST), College of Health Sciences, School of Medical Sciences, Kumasi, Ashanti, Ghana.
| | - Ernestine A Addy
- Department of Community Health, Kwame Nkrumah University of Science and Technology (KNUST), College of Health Sciences, School of Medical Sciences, Kumasi, Ashanti, Ghana.
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Kabagenyi A, Ndugga P, Wandera SO, Kwagala B. Modern contraceptive use among sexually active men in Uganda: does discussion with a health worker matter? BMC Public Health 2014; 14:286. [PMID: 24673890 PMCID: PMC3986853 DOI: 10.1186/1471-2458-14-286] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 03/19/2014] [Indexed: 11/12/2022] Open
Abstract
Background Family planning programs have recently undergone a fundamental shift from being focused on women only to focusing on men individually, or on both partners. However, contraceptive use among married men has remained low in most high-fertility countries including Uganda. Men’s role in reproductive decision-making remains an important and neglected part of understanding fertility control both in high-income and low-income countries. This study examines whether discussion of family planning with a health worker is a critical determinant of modern contraceptive use by sexually active men, and men’s reporting of partner contraceptive use. Methods The study used data from the 2011 Uganda Demographic and Health Survey comprising 2,295 men aged 15–54 years. Specifically, analyses are based on 1755 men who were sexually active 12 months prior to the study. Descriptive statistics, Pearson’s chi-square test, and logistic regression were used to identify factors that influenced modern contraceptive use among sexually active men in Uganda. Results Findings indicated that discussion of family planning with a health worker (OR =1.85; 95% CI: 1.29–2.66), region (OR = 0.41; 95% CI: 0.21–0.77), education (OR =2.13; 95% CI: 1.01–4.47), wealth index: richer (OR = 2.52; 95% CI: 1.58–4.01), richest (OR = 2.47; 95% CI: 1.44–4.22), surviving children (OR = 2.04; 95% CI:1.16–3.59) and fertility preference (OR = 3.50; 95% CI: 1.28–9.61) were most significantly associated with modern contraceptive use among men. Conclusions The centrality of the role of discussion with health workers in predicting men’s participation in family planning matters may necessitate creation of opportunities for their further engagement at health facilities as well as community levels. Men’s discussion of family planning with health workers was significantly associated with modern contraceptive use. Thus, creating opportunities through which men interact with health workers, for instance during consultations, may improve contraceptive use among couples.
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Affiliation(s)
- Allen Kabagenyi
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.
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Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women's perceptions in two rural districts in Uganda. Reprod Health 2014; 11:21. [PMID: 24597502 PMCID: PMC3946591 DOI: 10.1186/1742-4755-11-21] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Accepted: 02/25/2014] [Indexed: 11/10/2022] Open
Abstract
Background Spousal communication can improve family planning use and continuation. Yet, in countries with high fertility rates and unmet need, men have often been regarded as unsupportive of their partner’s use of family planning methods. This study examines men and women’s perceptions regarding obstacles to men’s support and uptake of modern contraceptives. Methods A qualitative study using 18 focus group discussions (FGDs) with purposively selected men aged 15–54 and women aged 15–49 as well as eight key informant interviews (KIIs) with government and community leaders was conducted in 2012 in Bugiri and Mpigi Districts, Uganda. Open-ended question guides were used to explore men and women’s perceptions regarding barriers to men’s involvement in reproductive health. All FGDs and KIIs were recorded, translated, and transcribed verbatim. Transcripts were coded and analyzed thematically using ATLAS.ti. Results Five themes were identified as rationale for men’s limited involvement: (i) perceived side effects of female contraceptive methods which disrupt sexual activity, (ii) limited choices of available male contraceptives, including fear and concerns relating to vasectomy, (iii) perceptions that reproductive health was a woman’s domain due to gender norms and traditional family planning communication geared towards women, (iv) preference for large family sizes which are uninhibited by prolonged birth spacing; and (v) concerns that women’s use of contraceptives will lead to extramarital sexual relations. In general, knowledge of effective contraceptive methods was high. However, lack of time and overall limited awareness regarding the specific role of men in reproductive health was also thought to deter men’s meaningful involvement in issues related to fertility regulation. Conclusion Decision-making on contraceptive use is the shared responsibility of men and women. Effective development and implementation of male-involvement family planning initiatives should address barriers to men’s supportive participation in reproductive health, including addressing men's negative beliefs regarding contraceptive services.
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