scholarly journals EXAMINING TEMPORAL SHIFTS IN THE PROXIMATE DETERMINANTS OF FERTILITY IN LOW- AND MIDDLE-INCOME COUNTRIES

2017 ◽  
Vol 50 (4) ◽  
pp. 551-568 ◽  
Author(s):  
Erin Rogers ◽  
Rob Stephenson
Keyword(s):  
Contraceptive Use ◽  
Sexual Debut ◽  
Central Africa ◽  
High Fertility ◽  
Fertility Rates ◽  
Middle Income ◽  
Middle Income Countries ◽  
Proximate Determinants ◽  
Using Data ◽  
Low And Middle Income

SummaryTargeting reductions in fertility remains a key development goal, as too-high fertility hampers the economic and health prosperity of low- and middle-income countries. However, critical to the success of gaining reductions in fertility is the ability to understand the factors that are shaping fertility, and to understand the factors that are acting to keep fertility levels high. To contribute to this understanding, this study applied the Bongaarts (2015) adjusted proximate determinants of fertility model to 33 low- and middle-income countries using data collected from the Demographic and Health Survey (DHS) programme between 2000 and 2016. Results from the analysis indicate that there has been a universal decrease in the duration of breast-feeding and postpartum abstinence, which has contributed to stalling and increasing fertility rates in countries of Central Africa. In other regions of the world, such as Southern Africa, Latin America & Caribbean and Asia, increased contraceptive use and increased age at marriage, or sexual debut, has been able to offset this, leading to substantial decreases in fertility rates. These findings should serve as a guide to where additional development policy and programmatic attention should focus to reduce too-high fertility in resource-poor settings.

scholarly journals A systematic review and meta-analysis of postpartum contraceptive use among women in low- and middle-income countries

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Rubee Dev ◽  
Pamela Kohler ◽  
Molly Feder ◽  
Jennifer A. Unger ◽  
Nancy F. Woods ◽  
...  
Keyword(s):  
Systematic Review ◽  
South Asia ◽  
Contraceptive Use ◽  
Meta Analysis ◽  
Unmet Need ◽  
South East Asia ◽  
Middle Income ◽  
Middle Income Countries ◽  
Unmet Need For Contraception ◽  
Low And Middle Income

Abstract Background Short birth intervals increase risk for adverse maternal and infant outcomes including preterm birth, low birth weight (LBW), and infant mortality. Although postpartum family planning (PPFP) is an increasingly high priority for many countries, uptake and need for PPFP varies in low- and middle-income countries (LMIC). We performed a systematic review and meta-analysis to characterize postpartum contraceptive use, and predictors and barriers to use, among postpartum women in LMIC. Methods PubMed, EMBASE, CINAHL, PsycINFO, Scopus, Web of Science, and Global Health databases were searched for articles and abstracts published between January 1997 and May 2018. Studies with data on contraceptive uptake through 12 months postpartum in low- and middle-income countries were included. We used random-effects models to compute pooled estimates and confidence intervals of modern contraceptive prevalence rates (mCPR), fertility intentions (birth spacing and birth limiting), and unmet need for contraception in the postpartum period. Results Among 669 studies identified, 90 were selected for full-text review, and 35 met inclusion criteria. The majority of studies were from East Africa, West Africa, and South Asia/South East Asia. The overall pooled mCPR during the postpartum period across all regions was 41.2% (95% CI: 15.7–69.1%), with lower pooled mCPR in West Africa (36.3%; 95% CI: 27.0–45.5%). The pooled prevalence of unmet need was 48.5% (95% CI: 19.1–78.0%) across all regions, and highest in South Asia/South East Asia (59.4, 95% CI: 53.4–65.4%). Perceptions of low pregnancy risk due to breastfeeding and postpartum amenorrhea were commonly associated with lack of contraceptive use and use of male condoms, withdrawal, and abstinence. Women who were not using contraception were also less likely to utilize maternal and child health (MCH) services and reside in urban settings, and be more likely to have a fear of method side effects and receive inadequate FP counseling. In contrast, women who received FP counseling in antenatal and/or postnatal care were more likely to use PPFP. Conclusions PPFP use is low and unmet need for contraception following pregnancy in LMIC is high. Tailored counseling approaches may help overcome misconceptions and meet heterogeneous needs for PPFP.

scholarly journals Contraception in adolescence: the influence of parity and marital status on contraceptive use in 73 low-and middle-income countries

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Carolina de Vargas Nunes Coll ◽  
Fernanda Ewerling ◽  
Franciele Hellwig ◽  
Aluísio Jardim Dornellas de Barros
Keyword(s):  
Marital Status ◽  
Contraceptive Use ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Contraceptive Use in Adolescent Girls and Adult Women in Low- and Middle-Income Countries

2020 ◽  
Vol 3 (2) ◽  
pp. e1921437 ◽  
Author(s):  
Zhihui Li ◽  
George Patton ◽  
Farnaz Sabet ◽  
Zhiying Zhou ◽  
S. V. Subramanian ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Contraceptive Use ◽  
Adult Women ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals 709Inequalities and the role of sterilization in modern contraception in low- and middle-income countries

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Franciele Hellwig ◽  
Aluisio JD Barros
Keyword(s):  
Contraceptive Use ◽  
Female Sterilization ◽  
Middle Income ◽  
Middle Income Countries ◽  
Index Of Inequality ◽  
Wealth Inequalities ◽  
Using Data ◽  
Long Acting ◽  
Women In India

Abstract Background Contraceptive use has increased impressively in the last years. Our aim was to track the proportion of female sterilization in demand for family planning satisfied with modern methods (mDFPS) and its inequalities in terms of wealth. Methods Using data from national health surveys carried out since 2010 in 105 countries, we estimated mDFPS, separating according to type of method. Where the share of female sterilization was at least 25%, we analysed wealth inequalities in the share of sterilization by wealth quintiles and Slope Index of Inequality (SII). Results We included 20 countries, among which mDFPS varied widely (from 6% in Albania to 94% in Brazil). Female sterilization was reported by more than half of women in India, Dominican Republic, El Salvador, Mexico, and Colombia. Most countries presented higher use of sterilization among the richest, but inequality patterns varied greatly. Higher levels of pro-rich inequality were found for Guatemala and Costa Rica (SII of 0.24 and 0.22, respectively). Higher levels of pro-poor inequality were found for Albania and Brazil (SII of -0.25). Conclusions Despite the wider range of methods available, several countries present a large proportion of mDFPS satisfied through female sterilization. Key messages Sterilization might be recommended to some couples, however, its role in mDFPS is excessively high. Promotion of long-acting reversible contraceptives should be strengthened as they are easy to use, highly effective and do not eliminate women’s agency about maternity in the future.

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