Determinants of Multimethod Contraceptive Use in a Sample of Adolescent Women Diagnosed with Psychological Disorders

Objective. Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, multimethod contraceptive use among women is poor. This study examined individual-, interpersonal-, and environmental-level factors that predict multimethod use among sexually active adolescent women diagnosed with psychological disorders.Methods. This multisite study analyzed data from 288 sexually active adolescent women who provided sociodemographic, psychosocial, and behavioral data related to birth control and condom use.Results. 34.7% of the participants reported multimethod use in the past three months. Controlling for empirically and theoretically relevant covariates, a multivariable logistic regression identified self-efficacy, multiple partners, pregnancy history, parental communication, parental norms about sex, and neighborhood cohesion as significant predictors of multimethod use.Conclusions. While continued targeted messages about multi-method contraceptive use are imperative at the individual level, an uptake in messages targeting interpersonal- and environmental-level factors such as adolescents' parents and the broader community is urgently needed.

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INFLUENCE OF INDIVIDUAL AND COMMUNITY-LEVEL ASSOCIATES OF CONTRACEPTIVE USE IN PAKISTAN: A MULTI-LEVEL MIXED EFFECT ANALYSIS (PDHS 2017-18)

Humanities & Social Sciences Reviews ◽

10.18510/hssr.2021.9375 ◽

2021 ◽

Vol 9 (3) ◽

pp. 764-775

Author(s):

Asifa Kamal ◽

Sadaf Malik ◽

Hafsa Batool ◽

Afza Rasul

Keyword(s):

Mass Media ◽

Women's Education ◽

Contraceptive Use ◽

Media Exposure ◽

Married Women ◽

Community Level ◽

Women’S Empowerment ◽

Individual Level ◽

The Individual ◽

Mass Media Exposure

Purpose of the study: This research aims to investigate the impact of mass media exposure and women's autonomy on the use of contraceptives, along with other potential determinants at the individual level and community level among women in Pakistan. Methodology: Data was extracted from Pakistan Demographic & Health Surveys 2017-18. The sample size included 10,461 non-pregnant and married women from a total of 15,068 ever-married women. The analysis was done using two-level mixed-effects logistic regression for the binary outcome variable, i.e., current contraceptive use (yes/no). Main Findings: Significant factors positively associated with contraceptive use at the individual level were women's education, wealth index, parity, age at first cohabitation, child mortality experience, and mass media exposure. Community attributes like region (Sindh, KPK, Balochistan as compared to Punjab), residence (rural as compared to urban) had an inverse relationship with contraceptive use. At the same time, women's education and an ideal number of children were the significant positive associates. Women's empowerment has though insignificant, but it has a positive impact on the use of contraceptives at both individual and community levels. Applications of this study: Family planning programs can be extended by focusing on women residing in rural settings or in high fertility intentions communities, less educated and unprivileged younger women who had reduced the uptake of contraceptives. An increase in women's access to education, media exposure, employment, and women's empowerment can help attain Pakistan's contraceptive prevalence targets. Novelty/Originality of this study: The current study's effect of individual and community-level factors was investigated using National-level data, mainly focusing on the role of mass media and women's autonomy.

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AREA VARIATIONS IN USE OF MODERN CONTRACEPTION IN RURAL BANGLADESH: A MULTILEVEL ANALYSIS

Journal of Biosocial Science ◽

10.1017/s0021932099003272 ◽

1999 ◽

Vol 31 (3) ◽

pp. 327-341 ◽

Cited By ~ 3

Author(s):

NASHID KAMAL ◽

ANDREW SLOGGETT ◽

JOHN G. CLELAND

Keyword(s):

Contraceptive Use ◽

Household Head ◽

Educational Levels ◽

Household Level ◽

Individual Level ◽

Rural Bangladesh ◽

Levels Of Use ◽

Cluster Variation ◽

The Individual ◽

Different Levels

This study in Bangladesh found that inter-cluster variation in the use of modern reversible methods of contraception was significantly attributable to the educational levels of the female family planning workers working in the clusters. Women belonging to clusters served by educated workers had a higher probability of being contraceptive users than those whose workers had only completed primary education. At the household level, important determinants of use were socioeconomic status and religion. At the individual level, the woman being the wife of the household head and having some education were positively related to her being a user. The model also found that inter-household variation was significantly greater than inter-cluster variation. Finally, the study concludes that after controlling for various covariates at all three levels, the clusters do not have significantly different levels of use of modern reversible methods of contraception. There are, however, some special areas where contraceptive use is dramatically low, and these contribute significantly to the observed inter-cluster variation.

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Testing The Effect of an Integrated-Intervention To Promote Access to Sexual and Reproductive Healthcare and Rights Among Women With Disabilities In Ghana: A Quasi-Experimental Study Protocol

10.21203/rs.3.rs-144242/v1 ◽

2021 ◽

Author(s):

John K. Ganle ◽

Charlotte Ofori ◽

Samuel Dery

Keyword(s):

Health Facility ◽

Control Group ◽

Local Health ◽

Sexually Active ◽

Individual Level ◽

The Third ◽

Health Facility Level ◽

Quasi Experimental ◽

Facility Level ◽

The Individual

Abstract Background: There is evidence that women with disabilities (WWDs) experience the most difficulty accessing and using sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable interventions to reach WWDs with essential SRHR services. This study aims to test the effect of an integrated health facility and individual-level intervention on access to SRHRs information and services among sexually active WWDs aged 15-49years in Ghana. Methods: A quasi-experimental study design with four arms will be implemented in four districts in the Northern region of Ghana to test the effect of three inter-related interventions. The inventions are (1) capacity building in disability-centred SRHRs information and service delivery for healthcare providers, (2) support for WWDs to access disability-unfriendly healthcare infrastructure, and (3) one-on-one regular SRHRs education, information provision, and referral. The first two interventions are at the health-facility level while the third one is at the individual/family level. The first arm of the experiment will expose eligible WWDs to all three interventions. In the second arm, WWDs will be exposed to only the two-health facility-level interventions. The third arm will expose WWDs to only the individual level intervention. The forth arm will constitute the control group. A total of 680 (170 in each arm) sexually active women with physical disability and visual impairments will take part in the study over a period of 12months. To assess the effect of the interventions on key study outcomes (i.e. awareness about, and use of modern contraceptive, ANC attendance, and skilled delivery among parous women), pre- and post-intervention surveys will be conducted. Difference-in-Difference analysis will be used to examine the effect of each intervention in comparison to the control group, while controlling for effect modifiers. Cost-effectiveness analyses will also be conducted on the three-intervention arms vis a vis changes in key outcome measures to identify which of the three interventions is likely to yield greater impact with lower costs. Discussion: Lack of access to SRHRs information and services for WWDs is not only a violation of their right to appropriate and quality SRH care but could also undermine efforts to achieve equitable healthcare access as envisaged under SDG 3. This research is expected to generate evidence to inform local health programmes to increase access to SRHRs among WWDs by strengthening local health system capacity to provide disability-sensitive SRHRs services.

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Modern contraceptive use among sexually active women aged 15–19 years in North-Western Tanzania: results from the Adolescent 360 (A360) baseline survey

BMJ Open ◽

10.1136/bmjopen-2019-030485 ◽

2019 ◽

Vol 9 (8) ◽

pp. e030485 ◽

Cited By ~ 7

Author(s):

Mussa Kelvin Nsanya ◽

Christina J Atchison ◽

Christian Bottomley ◽

Aoife Margaret Doyle ◽

Saidi H Kapiga

Keyword(s):

Marital Status ◽

Contraceptive Use ◽

Baseline Survey ◽

Modern Contraceptive ◽

Sexually Active ◽

Modern Contraception ◽

Adolescent Women ◽

Modern Contraceptive Use ◽

North Western ◽

Western Tanzania

ObjectivesTo describe differences in modern contraceptive use among adolescent women aged 15–19 years according to their marital status and to determine factors associated with modern contraceptive use among sexually active women in this population.DesignCross-sectional analysis of Adolescent 360 evaluation baseline survey.SettingThe 15 urban and semiurban wards of Ilemela district, Mwanza region, North-Western Tanzania.ParticipantsAdolescent women aged 15–19 years who were living in the study site from August 2017 to February 2018 and who provided informed consent. Women were classified as married if they had a husband or were living as married. Unmarried women were classified as sexually active if they reported having sexual intercourse in the last 12 months.Outcome measurePrevalence of modern contraceptive among adolescent women aged 15–19 years.ResultsData were available for 3511 women aged 15–19 years, of which 201 (5.7%) were married and 744 (22.5%) were unmarried-sexually active. We found strong evidence of differences in use of modern contraceptive methods according to marital status of adolescent women. Determinants of modern contraception use among unmarried-sexually active women were increasing age, increasing level of education, being in education, hearing of modern contraception from interpersonal sources or in the media in the last 12 months, perceiving partner and/or friends support for contraceptive use, as well as higher knowledge and self efficacy for contraception.ConclusionsSexual and reproductive health programmes aiming to increase uptake of modern contraceptives in this population of adolescent women should consider the importance of girl’s education and social support for contraceptive use particularly among unmarried-sexually active women.

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Contraceptive use in Eswatini: do contextual influences matter?

Journal of Biosocial Science ◽

10.1017/s0021932019000889 ◽

2020 ◽

Vol 53 (1) ◽

pp. 20-37

Author(s):

Clifford Odimegwu ◽

Garikayi B. Chemhaka

Keyword(s):

Rural Women ◽

Socioeconomic Development ◽

Contraceptive Use ◽

Community Level ◽

High Fertility ◽

Modern Contraceptive ◽

Community Factors ◽

Individual Level ◽

Modern Contraceptives ◽

The Individual

AbstractThis study sought to investigate the determinants of current use of modern contraceptives beyond the individual level in Eswatini (formerly Swaziland). Previous studies have overlooked the role of community characteristics such as socioeconomic development, women’s empowerment and fertility norms in shaping contraceptive use. Hierarchical structured subsample data of 4112 sexually experienced women from the 2007 Eswatini Demographic Health Survey were analysed using multilevel logistic regression to identify factors contributing to community/cluster variations in women’s current use of modern contraceptives. Less than half (44.2%) of the sexually active women were using modern contraceptive methods in 2007. At the community level, the odds of contraceptive use decreased for rural women (AOR = 0.82, 95% CI: 0.68–0.98) and among women residing in communities with high-fertility norms (AOR = 0.77, 95% CI: 0.66–0.89). After adjusting for both individual- and community-level factors, no community-level variables considered for the study were significantly associated with contraceptive use. The findings highlight in all four models, from the empty to full model, that there is a small and decreasing significant variation in women’s contraceptive use across communities (MOR, 1.37–1.17). In 2007, the findings suggest individual rather than community factors account for some contextual variability in contraceptive use. The study proposes the use of ethnographic techniques to unravel community factors that promote modern contraceptive use in Eswatini.

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Testing the effect of an integrated-intervention to promote access to sexual and reproductive healthcare and rights among women with disabilities in Ghana: a quasi-experimental study protocol

Reproductive Health ◽

10.1186/s12978-021-01253-1 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

John Kuumuori Ganle ◽

Charlotte Ofori ◽

Samuel Dery

Keyword(s):

Health Facility ◽

Control Group ◽

Local Health ◽

Sexually Active ◽

Individual Level ◽

The Third ◽

Health Facility Level ◽

Quasi Experimental ◽

Facility Level ◽

The Individual

Abstract Background There is evidence that women with disabilities (WWDs) experience the most difficulty accessing and using sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable interventions to reach WWDs with essential SRHR services. This study aims to test the effect of an integrated health facility and individual-level intervention on access to SRHRs information and services among sexually active WWDs aged 15–49 years in Ghana. Methods A quasi-experimental study design with four arms will be implemented in four districts in the Northern region of Ghana to test the effect of three inter-related interventions. The inventions are (1) capacity building in disability-centred SRHRs information and service delivery for healthcare providers, (2) support for WWDs to access disability-unfriendly healthcare infrastructure, and (3) one-on-one regular SRHRs education, information provision, and referral. The first two interventions are at the health-facility level while the third one is at the individual/family level. The first arm of the experiment will expose eligible WWDs to all three interventions. In the second arm, WWDs will be exposed to only the two-health facility-level interventions. The third arm will expose WWDs to only the individual level intervention. The forth arm will constitute the control group. A total of 680 (170 in each arm) sexually active women with physical disability and visual impairments will take part in the study over a period of 12 months. To assess the effect of the interventions on key study outcomes (i.e. awareness about, and use of modern contraceptive, ANC attendance, and skilled delivery among parous women), pre- and post-intervention surveys will be conducted. Difference-in-Difference analysis will be used to examine the effect of each intervention in comparison to the control group, while controlling for confounders. Cost-effectiveness analyses will also be conducted on the three-intervention arms vis a vis changes in key outcome measures to identify which of the three interventions is likely to yield greater impact with lower costs. Discussion Lack of access to SRHRs information and services for WWDs is not only a violation of their right to appropriate and quality SRH care but could also undermine efforts to achieve equitable healthcare access as envisaged under SDG 3. This research is expected to generate evidence to inform local health programmes to increase access to SRHRs among WWDs by strengthening local health system capacity to provide disability-sensitive SRHRs services. Trial registration Name of the registry: Pan African Clinical Trials Registry (PACTR). Trial ID: 14591. Date of registration: 02/01/2020. URL of trial registry record: https://pactr.samrc.ac.za/Researcher/TrialRegister.aspx?TrialID=14591

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Differential Effects of Competence and Morality on Self-Esteem at the Individual and the Collective Level

Social Psychology ◽

10.1027/1864-9335/a000410 ◽

2020 ◽

Vol 51 (3) ◽

pp. 183-198

Author(s):

Wiktor Soral ◽

Mirosław Kofta

Keyword(s):

Self Esteem ◽

Differential Effects ◽

Individual Level ◽

The Subject ◽

The Individual

Abstract. The importance of various trait dimensions explaining positive global self-esteem has been the subject of numerous studies. While some have provided support for the importance of agency, others have highlighted the importance of communion. This discrepancy can be explained, if one takes into account that people define and value their self both in individual and in collective terms. Two studies ( N = 367 and N = 263) examined the extent to which competence (an aspect of agency), morality, and sociability (the aspects of communion) promote high self-esteem at the individual and the collective level. In both studies, competence was the strongest predictor of self-esteem at the individual level, whereas morality was the strongest predictor of self-esteem at the collective level.

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Empirical analysis of trait models at the individual level

PsycEXTRA Dataset ◽

10.1037/e633912013-137 ◽

2004 ◽

Author(s):

James W. Grice

Keyword(s):

Empirical Analysis ◽

Individual Level ◽

The Individual

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Metonymy in Dance: Ballet Bunheads Take a Cognitive Turn

Dance Research ◽

10.3366/drs.2019.0251 ◽

2019 ◽

Vol 37 (1) ◽

pp. 18-34

Author(s):

Edward C. Warburton

Keyword(s):

Identity Formation ◽

Cognitive Science ◽

Artistic Development ◽

Individual Level ◽

Figures Of Speech ◽

Self Image ◽

Level I ◽

Dance Educators ◽

The Individual ◽

Metaphor And Metonymy

This essay considers metonymy in dance from the perspective of cognitive science. My goal is to unpack the roles of metaphor and metonymy in dance thought and action: how do they arise, how are they understood, how are they to be explained, and in what ways do they determine a person's doing of dance? The premise of this essay is that language matters at the cultural level and can be determinative at the individual level. I contend that some figures of speech, especially metonymic labels like ‘bunhead’, can not only discourage but dehumanize young dancers, treating them not as subjects who dance but as objects to be danced. The use of metonymy to sort young dancers may undermine the development of healthy self-image, impede strong identity formation, and retard creative-artistic development. The paper concludes with a discussion of the influence of metonymy in dance and implications for dance educators.

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