scholarly journals Spatial variations and associated factors of modern contraceptive use in Ethiopia: a spatial and multilevel analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037532
Author(s):  
Teketo Kassaw Tegegne ◽  
Catherine Chojenta ◽  
Peta Michelle Forder ◽  
Theodros Getachew ◽  
Roger Smith ◽  
...  
Keyword(s):  
Health Facility ◽  
Contraceptive Use ◽  
Addis Ababa ◽  
Married Women ◽  
Spatial Variations ◽  
High Fertility ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use

ObjectiveTo assess spatial variations in modern contraceptive use and to identify factors associated with it among married women in Ethiopia.DesignCross-sectional analysis of population-based and health facility data.SettingEthiopia Demographic and Health Survey data linked to Service Provision Assessment data.Population8473 married women and 1020 facilities that reported providing family planning services.MethodsA linked secondary data analysis of population and health facility data was carried out. Both multilevel and spatial analyses were conducted to identify key determinants of women’s use of modern contraceptive and spatial clustering of modern contraceptive use.Main outcome measureModern contraceptive use.ResultsAbout 24% of the variation in the use of modern contraception was accounted for by location. A one-unit increase in the mean score of health facilities’ readiness to provide short-term modern contraceptives in a typical region was associated with a 20-fold increase in the odds of modern contraceptive use (adjusted OR (AOR) 20.49, 95% CI 1.44 to 29.54). In the spatial analysis, it was found that Addis Ababa and the Amhara region had high clusters of modern contraceptive use rates. On the other hand, low rates of contraceptive use were clustered in the Afar and Somali regions.ConclusionThere were significant variations in the use of modern contraceptives across the different regions of Ethiopia. Therefore, regions with low contraceptive rates and high fertility rates should be targeted for scaling up and tailoring of services to the culture and lifestyles of the population of those regions.

scholarly journals Family planning counseling and its associations with modern contraceptive use, initiation, and continuation in rural Uttar Pradesh, India

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Nabamallika Dehingia ◽  
Anvita Dixit ◽  
Sarah Averbach ◽  
Vikas Choudhry ◽  
Arnab Dey ◽  
...  
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Uttar Pradesh ◽  
Married Women ◽  
Modern Contraceptive ◽  
Advantages And Disadvantages ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
Continued Use

Abstract Background We examine the association between the quality of family planning (FP) counseling received in past 24 months, and current modern contraceptive use, initiation, and continuation, among a sample of women in rural Uttar Pradesh, India. Methods This study included data from a longitudinal study with two rounds of representative household survey (2014 and 2016), with currently married women of age 15–49 years; the analysis excluded women who were already using a permanent method of contraceptive during the first round of survey and who reported discontinuation because they wanted to be pregnant (N = 1398). We measured quality of FP counseling using four items on whether women were informed of advantages and disadvantages of different methods, were told of method(s) that are appropriate for them, whether their questions were answered, and whether they perceived the counseling to be helpful. Positive responses to every item was categorized as higher quality counseling, vs lower quality counseling for positive response to less than four items. Outcome variables included modern contraceptive use during the second round of survey, and a variable categorizing women based on their contraceptive use behavior during the two rounds: continued-users, new-users, discontinued-users, and non-users. Results Around 22% had received any FP counseling; only 4% received higher-quality counseling. Those who received lower-quality FP counseling had 2.42x the odds of reporting current use of any modern contraceptive method (95% CI: 1.56–3.76), and those who received higher quality FP counseling at 4.14x the odds of reporting modern contraceptive use (95% CI: 1.72–9.99), as compared to women reporting no FP counseling. Women receiving higher-quality counseling also had higher likelihood of continued use (ARRR 5.93; 95% CI: 1.97–17.83), as well as new use or initiation (ARRR: 4.2; 95% CI: 1.44–12.35) of modern contraceptives. Receipt of lower-quality counseling also showed statistically significant associations with continued and new use of modern contraceptives, but the effect sizes were smaller than those for higher-quality counseling. Conclusions Findings suggest the value of FP counseling. With a patient-centered approach to counseling, continued use of modern contraceptives can be supported among married women of reproductive age. Unfortunately, FP counseling, particularly higher-quality FP counseling remains rare.

scholarly journals Geographical variation and factor associated with modern contraceptive utilization among Young married women aged between 15-24 years: Spatial and multilevel analysis of EDHS 2016.

2020 ◽  
Author(s):  
Kedir Abdu Yesuf ◽  
Ayesheshim Muluneh Kassa ◽  
Eueail Teferi Asrese
Keyword(s):  
Contraceptive Use ◽  
Addis Ababa ◽  
Married Women ◽  
Scan Statistics ◽  
Modern Contraceptive ◽  
Age Group ◽  
Contraceptive Utilization ◽  
Modern Contraceptive Use ◽  
Spatial Scan ◽  
Low Prevalence

Abstract Introduction: Despite increase in trend of modern contraceptive use in worldwide it was still low in developing country. In Ethiopia modern contraceptive utilization among young married women was low which shows gaps between women reproductive desire to avoid pregnancy and contraceptive behavior. This study showsvaration in modern contraceptive utilization and factor associated with it among young merried age group between 15-24 years in Ethiopia.Objective: The aim of the study was to assess the geographical varation of modern contraceptive utilization and associated factor among young married women aged between 15- 24 year in Ethiopia. Methods:In this study cross-sectional study design was conducted using Ethiopia demographic and health survey 2016 data. The sample size was 2298 young married women aged between 15-24 years.Geographical variation assessed by Spatial analysis using spatial autocorrelation Moran’s I, Gettis-OrdGi* and spatial scan statics to identify significant clusters of modern contraceptive utilization among young married women. Determinant factor for modern contraceptive use were analyzed using a two level-mixed-effects logistic regression model which include both the individual and community level factors.Result: In Ethiopia, prevalence of modern contraceptive utilization among young married women age group between 15-24 years was 36.7 %. Geographical varaition asessed by spatial scan statistics identified primary clusters of modern contraceptive utilization were all zone of Amhara, Addis Ababa and Shewa. In other hand,Gettis-OrdGi* analysisindicated zone 1 of Afar region, Borena zone of Oromia region and all zone of Somalia regions were low prevalencespot region. In this study religion, respondent working status, number of living children, husband desire more children, region, community mas media exposure and community educational level were statically significant variables for modern contraceptive utilization among young married women.Conclusions: There is low prevalence of modern contraceptive utilization among young married women and it was varied across zone of Ethiopia. High and low prevalence spot area, most likely cluster, community and individual level factor associated with modern contraceptive utilization is identified which is important to prioritize family planning strategythat focus particularly for young population segment. Therefore, exerting much effort on all of this area is supreme important as it has significant public health contributions.

scholarly journals Modern contraceptive use among female refugee adolescents in Northern Uganda: prevalence and associated factors

2020 ◽  
Author(s):  
Ritah Bakesiima ◽  
Amanda Cleeve ◽  
Elin Larsson ◽  
James K. Tumwine ◽  
Grace Ndeezi ◽  
...  
Keyword(s):  
Decision Making ◽  
Contraceptive Use ◽  
Analytical Techniques ◽  
Cross Sectional Study ◽  
Northern Uganda ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Modern Contraceptives ◽  
Fertility Decision ◽  
Modern Contraceptive Use

Abstract Background: Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in Northern Uganda. Methods: This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection. Results: Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for six months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR=0.11, 95% CI: 0.04 to 0.35, p<0.001), cohabiting (OR=0.43, 95% CI: 0.20 to 0.93, p=0.032) or having an older partner (OR=0.93, 95% CI: 0.86 to 0.99, p=0.046) were less likely to use modern contraceptives.Conclusion: Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.

scholarly journals The aggregate effect of implementation strength of family planning programs on modern contraceptive use at the health systems level in rural Malawi

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0232504
Author(s):  
Anooj Pattnaik ◽  
Diwakar Mohan ◽  
Amy Tsui ◽  
Sam Chipokosa ◽  
Hans Katengeza ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Facility ◽  
Catchment Area ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Summary Measure ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Modern Contraceptive Use ◽  
Combined Impact

To explore the association between the strength of implementation of family planning (FP) programs on the use of modern contraceptives. Specifically, how strongly these programs are being implemented across a health facility’s catchment area in Malawi and the odds of a woman in that catchment area is using modern contraceptives. This information can be used to assess whether the combined impact of multiple large-scale FP programs is leading to change in the health outcomes they aim to improve. We used data from the 2017 Implementation Strength Assessment (ISA) that quantified how much of family planning programs at the health facility and community health worker levels were being implemented across every district of Malawi. We used a summary measure developed in a previous study that employs quantitative methods to combine data across FP domains and health system levels. We tested the association of this summary measure for implementation strength with household data from the 2015 Malawi Demographic Health Survey (DHS). We found that areas with stronger implementation of FP programs had higher odds of women using modern contraceptives compared with areas with weaker implementation. The association of ISA with use of modern contraception was different by education, marital status, and geography. After controlling for these factors, we found that the adjusted odds of using a modern contraceptive was three times higher in catchment areas with high implementation strength compared to those with lower strength. Metrics that summarize how strongly FP programs are being implemented were used to show a statistically significantly positive relationship between increasing implementation strength and higher rates of modern contraceptive use. Decisionmakers at the various levels of health authority can use this type of summary measure to better understand the combined impact of their diverse FP programming and inform future programmatic and policy decisions. The findings also reinforce the idea that having a well-supported and supplied cadre of community health workers supplementing FP provision at the health facility can be an important health systems mechanism, especially in rural settings and to target youth populations.

scholarly journals Spatial distribution and factors associated with modern contraceptive use among women of reproductive age in Nigeria: A multilevel analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0258844
Author(s):  
Obasanjo Afolabi Bolarinwa ◽  
Zemenu Tadesse Tessema ◽  
James Boadu Frimpong ◽  
Abdul-Aziz Seidu ◽  
Bright Opoku Ahinkorah
Keyword(s):  
Spatial Distribution ◽  
Multilevel Analysis ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
High Fertility ◽  
Modern Contraceptive ◽  
Women Of Reproductive Age ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
The Individual

Background Evidence suggests that in countries with high fertility and fecundity rates, such as Nigeria, the promotion of modern contraceptive use prevents approximately 32% and 10% of maternal and child mortality, respectively. Therefore, this study aimed to assess the spatial distribution of modern contraceptive use and its predictors among women of reproductive age in Nigeria. Methods The study employed a cross-sectional analysis of population-based data involving 24,281 women of reproductive age in Nigeria. The study adopted both multilevel and spatial analyses to identify the predictors of modern contraceptive use and its spatial clustering among women in Nigeria. Results Modern contraceptive use among the study population in Nigeria ranged from 0% to 75%, with regional variations. The spatial analysis showed that areas with a low proportion of modern contraceptive use were Sokoto, Yobe, Borno, Katsina, Zamfara, Kebbi, Niger, Taraba and Delta. Areas with a high proportion of modern contraceptive use were Lagos, Oyo, Osun, Ekiti, Federal capital territory, Plateau, Adamawa, Imo, and Bayelsa. The multilevel analysis revealed that at the individual level, women with secondary/higher education, women from the Yoruba ethnic group, those who had four children and above, and those exposed to mass media had higher odds of using modern contraceptives. On the other hand, women who were 35 years and above, those who were married, and women who were practicing Islam were less likely to use modern contraceptives. At the household/community level, women from the richest households, those residing in communities with medium knowledge of modern contraceptive methods, and women residing in communities with a high literacy level were more likely to use modern contraceptives. Conclusion There were major variations in the use of modern contraception across various regions in Nigeria. As a result, areas with low contraceptive rates should be given the most deserving attention by promoting contraceptive education and use as well as considering significant factors at the individual and household/community levels.

scholarly journals The aggregate effect of implementation strength of family planning programs on modern contraceptive use at the health systems level in rural Malawi

2020 ◽  
Author(s):  
Anooj Pattnaik ◽  
Diwakar Mohan ◽  
Amy Tsui ◽  
Sam Chipokosa ◽  
Hans Katengeza ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Facility ◽  
Catchment Area ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Summary Measure ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Modern Contraceptive Use ◽  
Combined Impact

AbstractBackgroundTo explore the association between the strength of implementation of family planning (FP) programs on the use of modern contraceptives. Specifically, how strongly these programs are being implemented across a health facility’s catchment area in Malawi and the odds of a woman in that catchment area is using modern contraceptives. This information can be used to assess whether the combined impact of multiple large-scale FP programs is leading to change in the health outcomes they aim to improve.Methods and findingsWe used data from the 2017 Implementation Strength Assessment (ISA) that quantified how much of family planning programs at the health facility and community health worker levels were being implemented across every district of Malawi. We used a summary measure developed in a previous study that employs quantitative methods to combine data across FP domains and health system levels. We tested the association of this summary measure for implementation strength with household data from the 2015 Malawi Demographic Health Survey (DHS). We found that areas with stronger implementation of FP programs had higher odds of women using modern contraceptives compared with areas with weaker implementation. The association of ISA with use of modern contraception was different by education, marital status, and geography. After controlling for these factors, we found that the adjusted odds of using a modern contraceptive was three times higher in catchment areas with high implementation strength compared to those with lower strength.ConclusionMetrics that summarize how strongly FP programs are being implemented were used to show a statistically significantly positive relationship between increasing implementation strength and higher rates of modern contraceptive use. Decisionmakers at the various levels of health authority can use this type of summary measure to better understand the combined impact of their diverse FP programming and inform future programmatic and policy decisions. The findings also reinforce the idea that having a well-supported and supplied cadre of community health workers supplementing FP provision at the health facility can be an important health systems mechanism, especially in rural settings and to target youth populations.

scholarly journals Associated factors of modern contraceptive use among women infected with human immunodeficiency virus in Enemay District, Northwest Ethiopia: a facility-based cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yibeltal Bimrew Kebede ◽  
Tesfahun Taddege Geremew ◽  
Yohannes Mehretie ◽  
Ayenew Negesse Abejie ◽  
Liknaw Bewket ◽  
...  
Keyword(s):  
Associated Factors ◽  
Contraceptive Use ◽  
Clinical Stage ◽  
Cross Sectional Study ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Modern Contraceptives ◽  
Resource Limited ◽  
Family Planning Counseling ◽  
Modern Contraceptive Use

Abstract Background The prevention of unplanned pregnancy among women infected with human immunodeficiency virus (HIV) is critical for the prevention of mother-to-child transmission (PMTCT) of HIV. Of the prevention strategies, deployment of modern contraceptives is principal one. However, there were limited facts on utilization of modern contraceptives and associated factors among HIV infected women, in particular of resource-limited settings in Ethiopia. Hence, we aimed to quantify the proportion of modern contraceptive utilization and the possible related factors among women infected HIV. Methods A facility-based cross-sectional study was conducted on randomly selected 632 women infected with HIV from 05 February to 25 March 2018. Data on their treatment, socio-economic, and demographic background were collected through a structured interviewer administered questionnaire. Binary logistic regression model was fitted to identify the associated factors of modern contraceptive use among women infected with HIV. Result We found 61.4% (95% CI, 57.6–65.2) were using modern contraceptives. Greater than four family size (AOR:2.17; 95%CI: 1.31–3.59), family planning counseling service (AOR: 2.37; 95% CI: 1.44–3.91), discussing contraceptive issues with sexual partner (AOR: 1.76; 95% CI: 1.12–2.77), history of giving birth (s) (AOR:2.21; 95%CI:1.20–4.05) and World Health Organization (WHO) clinical stage III or IV (AOR: 3.59; 95%CI: 1.37, 9.44) were positively associated with modern contraceptives use, whereas, older age (AOR: 0.45; 95% CI: 0.24–0.81) and being widowed (AOR: 0.34; 95% CI: 0.14–0.83), abridged the chances of modern contraceptives use. Conclusion The prevalence of modern contraceptive use among women infected with HIV is low. Higher family size, counseling on contraceptives, discussing contraceptives issues with partner, history of giving births and WHO clinical stage III/IV were positively related with contraceptives use, whereas, older age and being widowed abridged the chances of contraceptives use among HIV infected women. Therefore, our findings support calls for the district health office and the antiretroviral treatment clinics of the resource-limited settings to work more on family planning counseling services and promoting more dialogues with sexual partners on modern contraceptives use.

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