Belief System: A Barrier to the Use of Modern Contraceptives among the Idoma of Benue State, North Central Nigeria

2019 ◽  
Vol 55 (4) ◽  
pp. 600-616
Author(s):  
Chiemezie Scholastica Atama ◽  
Uzoma Odera Okoye ◽  
Amelia Ngozi Odo ◽  
Aloysius Odii ◽  
Uche Teresa Okonkwo

Despite the benefit of modern contraception, its use remains low in Nigeria. This study examined belief system as a barrier to the use of modern contraceptives among the Idoma of Benue State, North Central Nigeria. Questionnaire ( n = 1107), in-depth interview ( n = 6) and focus group discussion ( n = 52) were used to collect data from three local government areas (LGAs). The results showed high levels of knowledge (88.0%), however, only 37.8% used modern contraceptives. The male condom had the highest percentage use (56.7%). Chi-square results showed that LGA, education and occupation were significantly related to the use of modern contraceptives. Being of greater age increased the likelihood of use, whereas higher levels of education and income decreased the likelihood of modern contraceptive use ( p < 0.05). Qualitative data indicated that married women were expected to eschew modern contraceptives due to their belief in Alekwu, the community deity. Designing interventions that are culturally specific could promote use of modern contraceptives among the group.

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah

Abstract Background The use of modern contraceptives among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) remains an issue that needs urgent attention. This present study assesses the individual and contextual factors associated with modern contraceptive use among AGYW in SSA. Methods Data for this study was obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 29 countries in SSA. Data were analysed with Stata version 14.2 by employing both Pearson’s chi-square test of independence and a multilevel binary logistic regression. The selection of variables for the multilevel models was based on their statistical significance at the chi-square test at a p < 0.05. Model fitness for the multilevel models was checked using the log likelihood ratios and Akaike’s Information Criterion (AIC) and the results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results It was found that 24.7% of AGYW in SSA use modern contraceptives. In terms of the individual level factors, the study showed that AGYW aged 15–19 [aOR = 0.86, CI = 0.83–0.90], those who were married [aOR = 0.83, CI = 0.79–0.87], Muslims [aOR = 0.59, CI = 0.57–0.62], working [aOR = 0.92, CI = 0.89–0.95], those who had no child [aOR = 0.44, CI = 0.42–0.47], those who had no exposure to newspaper/magazine [aOR = 0.44, CI = 0.63–0.71] and radio [aOR = 0.82, CI = 0.78–0.86] had lower odds of using modern contraceptives. Conversely, the use of modern contraceptives was high among AGYW whose age at first sex was 15–19 years [aOR = 1.20, CI = 1.12–1.28]. With the contextual factors, the odds of using modern contraceptives was low among AGYW who lived in rural areas [aOR = 0.89, CI = 0.85–0.93] and in communities with low literacy level [aOR = 0.73, CI = 0.70–0.77] and low socio-economic status [aOR = 0.69, CI = 0.65–0.73]. Conclusion Several individual and contextual factors are associated with modern contraceptive use among AGYW in SSA. Therefore, Governments in the various countries considered in this study should intensify mass education on the use of modern contraceptives. This education should be more centered on AGYW who are in socio-economically disadvantaged communities, those who are not married, Muslims, those with high parity and high fertility preferences and those who are working.


2020 ◽  
Author(s):  
Sylvain Y. M. SOME ◽  
Christy Pu ◽  
Song-Lih Huang

Abstract Background In Burkina Faso, women still have difficulty satisfying their family planning demand because of the patriarchal and gender-unequal society. Despite evidence that women’s empowerment can help, few studies have measured its impact at both community and household levels. Taking into account these two parameters, we looked into the association between women’s empowerment and modern contraception use among Married Women of Reproductive Age (MWRA) with no desire for having children in Burkina Faso. Methods Using the 2010 Demographic and Health Survey (DHS), we analyzed data from 4714 MWRA with family planning needs from 573 communities. Indicators of gender equality at the community level were composed of aggregated variables for each primary sampling unit, and domains of women’s agency in households matters were derived with principal component analysis. A multilevel logistic regression model was used to gauge the effects of empowerment on modern contraceptives use adjusted for household socioeconomic status and demographics of women. Results Among MWRA, 30.8% satisfied their demand for family planning using modern methods. At the community level, higher women’s assets ownership (aOR 1.26, CI 1.04 - 1.54), secondary education (aOR 1.45, OR 1.08 - 1.64), and exposure to family planning messages (aOR 1.33, CI 1.08 - 1.64) were associated with more modern contraceptive use; higher ideal number of children was negatively associated (aOR 0.76, CI 0.61 - 0.95). Unexpectedly, higher community prevalence of female genital mutilation was positively associated with contraceptive use (aOR 1.25, CI 1.03-1.52). Women’s agency in household matters, including opposing domestic violence, involved with decisions and enjoying freedom in seeking healthcare were positively associated with use, but only the last domain remained significant in multilevel analysis (aOR 1.29, CI 1.08 - 1.54). Living in richer household, being older, and having secondary education level were also positively associated with modern contraceptive use. Conclusion Gender equality at the community level and women’s situation in the household constitute the context in which women’s demand for family planning is determined. Therefore, promoting gender equality and ensuring women’s entitlement to make life choices have the potential to increase modern contraceptive coverage along with improved life conditions.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Nabamallika Dehingia ◽  
Anvita Dixit ◽  
Sarah Averbach ◽  
Vikas Choudhry ◽  
Arnab Dey ◽  
...  

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.


2019 ◽  
Vol 3 ◽  
pp. 627
Author(s):  
Victor Chima ◽  
Oluwatobi Abel Alawode

Background: The world currently has the highest number of adolescents in all of history. Africa is home to quite a number of them, with most of these adolescents in Africa live in rural areas where they are more disadvantaged and their reproductive decisions could have telling impacts on their lives, family planning (contraception) has been identified as important to avoid such impacts. Factors associated with the use of modern contraceptives among female adolescents have been extensively researched but the importance of mass media family planning messages on modern contraceptives use among female adolescents in rural Nigeria is under-researched, hence this study. Method: This paper uses the 2013 Nigeria Demographic and Health Survey (NDHS) data with a weighted sample size (n=4473) to examine the association between exposure to family planning messages and use of modern contraceptives among female adolescents in rural Nigeria. Results: Findings indicated that exposure to family planning messages on radio and television were significantly associated with modern contraceptive use, however, educational attainment and region of residence were other factors that influenced modern contraceptive use.. Conclusion: The study concludes that family planning messages through mass media especially radio and television are associated with modern contraceptives use among rural adolescents. The continued use of mass media would enhance opportunities to achieve more results, however, other interventions addressing education with objectives of closing the rural-urban socio-economic gap should be encouraged also, as these factors play critical roles in improving uptake of family planning among rural adolescents.  Further, messages on modern contraceptive use should be sensitive to regional divides in terms of content and delivery.


2019 ◽  
Author(s):  
Getachew Andualem Belete ◽  
Almaz Aklilu Getu ◽  
Getahun Belay Gela

Abstract Background: The postpartum period is an important entry point for family planning service providers to reduce unintended and too closely spaced pregnancy. A postpartum modern contraceptive service is one of the recommended public health interventions for reducing maternal and child morbidity and mortalities. However, In Ethiopia modern contraceptive use during the postpartum period is low; resulting in unintended pregnancies and unwanted childbearing . there for this study was done to assess utilization and associated factors of modern contraceptives during the postpartum period among women who gave birth in the last 12 months in Injibara Town Awi Zone, North-Western Ethiopia. Methods: A Community based cross-sectional study design was conducted from March 01 to 15/2019 on 400 women who gave birth in the last 12 months preceding the survey. A simple random sampling technique was used to recruit study subjects. Data was collected using interviewer-administered pretested and structured questionnaires. Data were entered using Epi data 3.5 and exported to SPSS version 23 for analysis. The association between variables was analyzed using Bivariate and multivariable logistic regression models and p-value < 0.05 at 95% Confidence interval was considered as statistically significant. Result: The prevalence of modern contraceptive utilization was 58.5% (95% CI: 53.5- 63%) among postpartum mothers. Secondary school and higher educational levels [AOR= 5.02; 95% CI (1.53-16.47)],[AOR= 4.25; 95% CI:(1.32-13.64) respectively)], previous history of abortion [AOR= 3.93; 95%, CI: (1.43-10.84)], having three and four antenatal care visit [AOR= 4.74; 95%, CI: (1.94-11.54)] [AOR= 5.9; 95%, CI: (2.42-14.39) respectively], family planning counselling during antenatal care [AOR=2.81; 95% ,CI: (1.63- 4.86)], having postnatal care [AOR =1.79, 95%, CI: (1.09-2.96)], menses returning after birth [AOR=2.84, 95% CI: (1.77- 4.57)] and resuming sexual activity [AOR= 2.86, 95% CI: (1.71-4.78)] were factors affecting contraceptive use in postpartum period. Conclusion : The prevalence of modern contraceptive use among postpartum women was found to be high in Injibara town. Therefore, strengthen family planning counseling during antenatal care and postnatal care to reduce the missed opportunity of postpartum women to get family planning methods, especially long-acting reversible contraceptives.


2020 ◽  
Author(s):  
Ritah Bakesiima ◽  
Amanda Cleeve ◽  
Elin Larsson ◽  
James K. Tumwine ◽  
Grace Ndeezi ◽  
...  

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.


2021 ◽  
Author(s):  
Jully M Chilambwe ◽  
Tyson Chipokoso ◽  
Melvin Mwansa ◽  
Mowa Zambwe

OBJECTIVE: This study aimed to describe the modern contraceptive use by women of childbearing age in Zambia. METHODS: The study was retrospective descriptive observational design. Secondary data of 13,683 women aged 15 - 49 who participated in the ZDHS 2018 were analysed. Data were extracted using a data extraction tool and analysed using IBM SPSS Statistics 26. Since the ZDHS 2018 used numeric data, the study was quantitative research. The study examined the association between demographic and socioeconomic characteristics and modern contraceptive use using Pearson, Chi-Square and multiple logistic regression. RESULTS: In Zambia, the most used type of modern contraception were injectables (52%). Female condom is the most known type of modern contraceptives (55%). The significant factors associated with the use of modern contraceptives were age group 25-29 and 45-49 (AOR=1.41 95% CI=1.05, 1.90) and (AOR=0.41, 95% CI 0.28, 0.62), respectively. Being married and widowed (AOR=2.18, 95% CI 1.75, 2.71), and (AOR=0.50, 95% CI 0.31, 0.78), respectively. The likelihood utilization varied across the gradient of parity, educational attainment, and wealth. Educated and wealthy women were more likely to use modern methods compared to women with no education and in the poor category, respectively. CONCLUSION: The study established that factors such as age, marital status, the number of living children (parity), religion, and education level and wealth index remain significant issues in determining modern contraceptive use among childbearing women aged 15 to 49 in Zambia. Therefore, concerted efforts are required to increase use of modern methods of contraception by addressing these determinants.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0232504
Author(s):  
Anooj Pattnaik ◽  
Diwakar Mohan ◽  
Amy Tsui ◽  
Sam Chipokosa ◽  
Hans Katengeza ◽  
...  

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.


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

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.


2021 ◽  
Vol 5 ◽  
pp. 80
Author(s):  
Saleh Babazadeh ◽  
Julie Hearnandez ◽  
Philip Anglewicz ◽  
Jane Bertrand

Background: Spatial access has a direct effect on health service utilization in many settings. Distance to health facility has proven to affect family planning (FP) service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay. This study analyzed the significance of proximity to family planning services, service availability, and quality of family planning services on modern contraceptive use in Kinshasa, Democratic Republic of the Congo. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa from PMA2020 between 2014 and 2016. We used GPS coordinates to calculate the distance between the health facilities and households. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: 10,968 women were interviewed over four rounds of data collection. Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are strong barriers for women in Kinshasa to use modern contraceptives. Proximity to quality services did not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusions: This study notes that barriers other than proximity to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.


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