USING COUPLES’ DISCORDANT REPORTS TO ESTIMATE FEMALE COVERT USE OF MODERN CONTRACEPTION IN SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (3) ◽  
pp. 326-346 ◽  
Author(s):  
Natalie C. Gasca ◽  
Stan Becker
Keyword(s):  
Contraceptive Use ◽  
Modern Method ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Couple Communication ◽  
Significant Difference ◽  
Contraceptive Prevalence ◽  
Sub Saharan

SummarySubstantial numbers of married women use contraceptives without their partner’s knowledge in sub-Saharan Africa, but studies of female covert use across time are rare. This study investigates the levels, trends and correlates of covert use in nine countries and determines which contraceptive methods are more frequently used covertly by women. Data from monogamous couples in Demographic and Health Surveys were used from nine sub-Saharan African countries that had experienced an increase of 10 percentage points in current modern contraceptive use between an earlier (1991–2004) and later (2007–2011) survey. Covert use was indirectly estimated as the percentage of women who reported a female modern method whose husband did not report a modern method. The percentage of women using covertly increased in eight of the countries studied (significantly in three of them), yet when comparing across countries cross-sectionally, covert use was lower where contraceptive prevalence was higher. In general, women with more years of schooling and those with larger spousal schooling gaps had lower odds of covert use. There was no significant difference between covert and open injectable use, though more than half of both groups used this method in the later surveys. Encouraging couple communication about contraception, where the woman feels it is safe to do so, could be an important strategy to minimize covert use. Further research is needed to better identify the contraceptive prevalence and social context in which covert use declines within a country.

Factors Influencing Contraceptive Use in Sub-Saharan Africa: A Systematic Review

2017 ◽  
Vol 37 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Sarah R. Blackstone ◽  
Ucheoma Nwaozuru ◽  
Juliet Iwelunmor
Keyword(s):  
Contraceptive Use ◽  
Male Partner ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
African Countries ◽  
Factors Influencing ◽  
Contraceptive Side Effects ◽  
Modern Contraceptive Use ◽  
Negative Perceptions ◽  
Sub Saharan

The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women’s misconceptions of contraceptive side–effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.

scholarly journals The National Composite Index for Family Planning (NCIFP): Results and Methodological Issues

2022 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Rebecca Rosenberg ◽  
John Ross ◽  
Karen Hardee ◽  
Imelda Zosa-Feranil
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Composite Index ◽  
Modern Method ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Global Partnership ◽  
Planning Effort ◽  
Sub Saharan ◽  
Family Planning Effort

Background:  The “ FP2020 Global Partnership” signaled a shift to broader, rights-based approaches to family planning programs, and the National Composite Index for Family Planning was developed as part of related measurement efforts. Methods: In each country 10-15 experts on the family planning program completed a 35-item questionnaire, first in 2014 in 89 countries, and in 2017 in 84 countries. Data were entered in Excel, with checks for consistency and data quality. The total score, and scores for each of 5 dimensions of effort are averages across the 35 indicators. Analytic techniques included cross-tabulations, graphical and correlation approaches. Results: The average total score for all countries in 2017 was 64 of the maximum of 100 of effort. Sub-regions differed: Anglophone and Francophone sub-Saharan Africa (SSA) scored highest in the total score and across all 5 dimensions. Next in order came Latin America and the Caribbean, Asia, the Middle East and North Africa, and Eastern Europe and Central Asia. Despite large differences in scores, the sub-regions followed similar profiles across the 35  indicators. The long term rise in the basic family planning effort scores continued, extending the series from surveys approximately every five years beginning in the 1980s. The highest score reached was for the strategy dimension, but the others were close. Their relative levels remained essentially the same as in the 2014 survey.                     NCIFP scores correlated positively with modern contraceptive use in both the sub-Saharan Africa (SSA) and non-sub-Saharan Africa (non-SSA) countries, but the relationships were stronger for SSA. Access to long-acting and permanent methods (LAPMs) was accompanied by greater LAPM use and modern method use. Conclusion: Repeated surveys in most developing countries show improvements in family planning effort, though unevenly, by 35 indicators and across regions.

DISAGREEMENT IN SPOUSAL REPORTS OF CURRENT CONTRACEPTIVE USE IN SUB-SAHARAN AFRICA

2005 ◽  
Vol 38 (6) ◽  
pp. 779-796 ◽  
Author(s):  
STAN BECKER ◽  
MIAN B. HOSSAIN ◽  
ELIZABETH THOMSON
Keyword(s):  
Health Surveys ◽  
Contraceptive Use ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sex Partners ◽  
Recent Period ◽  
Survey Question ◽  
Contraceptive Prevalence ◽  
Sub Saharan ◽  
Using Data

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the ‘both’ category represented less than half in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods.

scholarly journals As long as (I think) my husband agrees…: role of perceived partner approval in contraceptive use among couples living in military camps in Kinshasa, DRC

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Julie H. Hernandez ◽  
Saleh Babazadeh ◽  
Philip A. Anglewicz ◽  
Pierre Z. Akilimali
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Educational Achievement ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Common Error ◽  
Couple Communication ◽  
Female Partners ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background Male partner’s approval is a key determinant of contraceptive use for women living in Sub-Saharan Africa and improving men’s support and couple communication is a cornerstone of family planning programs. However, approval is often only measured through the women’s perception of their partner’s opinion. Methods This study conducted in Kinshasa compares contraceptive approval variables from matched male and female partners (n = 252 couples) to establish the frequency of (in)accurate perceptions by the woman, then test their association with modern contraceptive use. Additional regressions estimate individual and couple variables associated with (in)correct perceptions. Results Results confirm women are poorly aware of their partner’s opinion but indicate that perceived approval or disapproval by the woman is a much stronger determinant of modern contraceptive use than her partner’s actual opinion. Higher educational achievement from the woman is the strongest driver of misunderstanding her partner’s approval. Conclusions Women’s perceptions of partner’s approval are much stronger determinant of contraceptive use than the latter’s actual opinion, and stereotyping men’s opinion of family planning is a common error of appreciation. However, findings also suggest these misunderstandings might serve women’s capacity to negotiate contraceptive use.

scholarly journals As Long as (I Think) My Husband Agrees…: Role of Perceived Partner Approval in Contraceptive Use Among Military Couples Living in Kinshasa, DRC

2021 ◽  
Author(s):  
Julie H. Hernandez ◽  
Saleh Babazadeh ◽  
Philip Anglewicz ◽  
Pierre Z Akilimali
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Educational Achievement ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
Common Error ◽  
Couple Communication ◽  
Female Partners ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: Male partner’s approval is a key determinant of contraceptive use for women living in Sub-Saharan Africa and improving men’s support and couple communication is a cornerstone of family planning programs. However, approval is often only measured through the women’s perception of their partner’s opinion.Methods: This study conducted in Kinshasa compares contraceptive approval variables from matched male and female partners to establish the frequency of (in)accurate perceptions by the woman, then test their association with modern contraceptive use. Additional regressions estimate individual and couple variables associated with (in)correct perceptions. Results: Results confirm women are poorly aware of their partner’s opinion but indicate that perceived approval or disapproval by the woman is a much stronger determinant of modern contraceptive use than her partner’s actual opinion. Higher educational achievement from the woman is the strongest driver of misunderstanding her partner’s approval. Conclusions: Women’s perceptions of partner’s approval are much stronger determinant of contraceptive use than the latter’s actual opinion, and stereotyping men’s opinion of family planning is a common error of appreciation. However, findings also suggest these misunderstandings might serve women’s capacity to negotiate contraceptive use.

scholarly journals Prevalence of anemia and its associated factors among married women in 19 sub-Saharan African countries

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Betregiorgis Zegeye ◽  
Felix Emeka Anyiam ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Eugene Budu ◽  
...  
Keyword(s):  
Associated Factors ◽  
Wealth Index ◽  
Married Women ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Factors Associated ◽  
Sub Saharan ◽  
Prevalence Of Anemia

Abstract Background Sub-Saharan Africa (SSA) remains the region with the highest burden of anemia globally. Since anemia has both health and non-health-related consequences, its reduction is one of the Sustainable Development Goals. Therefore, this study aimed to examine the prevalence of anemia and its associated factors among married women in SSA. Methods Using Stata version-14 software, the analysis was done on 89,029 married women from the Demographic and Health Surveys of 19 countries in SSA. Pearson Chi-Square test and Binary logistic regression analyses were used to examine the factors associated with anemia. The results were presented using adjusted Odds Ratio (aOR) at a 95% Confidence Interval (CI). A p-value less than or equal to 0.05 (p ≤ 0.05) was considered statistically significant. Results The pooled analysis showed that 49.7% of married women were anemic. Of these, 1.04% and 15.05% were severely and moderately anemic respectively, and the rest 33.61% were mildly anemic. Husband education (primary school-aOR = 0.84, 95% CI; 0.71–0.99), wealth index (middle-aOR = 0.81, 95% CI; 0.68–0.96, richer-aOR = 0.69, 95% CI; 0.57–0.84, richest-aOR = 0.68, 95% CI; 0.51–0.91), modern contraceptive use (yes-aOR = 0.68, 95% CI; 0.56–0.81) and religion (Muslim-aOR = 1.27, 95% CI; 1.11–1.46, others-aOR = 0.73, 95% CI; 0.59–0.90) were factors associated with anemia among married women. Conclusion The findings show that nearly half of the married women are affected by anemia. Enhancing partners’ educational levels, and economic empowerment of women, strengthening family planning services, and working with religious leaders to reduce the perception and religious beliefs related to food restrictions can be the main focus to reduce the burden of anemia among married women in SSA.

scholarly journals Coverage and Determinants of Modern Contraceptive Use in Sub-saharan Africa: Further Analysis of Demographic and Health Surveys

2021 ◽  
Author(s):  
Isaac Boadu
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Women Of Reproductive Age ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age in Sub-Saharan Africa (SSA). Methods: Data for the study was obtained from the latest Demographic and Health Surveys (DHS) conducted between 1995-2020 across 37 SSA countries. Women of reproductive age (15-19 years) was the unit of analysis. Analyses of data was done using STATA version 16 for windows. A bivariate Rao Scott’s chi-square test of independence was done to determine factors associated with the use of modern contraceptives. Factors that showed significance (p<0.05) were included in a multilevel logistic regression to determine significant predictors of modern contraceptives. Clustering, stratification and sample weighting were accounted for in the analyses. Results: The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of contraceptives used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use contraceptive if they: had no education (aOR = 0.4, 95% CI: 0.38-0.44), had no children (aOR=0.27-0.42), not told of family planning at a health facility (aOR = 0.69, 95% CI: 0.67-0.71), not heard of family planning in the media (aOR = 0.77, 95% CI: 0.74-0.79) and being poor (aOR=0.76, 95%CI: 0.73-0.79). On the other hand, women were more likely to use modern contraceptive if they were between the age of 35-39 years (aOR=1.69, 95%CI: 0.73-0.79), married (aOR=2.66, 95%CI: 2.50-2.83), had seven or more children (aOR=1.27, 95%CI:1.17-0.38), had knowledge of any method of contraceptives (aOR=303.8, 95%CI: 89.9-1027.5) and when field worker visited and talked about family planning (aOR=1.53, 95%CI: 1.39-0.68).Conclusion: The study showed a low prevalence of modern contraceptive use in Sub-Sahara Africa. Findings from the study highlight the need to provide education to women to increase uptake of contraceptive use and also re-enforce contraceptive interventions to improve women’s health and well-being.

scholarly journals Unequal access and use of contraceptives among parenting adolescent girls in sub-Saharan Africa: a cross-sectional analysis of demographic and health surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051583
Author(s):  
Bright Opoku Ahinkorah ◽  
Matthew Tobiloba Obisesan ◽  
Abdul-Aziz Seidu ◽  
Anthony Idowu Ajayi
Keyword(s):  
Adolescent Girls ◽  
Adolescent Mothers ◽  
Contraceptive Use ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Binary Logistic Regression Analysis ◽  
Demographic And Health Surveys ◽  
Significant Heterogeneity ◽  
African Countries ◽  
Sub Saharan

ObjectiveWe examined the divergent patterns, prevalence and correlates of contraceptive use among parenting adolescents in sub-Saharan Africa using the Demographic and Health Survey datasets of 17 countries.DesignWe included a weighted sample of 9488 parenting adolescent girls in our analysis. Current contraceptive use was defined as the use of any methods to delay or avoid getting pregnant at the survey time. We reported the prevalence of any contraceptive use for all countries and used multilevel binary logistic regression analysis to examine the individual and contextual factors associated with contraceptive use.Outcome measuresContraceptive use.ResultsWe found an overall contraceptive prevalence of 27.12% (CI 27.23% to 28.03%) among parenting adolescent girls in sub-Saharan Africa, ranging from 70.0% (CI 61.76% to 77.16%) in South Africa to only 5.10% (CI 3.04% to 8.45%) in Chad. The prevalence of contraceptive use was lowest in West andCentral Africa, with most countries having less than 20% prevalence. Increasing age (adjusted OR (aOR)=1.46, 95% CI 1.28 to 1.65), being married (aOR=1.63, 95% CI 1.43 to 1.87), having a secondary or higher level of education (aOR=2.72, 95% CI 2.25 to 2.3.27), and media exposure (aOR=1.21, 95% CI 1.08 to 1.36), were associated with higher odds of contraceptive use in the pooled data but preference for a higher number of children (more than five children) (aOR=0.61, 95% CI 0.52 to 0.72) was related to lower likelihood of use. Significant heterogeneity was observed in the country-level disaggregated results.ConclusionAfrican countries differ widely when it comes to contraceptive use among parenting adolescent girls, with only three countries having a relatively high prevalence of use. The governments of countries in sub-Saharan Africa, particularly those in West and Central Africa, should invest in expanding access to contraceptives for adolescent mothers to prevent repeat pregnancy and improve the overall well-being of parenting adolescent girls.

scholarly journals International Migration and Modern Contraceptive Use: A Research Note on African Migrants to France

Demography ◽  
2021 ◽  
Author(s):  
Julia A. Behrman ◽  
Michelle A. Eilers ◽  
Isabel H. McLoughlin Brooks ◽  
Abigail Weitzman
Keyword(s):  
Contraceptive Use ◽  
Family Background ◽  
Research Note ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Proximate Determinant ◽  
African Migrants ◽  
Modern Contraceptive Use ◽  
Long Acting

Abstract This research note presents a multisited analysis of migration and contraceptive use by standardizing and integrating a sample of African migrants in France from six West and Central African countries in the Trajectoires et Origines survey with a sample of women living in the same six African countries in the Demographic and Health Surveys. Descriptive analyses indicate that the contraceptive use of migrants more closely aligns with that of native French women than with that of women from origin countries. In particular, migrants report dramatically higher use of long-acting reversible contraceptives and short-acting hormonal methods and lower use of traditional methods than do women in the countries of origin. Although migrants differ from women in the countries of origin on observed characteristics, including education and family background, reweighting women in the origin countries to resemble migrants on these characteristics does little to explain differences in contraceptive use between the groups. Given that contraceptive use is an important proximate determinant of fertility, our results suggest that contraceptive use should feature more prominently in the dominant demographic paradigms of migrant fertility.

Conceiving of Contraception: World Society, Cultural Resistance, and Contraceptive Use, 1970–2012

Social Forces ◽  
2020 ◽  
Author(s):  
Wade M Cole ◽  
Claudia Geist
Keyword(s):  
Contraceptive Use ◽  
Unmet Need ◽  
World Society ◽  
Modern Contraceptive ◽  
Cultural Resistance ◽  
African Countries ◽  
Orthodox Christian ◽  
Cultural Effects ◽  
Sub Saharan ◽  
Using Data

Abstract Taking world society theory as our point of departure, we examine the effect of world culture on contraceptive use rates around the world. World-cultural rhetoric frames contraception as a necessity for economic development, a human rights issue, and a women’s health matter. Using data on contraceptive use among married women for a sample of 159 countries over the period from 1970 to 2012, we find that linkages to all three sets of discourses are associated with increased use of modern contraceptive methods, over and above countries’ sociocultural and economic characteristics. Nevertheless, we also find that world society influences vary across major cultural zones, defined in terms of predominant religions and geographic regions. World cultural effects are strongest in Orthodox Christian, Hindu, non-Western Protestant, and sub-Saharan African countries. There is no effect in Western and East Asian countries, where contraceptive use is comparatively high, or in zones such as non-Western Catholic nations, where the unmet need for contraception is often greatest. Compared to development and women’s rights rhetoric, health-based frames appear to have the broadest and most effective reach across cultural divides. Overall, however, we find that world society processes tend to produce cross-cultural convergence in contraceptive use rates.

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