Extent of contraception methods practised by unmet need couples after counselling: a cross-sectional follow-up study in Puducherry, South India

Abstract Background Information is paucity about the extent of contraception practise among the unmet need eligible couples after counselling. Objective To assess the prevalence and associated factors of unmet need for family planning (FP), the extent to which they practise desired contraception methods after baseline counselling and the reasons for not practicing it. Methods A community-based cross-sectional analytical study was conducted between 2016 and 2019 among 2228 currently married couples with periodic follow ups of unmet need group. Baseline data on unmet need were collected based on the National Family Health Survey questionnaire. Individual and couple counselling were performed through informing choice and the support for decision making was based on the unmet need reasons with follow-ups. The data were analysed using Stata software version 12.0 (StataCorp, College Station, TX). Results The total study population was 1924. The prevalence of unmet need for FP was 7.1% (137) with 2.9% (55) of unmet need for spacing and 4.3% (82) of limiting births. Age groups between 18 and 24 [adjusted odds ratio (AOR) = 4.463], 25–29 (AOR = 2.339), not having a child (AOR = 0.250), having one child (AOR = 2.369) and having lower socioeconomic status (AOR = 0.155) were significantly associated with unmet need. During the follow-ups, 37.2% (29/78) received who desired limiting births, while 43.6% (34/78) changed to spacing methods. In fact, the main reason for not adopting limiting births is the fear of post-operative surgery-related health problems. Conclusions This study emphasizes the need for follow-up counselling for guiding contraceptive use and recorded that majority of the unmet need couples started practicing contraception methods during the follow-ups. Besides, change in desired contraception methods was observed.

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Male-Female Concordance in Reported Involvement of Women in Contraceptive Decision-Making and Its Association With Modern Contraceptive Use Among Couples in Rural Maharashtra, India.

10.21203/rs.3.rs-358822/v1 ◽

2021 ◽

Author(s):

Anvita Dixit ◽

Nicole E Johns ◽

Mohan Ghule ◽

Madhusudana Battala ◽

Shahina Begum ◽

...

Keyword(s):

Decision Making ◽

Partner Violence ◽

Contraceptive Use ◽

Unmet Need ◽

Married Couples ◽

Cross Sectional Study ◽

Modern Contraceptive ◽

Cross Sectional ◽

Lower Odds ◽

Modern Contraceptive Use

Abstract Objective: Women’s involvement in contraceptive decision-making increases contraceptive use and reduces unmet need, but study of this has been limited to women’s self-reports. Less research is available examining couple concordance and women’s involvement in contraceptive decision-making as reported by both men and women. Study Design: We carried out a cross-sectional study using data from rural India (N=961 young married couples). Using multivariable regression we examined the association between concordance or discordance in spousal reports of wife’s involvement in contraceptive decision-making and modern contraceptive use, adjusting for demographics, intimate partner violence, and contraceptive use discussion. Results: More than one third (38.3%) of women reported current modern contraceptive use. Report of women’s involvement in contraceptive decision-making showed 70.3% of couples agreed that women were involved, jointly or alone (categorized as Concordant 1), 4.2% agreed women were not involved (categorized at Concordant 2), 13.2% had women report involvement but men report women were uninvolved (categorized as Discordant 1), and 12.2% had women report uninvolvement but men report that women were involved (categorized as Discordant 2). Discordant 2 couples had lower odds of modern contraceptive use relative to Concordant 1 couples (adjusted RR=0.61, 95% CI 0.45-0.83). No other significant differences between Concordant 1 couples and other categories were observed. Conclusion: One in four couples indicated discordance on women’s involvement in contraceptive decision making, with Discordant 2 category having lower odds of contraceptive use. Couples’ concordance in women’s involvement in contraceptive decision-making offers a target for family planning research and interventions to better meet their needs.Trial registrationClinicalTrial.gov, NCT03514914. https://clinicaltrials.gov/ct2/show/NCT03514914

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Prevalence of Contraceptive Methods among Eligible Couples in an Urban Area of Chennai - A Cross Sectional Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i55a33831 ◽

2021 ◽

pp. 262-267

Author(s):

K. R. Deepak Avinash ◽

S. Suganthi ◽

E. Venmathi

Keyword(s):

Urban Area ◽

Contraceptive Use ◽

Mode Of Delivery ◽

Unmet Need ◽

Population Expansion ◽

Married Couples ◽

Cross Sectional Study ◽

Sectional Study ◽

Contraceptive Methods ◽

Cross Sectional

Introduction: Rapid population expansion is putting a strain on many developing countries' resources, especially in India. Optimal fertility management enables women and men to avoid and achieve conception and parenthood when desired. India launched officially Family Planning Programme way back in 1952 to address these issues, yet its goals were far from achieving facing stern obstacles in many forms. Surveys and studies by individual authors to find out the prevalence of contraceptive use and their determinants have been conducted in various parts of India. However, the contraceptive prevalence is not uniform across India. The aim of the study is to estimating the prevalence of contraception usage among eligible couples and to assess the factors associated with contraception usage. Methods: This was a cross sectional study conducted among married eligible couples living in the urban area named Semencheri in Chennai. It was carried out for a period of 4 months from 2ndApril to 5th of July 2019. The study population consisted of eligible married couples with female partner of age between 15 to 49yrs of age married for at least 2 year, and having minimum one child, Based on the results of a pilot study the sample size was calculated and estimated to be 120, structured questionnaire was used to collect data. Results: The prevalence of contraception was only 63.3% though 92.5% of couples studied were aware of the contraceptive methods, the factors like education of either of the couple and mode of delivery of the previous child were significantly associated with contraception usage. Conclusion: Even though the use of contraception has increased among couples, still there is an unmet need for contraception, in spite of increased education qualification and knowledge about contraceptive methods.

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Male–female concordance in reported involvement of women in contraceptive decision-making and its association with modern contraceptive use among couples in rural Maharashtra, India

Reproductive Health ◽

10.1186/s12978-021-01187-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Anvita Dixit ◽

Nicole E. Johns ◽

Mohan Ghule ◽

Madhusudana Battala ◽

Shahina Begum ◽

...

Keyword(s):

Decision Making ◽

Partner Violence ◽

Contraceptive Use ◽

Unmet Need ◽

Married Couples ◽

Cross Sectional Study ◽

Modern Contraceptive ◽

Cross Sectional ◽

Lower Odds ◽

Modern Contraceptive Use

Abstract Objective Women’s involvement in contraceptive decision-making increases contraceptive use and reduces unmet need, but study of this has been limited to women’s self-reports. Less research is available examining couple concordance and women’s involvement in contraceptive decision-making as reported by both men and women. Study design We carried out a cross-sectional study using data from rural India (N = 961 young married couples). Using multivariable regression we examined the association between concordance or discordance in spousal reports of wife’s involvement in contraceptive decision-making and modern contraceptive use, adjusting for demographics, intimate partner violence, and contraceptive use discussion. Results More than one third (38.3%) of women reported current modern contraceptive use. Report of women’s involvement in contraceptive decision-making showed 70.3% of couples agreed that women were involved, jointly or alone (categorized as Concordant 1), 4.2% agreed women were not involved (categorized at Concordant 2), 13.2% had women report involvement but men report women were uninvolved (categorized as Discordant 1), and 12.2% had women report uninvolvement but men report that women were involved (categorized as Discordant 2). Discordant 2 couples had lower odds of modern contraceptive use relative to Concordant 1 couples (adjusted RR = 0.61, 95% CI 0.45–0.83). No other significant differences between Concordant 1 couples and other categories were observed. Conclusion One in four couples indicated discordance on women’s involvement in contraceptive decision making, with Discordant 2 category having lower odds of contraceptive use. Couples’ concordance in women’s involvement in contraceptive decision-making offers a target for family planning research and interventions to better meet their needs. Trial registration ClinicalTrial.gov, NCT03514914. https://clinicaltrials.gov/ct2/show/NCT03514914

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Socioeconomic determinants of unmet need for outpatient healthcare services in Iran: a national cross-sectional study

BMC Public Health ◽

10.1186/s12889-021-10477-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sajad Vahedi ◽

Amin Torabipour ◽

Amirhossein Takian ◽

Saeed Mohammadpur ◽

Alireza Olyaeemanesh ◽

...

Keyword(s):

Health System ◽

Age Groups ◽

Unmet Need ◽

Healthcare Services ◽

Cross Sectional Study ◽

Outpatient Services ◽

Self Medication ◽

Cross Sectional ◽

Organizational Policies ◽

Utilization Of Healthcare

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.

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Predictors of Discontinuation of Modern Spacing Contraceptives in India

Asia Pacific Journal of Public Health ◽

10.1177/1010539520983149 ◽

2020 ◽

pp. 101053952098314

Author(s):

Shahina Begum ◽

Himanshu Chaurasia ◽

Kusum V. Moray ◽

Beena Joshi

Keyword(s):

Contraceptive Use ◽

Oral Contraceptive Pill ◽

Family Health ◽

Reproductive Age ◽

Health Priorities ◽

Unintended Pregnancies ◽

Reproductive Age Women ◽

One Year ◽

Women In India

Data from National Family Health Survey (2015-2016) was analyzed to examine the contraceptive acceptance, discontinuation rates, and associated factors among reproductive age women in India over one year. Findings revealed that 11.7% accepted modern methods of which 68% were for spacing. Only 5% switched to other methods. Discontinuation rate was high among condom (56.8%) and oral contraceptive pill users (34.5%), among women aged less than 25 years, with parity less than 2, belonging to rural area, and having no education. Health concerns/side effects, husband’s disapproval, or method failure were most common reasons cited for discontinuation. The data show high discontinuation rates among some subgroups of women and for certain methods. Hence, women need to be provided options to switch methods to meet changing contraceptive needs and health priorities. Continuum of care with follow-up and counselling can facilitate sustained contraceptive use to avert unintended pregnancies.

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Reasons for Vaccine Rejection in 0 to 2 Years Old Children Registered to Family Health Centers in Konya

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0041-1722972 ◽

2021 ◽

Vol 16 (02) ◽

pp. 074-079

Author(s):

Hasan Kucukkendirci ◽

Fatih Kara ◽

Gulsum Gulperi Turgut

Keyword(s):

Health Personnel ◽

Family Health ◽

Cross Sectional Study ◽

World Health ◽

University Graduates ◽

Cross Sectional ◽

Vaccination Programs ◽

Vaccine Preventable Diseases ◽

Health Organization

AbstractObjective According to the 2017 report of the World Health Organization (WHO), ∼1.5 million people die from vaccine preventable diseases. The WHO is working to generate and popularize effective vaccination programs. However, the concept of “vaccine rejection,” which first started in Europe and United States, has started to make an impact in Turkey during the past 10 years. It is therefore seen as a growing danger in future. This study was conducted to determine, detect, and prevent the reasons of vaccine rejection that have increased in recent years.Methods A cross-sectional study was conducted between June and December at 2015. In all districts of Konya (n = 31), it was aimed to reach all 242 families who rejected vaccination to their 0 to 2 years old babies. Families having more than one child refused to vaccinate all of their children. A questionnaire consisting of 47 questions was prepared by the researchers, using the standard trainings of the Ministry of Health and the literature. A total of 172 families agreed to participate in this study. The questionnaire was applied to the parents using the telephone interview technique. Data were presented as mean ± standard deviation and percentage.Results About 41.3% (n = 71) of the mothers were high school graduates, 50.6% (n = 87) of their fathers were university graduates. About 82.6% (n = 142) of the participants received examination, treatment and follow-up services from family physicians and family health personnel. About 20.9% (n = 36) of the children were the only children of the family. About 55.8% (n = 96) of the families also refused the vaccination for other children. About 83.7% (n = 144) of the unvaccinated children had infants/children follow-up care. While all participants stated that vaccines had side effects, 31.4% (n = 54) of these believed that vaccines cause autism or paralysis in infants. About 62.2% (n = 107) of their mothers did not receive tetanus vaccine during pregnancy. The highest rate of nonvaccination was with the second dose of hepatitis A vaccine, which 96.5% (n = 166) refused. The most accepted vaccine was the first dose of hepatitis B vaccine, which was refused by 18.0% (n = 31). About 79.7% (n = 137) of the participants did not know the reason for the vaccination and 95.9% (n = 165) thought that the vaccines were not required. All participants received information from the health personnel about the vaccines. While 9.9% (n = 17) of the families thought that vaccines cause infertility, 44.8% (n = 77) did not receive vaccination because the vaccines were produced abroad.Conclusion A growing number of families refuse to have their babies vaccinated. The production of vaccines abroad is a major cause of insecurity. There are also beliefs that vaccines cause infertility. Vaccine production in Turkey should be accelerated and public education about vaccines should be reviewed. Training provided to families about vaccines should also be reviewed.

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Prevalence and Determinants of Adequate Compliance with Antenatal Care in Peru

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0041-1732463 ◽

2021 ◽

Vol 43 (06) ◽

pp. 442-451

Author(s):

Cesar Tello-Torres ◽

Akram Hernández-Vásquez ◽

Karla F. Dongo ◽

Rodrigo Vargas-Fernández ◽

Guido Bendezu-Quispe

Keyword(s):

Antenatal Care ◽

Health Care Professionals ◽

Age Groups ◽

Family Health ◽

Wealth Quintile ◽

First Trimester ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Cross Sectional ◽

First Trimester Of Pregnancy

Abstract Objective To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. Methods An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. Results A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, having secondary or higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. Conclusion Only 3 out of 10 women in Peru showed adequate compliance with ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.

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Side Effects Following Administration of the First Dose of Oxford-AstraZeneca’s Covishield Vaccine in Bangladesh: A Cross-Sectional Study

Infectious Disease Reports ◽

10.3390/idr13040080 ◽

2021 ◽

Vol 13 (4) ◽

pp. 888-901

Author(s):

Nishat Jahan ◽

Fahad Imtiaz Rahman ◽

Poushali Saha ◽

Sadia Afruz Ether ◽

ASM Roknuzzaman ◽

...

Keyword(s):

Side Effects ◽

Rapid Development ◽

Age Groups ◽

Cross Sectional Study ◽

Cross Sectional ◽

Post Vaccination ◽

Long Term Follow Up ◽

Larger Sample

In response to the raging COVID-19 pandemic, Bangladesh started its vaccine administration in early 2021; however, due to the rapid development and launch of the vaccines in the market, many people had concerns regarding the safety of these vaccines. The purpose of this study was to evaluate the side effects that were experienced by the Bangladeshi residents after receiving the first dose of the Oxford-AstraZeneca’s Covishield vaccine (ChAdOx1nCoV-19). The study was conducted using both online and printed questionnaires and the data were analysed using SPSS. The results included the responses of 474 vaccine recipients from March–April 2021. Pain at the site of injection, fever, myalgia, fatigue and headache were the most commonly reported symptoms, and the overall side effects were found to be significantly more prevalent in the younger population (p ≤ 0.05). These findings were consistent with the results indicated by the clinical trial of ChAdOx1nCoV-19. Logistic regression analysis further revealed that compared to people aged 70 years or above, the incidence of reported side effects was significantly higher in people aged 18–30 years (odds ratio (OR) = 8.56), 31–40 years, (OR = 5.05), 41–50 years (OR = 4.08), 51–60 years (OR = 3.77) and 61–70 years (OR = 3.67). In addition, a significantly higher percentage of female participants suffered from post-vaccination side effects compared to males (OR = 1.51). It was concluded that the Covishield vaccine was well-tolerated among people of different age groups. Nevertheless, further long-term follow-up study with a larger sample size is warranted to establish the long-term safety of the COVID-19 vaccine.

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Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis

BMJ Open ◽

10.1136/bmjopen-2019-034675 ◽

2020 ◽

Vol 10 (2) ◽

pp. e034675 ◽

Cited By ~ 2

Author(s):

Amrita Namasivayam ◽

Sarah Lovell ◽

Sarah Namutamba ◽

Philip J Schluter

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Unmet Need ◽

Secondary Data ◽

Population Level ◽

Modern Contraceptive ◽

Cross Sectional ◽

Factors Affecting ◽

Logistic Regression Models ◽

Modern Contraceptive Use

Objective(s)Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.Study designA nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).SettingUganda.ParticipantsAll women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.Primary outcome measuresModern contraceptive use.ResultsOverall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).Conclusion(s)Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.

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Improving sexual and reproductive health knowledge and practice in Mozambican families with media campaign and volunteer family health champions

Family Medicine and Community Health ◽

10.1136/fmch-2018-000089 ◽

2019 ◽

Vol 7 (4) ◽

pp. e000089

Author(s):

Paulo Henrique Pires ◽

Ronald Siemens ◽

Martins Mupueleque

Keyword(s):

Family Planning ◽

Reproductive Health ◽

Sexual And Reproductive Health ◽

Health Knowledge ◽

Unmet Need ◽

Family Health ◽

Media Campaign ◽

Planning Practice ◽

Cross Sectional ◽

Before And After

ObjectiveTo increase knowledge, attitudes and practice of sexual and reproductive health and family planning and to reduce maternal and neonatal mortality rates in Mozambique.DesignAn implementation research project’s intermediate evaluation, applying two cross-sectional surveys. The surveys were planned for 316 subjects before and after interventions.SettingResearch performed in Natikiri district of Nampula province in northern Mozambique, targeting a suburban and rural populations in their homes.Participants452 people were surveyed (91 before, 361 after), all belonging to the Macua ethnic group.InterventionsA media campaign (2 weekly radio spots, bimonthly theatre performances) was performed for 8 months (2017 to 2018) and family health champions’ teachings (monthly home visits) performed for 3 months, on sexual and reproductive health and family planning. Outcome measures planned and measured were adolescent’s and adult’s knowledge, attitudes and practice about those. Data were analysed by gender, age group and frequencies, using a CI of 95% (p<0.5 statistically significant).ResultsRadio spots, community theatre and volunteer champions increased population’s knowledge about sexual and reproductive health and led to a more positive attitude toward family planning. Concerning attitude, results show differences between adults’ proportions before and after: (1) did you hear about sexual and reproductive health (p=0.0425); (2) knows project key messages (p<0.001); (3) knows prenatal visits importance (p=0.0301); (4) access to contraceptives was easy (p<0.001). Adolescents showed statistically significant differences before and after: (1) knows project key messages (p<0.001); (2) access to contraceptives was easy (p=0.0361). Family planning practice did not increase in both groups.ConclusionA health education intervention, using a media campaign and local volunteers, is useful to promote mother and child health. There is an unmet need for family planning and the use of modern contraception is below desired practice, needing further research about cultural barriers. Communication for behaviour change activities will pursue and impact will be assessed to document family planning practice improvement.

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