Determinants of Short Birth Intervals among married women in Karachi, Pakistan

Introduction: Birth spacing is a critical pathway to improving reproductive health. The World Health Organization recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, and infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in three peri-urban municipalities in Karachi, Pakistan. Methods: We used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the six years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history, and a six-year reproductive calendar were collected. To identify factors associated with SBIs, we fitted simple and multiple Cox-proportional hazards models and computed hazard ratios (HR) with their 95% confidence intervals (CI). Results: The median birth interval was 25 months (IQR: 14-39 months), with 22.9% of births occurring within 33 months of the index birth. Women increasing age [25-29 years (aHR=0.64, 95% CI: 0.54-0.77), 30+ years (aHR=0.30, 95% CI: 0.23-0.40) compared to <25 years]; secondary education [aHR 0.78. 95% CI: 0.65-0.93], intermediate education [aHR 0.63, 95% CI: 0.49-0.82], higher education (aHR=0.71, 95% CI: 0.53-0.96) compared to no education, and a male child of the index birth (aHR=0.79, 95% CI: 0.68-0.92) reduced the likelihood of SBIs. Women younger age <20 years [aHR 1.32, 95% CI 1.03-1.70] compared to 20-24 years, and those who did not use contraception within 9-months of the index birth had a higher likelihood for SBIs for succeeding birth compared to those who used contraception (aHR=2.33, 95% CI: 2.01-2.70). Conclusion: This study evaluates factors associated with birth spacing practices among married women of childbearing age in urban settlements of Karachi. Our study shows that birth intervals in the study population are lower than the national average. To optimize birth intervals, programs should target child spacing strategies and counsel MWRA on the benefits of optimal birth spacing, family planning services and contraceptive utilization.

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Determinants of short birth intervals among married women: a cross-sectional study in Karachi, Pakistan

BMJ Open ◽

10.1136/bmjopen-2020-043786 ◽

2021 ◽

Vol 11 (4) ◽

pp. e043786

Author(s):

Sidrah Nausheen ◽

Maria Bhura ◽

Kristy Hackett ◽

Imtiaz Hussain ◽

Zainab Shaikh ◽

...

Keyword(s):

Family Planning ◽

Birth Spacing ◽

Cross Sectional Study ◽

Married Women ◽

Reproductive Age ◽

Sectional Study ◽

Birth Intervals ◽

Critical Pathway ◽

Cross Sectional ◽

Factors Associated

IntroductionBirth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan.MethodsWe used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were collected. To identify factors associated with SBIs, we fitted simple and multiple Cox proportional hazards models and computed HRs with their 95% CIs.ResultsThe median birth interval was 25 months (IQR: 14–39 months), with 22.9% (833) of births occurring within 33 months of the index birth. Women’s increasing age (25–30 years (aHR 0.63 (0.53 to 0.75), 30+ years (aHR 0.29, 95% CI 0.22 to 0.39) compared with 20-24 years; secondary education (aHR 0.75, 95% CI 0.63 to 0.88), intermediate education (aHR 0.62, 95% CI 0.48 to 0.80), higher education (aHR 0.69, 95% CI 0.51 to 0.92) compared with no education, and a male child of the index birth (aHR 0.81, 95% CI 0.70 to 0.94) reduced the likelihood of SBIs. Women’s younger age <20 years (aHR 1.24, 95% CI 1.05 to 1.24) compared with 20–24 years, and those who did not use contraception within 9 months of the index birth had a higher likelihood for SBIs for succeeding birth compared with those who used contraception (aHR 2.23, 95% CI 1.93 to 2.58).ConclusionStudy shows that birth intervals in the study population are lower than the national average. To optimise birth intervals, programmes should target child spacing strategies and counsel MWRA on the benefits of optimal birth spacing, family planning services and contraceptive utilisation.

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Factors Associated with Unmet Need for Family Planning among Married Reproductive Age Women in Toke Kutaye District, Oromia, Ethiopia

International Journal of Reproductive Medicine ◽

10.1155/2021/5514498 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Abebe Tadesse G/Meskel ◽

Habtamu Oljira Desta ◽

Elias Teferi Bala

Keyword(s):

Family Planning ◽

Maternal Education ◽

Health Workers ◽

Unmet Need ◽

Married Women ◽

Reproductive Age ◽

Cross Sectional ◽

Factors Associated ◽

Reproductive Age Women ◽

Living Children

Background. It is estimated that more than 142 million married women in developing countries have an unmet need for family planning. This study is aimed at identifying factors associated with the unmet need of family planning among married women of reproductive age in Toke Kutaye district, Ethiopia in 2019. Methods. A community-based cross-sectional study was conducted in Toke Kutaye district from March 1–30, 2019. A systematic random sampling technique was used to select 494 reproductive-age women who were married during data collection. Data were collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were used to assess factors associated with the unmet need of family planning at 95% CI with a p value of ≤ 0.05. Result. The prevalence of unmet need for family planning in the Toke Kutaye district was 23.1% [95% CI (19.2-26.7)], with 15.2% for spacing and 7.9% for limiting. Women’s education [AOR, 3.64, 95% CI: 1.43-9.25], number of living children [AOR, 2.63, 95% CI: 1.37-5.05], husband disapproval of family planning [AOR, 3.68, 95% CI: 2.20-6.16], and discussion with healthcare providers on family planning [AOR, 0.20, 95% CI: 0.13-0.37] were significantly associated with unmet need for family planning. Conclusion. The prevalence of unmet need for family planning was high. Therefore, program managers, partners, and health workers should work to address the gaps in maternal education, the number of living children, partner disapproval of family planning, and discussion on family planning issues through enhancing female education, awareness on family planning, and male involvement in family planning services.

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Assessing the Determinants and Clues-to-Actions Influencing the Uptake of Modern Contraceptives Among Women of Reproductive Age 15-49 years in Federal Capital Territory, Abuja, Nigeria

Advances in Social Sciences Research Journal ◽

10.14738/assrj.83.9708 ◽

2021 ◽

Vol 8 (3) ◽

pp. 539-561

Author(s):

James Allen Otunomeruke ◽

Juliana Sunday

Keyword(s):

Family Planning ◽

Side Effects ◽

Health Beliefs ◽

Traditional Method ◽

Modern Method ◽

Married Women ◽

Reproductive Age ◽

Childbearing Age ◽

Health Concerns ◽

Modern Contraceptives

The contraceptive prevalence rate for any family planning method among currently married women in Federal Capital Territory (FCT) is 23.9%; use of any modern method (20.3%) among currently married women, use of any traditional method (3.6%), not currently using any method (76.1%), and total fertility rate is 4.3 per woman (NDHS 2018). The study aimed at assessing the determinants and clues-to-action influencing the uptake of contraceptives among women of childbearing age (15-49) years. A cross-sectional household survey was conducted from February 20-March 15, 2019 in FCT, Abuja. A multi-stage sampling method was used to recruit 360 women, out of which 348 were successfully interviewed by trained interviewers yielding a response rate of 96.7%. SPSS version 20.0 was used for analysis. Findings revealed that 94.4% of women were aware of family planning services, 24.4% reported of ever used any family planning methods, 20.6% used any modern method, and 3.8% using any traditional method. Major reasons for discontinuation of modern contraceptives indicated were: became pregnant while using contraceptives (33.8%), desire to become pregnant (31.8%), delay in conception (30.9%), health concerns (24.3%), fear of having disable babies (22.1%) and side effects (13.8%). Applying Health Beliefs model the clues-to-action for uptake of contraceptives were: quality-of-care, women’s satisfaction of products, beliefs/attitude, side effects and health concerns. Review demand creation strategies to include community health - and religious leaders as change agents, invest more in education. pharmaceutical companies to review products side effects, aggressive marketing, harmonization of stakeholders’ effort to reduce duplication, and entrench central database.

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The Analysis of Socio-Economic and Demographic Factors Associated with Contraceptive Use Among Married Women of Reproductive Age in Rwanda

The Open Public Health Journal ◽

10.2174/1874944501811010348 ◽

2018 ◽

Vol 11 (1) ◽

pp. 348-359 ◽

Cited By ~ 2

Author(s):

Faustin Habyarimana ◽

Shaun Ramroop

Keyword(s):

Contraceptive Use ◽

Religious Affiliation ◽

Demographic Factors ◽

Wealth Quintile ◽

Married Women ◽

Reproductive Age ◽

Childbearing Age ◽

Women Of Reproductive Age ◽

Factors Associated ◽

Living Children

Background: Contraceptive use is seen as pivotal for protecting women’s health and rights, influencing fertility and population growth, and helping to promote economic development. The main objective of this study was to identify the socio-economic and demographic factors associated with contraceptive use among married women of childbearing age in Rwanda. Methods: The current study used survey logistic regression model in order to account for the complexity of sampling design and heterogeneity between the observations from the same cluster. The 2014/2015 Rwanda Demographic and Health Survey data was used as application. Results: The findings from this study revealed that education level of the woman, wealth quintile of the household, woman’s province of residence, woman’s age at first cohabitation, current age of the respondent, woman’s working status, number of living children, husband’s desire for more children compared to the wife or partner, religious affiliation, health facilities, exposure to contraceptive information in media and by family planning workers, and current age of husband or partner were significant determinants of contraceptive use among ever married women of reproductive age. Conclusion: The findings from this study suggest improvement of exposure to the information of contraceptive use in health centres, empowerment of women for access to quality contraceptive use services and religious affiliation to play an important role to explain and inform their adherents on the importance of using a contraceptive method.

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Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia

BMJ Open ◽

10.1136/bmjopen-2019-030980 ◽

2020 ◽

Vol 10 (3) ◽

pp. e030980 ◽

Cited By ~ 6

Author(s):

Joseph Lasong ◽

Yuan Zhang ◽

Simon Afewerki Gebremedhin ◽

Sampson Opoku ◽

Chrissie Stansie Abaidoo ◽

...

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Cross Sectional Study ◽

Married Women ◽

Reproductive Age ◽

Modern Contraceptive ◽

Cross Sectional ◽

Factors Associated ◽

Modern Contraceptive Use ◽

Rural Zambia

ObjectiveZambia is among the world’s top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women.DesignCross-sectional study.SettingRural Zambia.ParticipantsSecondary data of 4903 married or cohabiting rural women (15–49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson’s χ2and descriptive statistics were performed to examine factors associated with modern contraceptive use.ResultsFactors that were positively associated with contraceptive use were respondent’s education (secondary adjusted ORs (AOR = 1.61, p≤0.002); higher (AOR = 2.39, p≤0.050)), wealth index (middle class, (AOR = 1.35, p≤0.005); rich (AOR = 2.04, p≤0.001) and richest (AOR = 1.95, p≤0.034)), high parity (1–2 (AOR = 5.31, p≤0.001); 3–4 (AOR = 7.06, p≤0.001); 5+ (AOR = 8.02, p≤0.001)), men older than women by <10 years (AOR = 1.50, p≤0.026) and women sensitised about family planning at health facility (AOR = 1.73, p≤0.001). However, old age (40–49 years (AOR = 0.49, p≤0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR = 0.77, p≤0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR = 0.78, p≤0.026) and women without knowledge of number of children husband desires (AOR = 0.71, p≤0.001) were negatively associated with contraceptive use.ConclusionModern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.

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Assessment of birth spacing among married women in Southern Karnataka

10.51131/ijpccr/v1i1.8 ◽

2020 ◽

Vol 1 (1) ◽

pp. 23-25

Author(s):

J Sushma ◽

Keyword(s):

Birth Spacing ◽

Cross Sectional Study ◽

Married Women ◽

Reproductive Age ◽

Childbearing Age ◽

R Software ◽

Cross Sectional ◽

Group A ◽

And Child Health ◽

Reproductive Age Group

Several factors influence maternal and child health, one among which is adequate birth spacing. Studies have shown that a recommended duration of birth spacing is not being observed among a larger population of women of childbearing age. The objective of the current study is to assess the pattern of birth spacing among married women of reproductive age group. A cross-sectional study was conducted in Tilaknagar, Mysore with a sample size of 180. Descriptive statistics like frequency and proportions for data analysis were calculated using R software. Among 180 subjects, only 36.1% of respondents had adequate birth spacing (≥36months) between the first two consecutive children. Among women having a third child, 52.9% had adequate spacing between the second and the third child. Keywords: Birth interval; Spacing

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Unmet need for family planning and associated factors among currently married women of reproductive age in Bishoftu town, Eastern Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0260972 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0260972

Author(s):

Megersa Girma Garo ◽

Sileshi Garoma Abe ◽

Worku Dugasa Girsha ◽

Dawit Wolde Daka

Keyword(s):

Family Planning ◽

Statistical Significance ◽

Unmet Need ◽

Married Women ◽

Reproductive Age ◽

Outcome Variable ◽

Family Planning Services ◽

Rapid Urbanization ◽

Eastern Ethiopia ◽

Factors Associated

Background Unmet family planning is one of the common causes for low contraceptive prevalence rates in developing countries, including Ethiopia. Rapid urbanization had profound effect on population health, however, little is known about the unmet need of family planning in settings where there was increased industrializations and internal migrations in Ethiopia. This study aims to determine the unmet need for family planning services among currently married women and identify factors associated with it in Bishoftu town, Eastern Ethiopia. Methods Community-based cross-sectional study was conducted from 1st January to 28th February, 2021 among 847 randomly sampled currently married women of the reproductive age group. Data were collected using semi structured interviewer administered questionnaire. Multivariate logistic regression was used to identify factors associated with the outcome variable and a 95% confidence interval was used to declare the presence of statistical significance associations. Results Eight hundred twenty-eight women were participated in the study. The prevalence of unmet need for family planning among currently married women was 26% [95% CI: 23,29]. Maternal age [AOR, 3.00, 95% CI:1.51–5.95], educational status [AOR, 2.49, 95% CI:1.22–5.07], occupational status of self-employee [AOR, 1.98, 95% CI:1.15–3.39] and housewife [AOR, 1.78, 95% CI:1.02–3.12], being visited by health care provider in the last 12 months [AOR, 1.81, 95% CI: 1.26–2.60] and desired number of children less than two [AOR, 1.53, 95% CI:1.01–2.30] were significantly associated with unmet need for family planning. Conclusions Unmet need for family planning was higher in the study area compared with the United Nations sphere standard of unmet need for family planning and the national average, and slightly lower than the regional average. Socio-demographic, economic, and health institution factors were determinants of the unmet need for family planning in the study area. Therefore, health education and behaviour change communication related to family planning services should be strengthened and access to family planning services should be improved.

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Unmet need to space and limit childbirth among reproductive age women in Pangkalpinang City, Bangka Belitung Province, Indonesia

GHMJ (Global Health Management Journal) ◽

10.35898/ghmj-1195 ◽

2017 ◽

Vol 1 (1) ◽

pp. 4

Author(s):

Antarini Antarini ◽

Siti Masfiah ◽

Ayu Fitriani ◽

Lili Junaidi

Keyword(s):

Family Planning ◽

Low Income ◽

Unmet Need ◽

Birth Spacing ◽

Reproductive Age ◽

Early Marriage ◽

Access To Health Services ◽

Childbearing Age ◽

Reproductive Age Women ◽

Background Population

Background: Population growth has become one of priority problems should be solved in almost all of developing countries, including Indonesia. Backward, Indonesia had successful family planning history. However, it shows decline figures nowadays. While, unmet need of family planning in several regions found increased. In 2007, unmet need was 8.6 %, inclined to 11.4% in 2015, which is consisted of 4.5% for spacing children and 8.6% for limiting children. Social demography, economic, access to health services, family support and perception revealed have the contribution to unmet need. Aims: This study aimed to explore unmet need family planning due to birth spacing and limiting situation among reproductive age women in Pangkal Pinang City, Bangka Belitung Province.Methods: This study was an explanatory research used cross-sectional design. The population was women of childbearing age who experienced unmet need of family planning in Pangkal Pinang, 2016. 98 women were taken by proportional random sampling to participate in this study.Results: Research showed that the most of the unmet need for family planning were among 25-29 years old women. About two third (66.3%) of unmet need women occurred due to the willingness to space the childbirth and 33.7% willing to limit the childbirth. Birth spacing tended to be favored by young mothers, early marriage (1-5 years old), had low parity and had low education attainment. Whilst, limiting childbirth tended to be preferred by women with lenght marriage experience (>15 years old), had high parity, older mothers, and middle education level (senior high school) attainment. Conclusion: Both of spacing and limiting have no difference according to the economic situation, all of them mostly were the household wife from low-income family. Husband support to do not use contraception were found in both birth spacing and birth limiting. The study suggest to provincial health office and national family planning coordination board that family planning program should not just involve the wife, but husband as well due to their high influence in family planning decision. Keyword: Unmet need, family planning, birth spacing and limiting

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Role of husband’s attitude towards the usage of contraceptives for unmet need of family planning among married women of reproductive age in Pakistan

BMC Women s Health ◽

10.1186/s12905-021-01314-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Muhammad Farhan Asif ◽

Zahid Pervaiz ◽

Jawad Rahim Afridi ◽

Ghulam Abid ◽

Zohra S. Lassi

Keyword(s):

Family Planning ◽

Unmet Need ◽

Wealth Quintile ◽

Married Women ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Family Planning Programs ◽

Contraception Use ◽

Wide Range

Abstract Background Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. Method The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. Results The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. Conclusions Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.

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Knowledge, attitude and practice of family planning among married women of reproductive age in a VDC of eastern Nepal

Journal of Chitwan Medical College ◽

10.3126/jcmc.v6i1.16655 ◽

2017 ◽

Vol 6 (1) ◽

pp. 48-53 ◽

Cited By ~ 3

Author(s):

S Uprety ◽

I S Poudel ◽

A Ghimire ◽

M Poudel ◽

S Bhattrai ◽

...

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Descriptive Analysis ◽

Married Women ◽

Reproductive Age ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Cross Sectional ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Contraceptive use and fertility rates vary substantially among developing countries. An important factor, which affects the fertility of any population, is Contraceptive. Contraceptive use varies by age. Nepal over the past 15 years show an impressive increase in the use of modern contraceptive methods from 26 percent in 1996 to 43 percent in 2011. Objectives of the is to assess the knowledge, attitude regarding family planning and the practice of contraceptives among the married women of Dhabi VDC of Eastern Nepal. A descriptive cross-sectional observational study was done in Dhabi VDC. Total of 300 married women age 15-49 sample were taken from family planning center situated in Dhabi. Knowledge, attitude and practice on contraceptives were evaluated with the help of a predesigned questionnaire. Descriptive analysis was done by using SPSS 11.5 software to obtain frequencies and percentages. Out of 300 interviewed women, the mean age was 27.94 years, 98% had heard about Family planning method. Radio was the main Source of family planning information. Regarding the usage of contraceptive methods, about 79.3% had ever used and 63.3 had current using some sort of contraception, among the method used Injectables were the commonly used methods About 71% of married women other child in the further. Despite the knowledge of all family planning methods majority of the women used Injectables. Easily accessible and easily to use were the main reasons for choosing Injectables methods.

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