Predictors of Discontinuation of Modern Spacing Contraceptives in India

2020 ◽  
pp. 101053952098314
Author(s):  
Shahina Begum ◽  
Himanshu Chaurasia ◽  
Kusum V. Moray ◽  
Beena Joshi

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.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Oumer Abdulkadir Ebrahim ◽  
Ejigu Gebeye Zeleke ◽  
Atalay Goshu Muluneh

Abstract Background High fertility rates and unintended pregnancies are public health concerns of lower and middle income countries such as Ethiopia. Long acting contraceptives (LACs) take the lion’s share in reducing unintended pregnancies and high fertility rates. Despite their numerous advantages, the utilization of LACs remains low in Ethiopia. This study is aimed to explore the geographic variation and associated factors of long acting contraceptive use among reproductive-age women in Ethiopia. Methods This is a secondary data analysis of 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of weighted sample sizes of 10,439 reproductive-age women were included in the final analysis. To clean and analyze the none-spatial data Stata 14 was used while ArcGIS 10.6 and SaTScanTM version 9.6 software were used for spatial analysis. Multilevel Mixed-effect Logistic regression model was used to identify associated factors of LACs utilization. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to identify significant variables. Results Long acting contraceptive utilization was non-random (Moran’s I: 0.30, p-value < 0.01). Statistically, clusters with significant low utilization of LACs were found in Somali, Afar, Gambela, northern Amhara, eastern Oromia and western part of Southern Nations Nationalities and Peoples (SNNP) regions. Adjusting for other factors such as being married (AOR = 2.51, 95% CI: 1.29–4.87), having one to two (AOR = 2.14, 95% CI: 1.43–3.22), and three to four children (AOR = 1.68, 95% CI: 1.02–2.76), urban (AOR = 1.59, 95% CI: 1.16–2.19), want no more children (AOR = 1.40, 95% CI: 1.08–1.83), working status of women (AOR = 1.33, 95% CI: 1.07–1.65) increased the odds of LACs utilization. While previous history of abortion (AOR = 0.56, 95% CI: 0.39–0.80), and living in the pastoralist community (AOR = 0.22, 95% CI: 0.14–0.35) reduced the odds of LACs utilization in Ethiopia Conclusions Significant geographic variation of LACs utilization was observed in Ethiopia. Spots with Low LACs utilization were found in the eastern, north eastern and western part of the country. Socio-demographic and pregnancy related factors were significant determinants of LACs utilization. Designing intervention programs targeting the identified hot spot clusters, and variables that can hinder the utilization of LACs is very important to increase the utilization.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Delayehu Bekele ◽  
Feiruz Surur ◽  
Balkachew Nigatu ◽  
Alula Teklu ◽  
Tewodros Getinet ◽  
...  

Abstract Background Ethiopia is the second most populous country in Africa, known for its high fertility and low contraceptive use. The magnitude of contraceptive use in the emerging regions of the country is below the national average. However, there is a paucity of evidence regarding the reasons for low contraceptive use in these regions. Therefore, this study aimed to assess contraceptive use and associated factors in the emerging regions of Ethiopia. Methods For the quantitative part, a community based cross-sectional study was conducted among 2891 reproductive age women who were selected by multistage sampling technique. Data were collected face to face using an open data kit software, and STATA version 14 was used for data analysis. Frequencies, percentages, summary measures and tables were used to summarize and present the data. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with contraceptive use, by computing odds ratio with 95% confidence interval. Level of significance was considered at p-value < 0.05. For the qualitative part, phenomenological study was conducted among 252 health care workers and community members who were selected purposely. The data were collected by focused group discussions, in-depth interviews and key informant interviews. The data were audio-recorded in the local languages, and then translated to English verbatim. NVivo version 11 was used to analyze the data through a thematic analysis method. Results The overall contraceptive prevalence rate was 22.2%; with 11.7, 38.6, 25.5 and 8.8% for Afar, Benshangul Gumuz, Gambela and Somali Regions, respectively. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. Additionally, the qualitative study identified three themes as barriers to contraceptive use: individual, health care system and sociocultural factors. Conclusions Contraceptive prevalence rate was low in this study compared to the national average. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. From the qualitative aspect, individual, health care system and sociocultural factors were identified as barriers to contraceptive use. Therefore, the emerging regions of Ethiopia need special focus in increasing contraceptive use through behavioral influence/change.


Author(s):  
David R. Soriano-Moreno ◽  
Anderson N. Soriano-Moreno ◽  
Angela Mejia-Bustamante ◽  
Cristhian A. Guerrero-Ramirez ◽  
Carlos J. Toro-Huamanchumo

2014 ◽  
Vol 5 (1) ◽  
pp. 14-18
Author(s):  
Md Atiqur Rahman ◽  
Md Mahfuzar Rahman ◽  
Sazia Huq ◽  
Sardar Mahmud Hossain

Bangladesh is a country having high density of population in the world. Its fertility rate ranges from 4.1 to 5.49 and life expectancy is 66years while the total fertility rate of Asia is 2.2 and life expectancy 70 years. This descriptive type of cross sectional survey was carried out among 240 married women of reproductive age from July to December, 2012 in some villages of Keranigonj, Upazila, Dhaka. 73(31%) were practicing some methods of contraception, while 167 (69%) were not using it. OCP (Oral Contraceptive Pill) was the commonest method of contraception followed by Condoms 12(5%), Injectable 12(5%), Implant 12(5%) & Tubectomy 6(3%). None was found using IUCD and Traditional method ( withdrawal, rhythm method ) and emergency contraceptive method. The use of contraceptive was more common in grand multipara (p<0.01), >35 years old ladies (p<0.05). Non users of contraceptives in this study were 167 (69%) and the major reason for the non use was intention to have more children 53(31.46%) followed by pressure from the husband 21(12.35%), prohibition by the religion 18 (10.9%) and desire for son 17 (10.11%). Among the 73 contraceptive users 38 (52%) experienced side effects with the use of contraceptives. The commonest side effects were menstrual irregularities 17(23.8%) followed by change in body weight 8(11.19%). Frequency of contraceptive use was found comparatively low among rural married women despite high level of awareness. Desire for larger family, religious concerns and fear of side effects were the main factors responsible for non users. Religious scholars must play their role in clarifying many aspects regarding contraceptives. DOI: http://dx.doi.org/10.3329/akmmcj.v5i1.18767 Anwer Khan Modern Medical College Journal Vol. 5, No. 1: January 2014, Pages 14-18


2020 ◽  
Vol 10 (2) ◽  
pp. 101-110
Author(s):  
Yusri Kartika ◽  
Sudarto Ronoatmodjo

Abstract Background: Prevalence of obesity in adult females in Indonesia is 32,9% in 2013. Hormonal contraceptives (pills, injections and implants) are widely used by reproductive-age women in Indonesia, and the prevalence is 45%. Objective: The aim of this study is to identify whether reproductive-age women who use hormonal contraceptives are at risk of developing obesity compared to WUS who do not use hormonal contraceptives. Method: The design of this study is a cross sectional study using secondary data (5th Indonesia Family Life Survey, and the sample is reproductive-age women (15-49 years old) consisting of 6045 respondents. The variables of this study are obesity, hormonal contraceptive use, age, education, occupation, and duration of contraceptive use. Data were analysed by using Cox Regression. Result: The results of bivariate analysis showed that hormonal contaceptive use, age, education, occupation, and duration of contraceptive use were associated with obesity among reproductive-age womenand statistically significant (P-Value <0,05). Multivariate analysis showed that hormonal contraceptive use did not increase the risk of obesity among reproductive-age women in Indonesia (PR 0.939; CI 95% 0.869 - 1.013). Conclusion: The use of hormonal contraception did not increase the risk of obesity among reproductive-age women. Key words: Hormonal Contraception; Obesity; Reproductive Age-Women Abstrak Latar belakang : Prevalensi obesitas pada perempuan dewasa di Indonesia sebesar 32,9 persen pada tahun 2013. Kontrasepsi hormonal (pil, suntikan dan implan) merupakan jenis kontrasepsi yang paling banyak digunakan oleh wanita usia subur (WUS) di Indonesia, dengan prevalensi sebesar 45%. Tujuan : untuk mengetahui apakah wanita usia subur (WUS) yang menggunakan kontrasepsi hormonal berisiko mengalami obesitas dibandingkan WUS yang tidak menggunakan kontrasepsi hormonal.  Metode : Desain penelitian ini adalah studi cross- sectional dengan menggunakan data sekunder IFLS 5 tahun 2014. Sampel adalah WUS (15-49 tahun) sebanyak 6.045 responden. Variabel dalam penilitian ini adalah obesitas pada WUS, penggunaan kontrasepsi hormonal, umur, pendidikan, pekerjaan, serta lama penggunaan kontrasepsi. Analisis data yang digunakan adalah Cox Regression. Hasil : Hasil analisis bivariat menunjukkan bahwa variabel penggunaan kontrasepsi hormonal, umur, pendidikan dan status pekerjaan, serta  lama penggunaan kontrasepsi berhubungan dengan obesitas pada WUS (p-value <0,05). Analisis multivariat menunjukkan bahwa penggunaan kontrasepsi hormonal tidak meningkatkan risiko obesitas secara bermakna pada WUS di Indonesia (PR 0,939; CI 95% 0,869 – 1,013). Kesimpulan: Penggunaan kontrasepsi hormonal tidak meningkatkan risiko WUS untuk mengalami obesitas.   Kata kunci: Kontrasepsi Hormonal; Obesitas; Wanita Usia Subur


Author(s):  
M. A. Rashidova ◽  
L. F. Sholokhov ◽  
M. A. Darenskaya ◽  
S. I. Kolesnikov ◽  
L. I. Kolesnikova

Background: Our previous study of the lipid peroxidation and antioxidant defense system (LPO-AOS) state in women with chronic viral hepatitis (CVH) showed the content of fat-soluble vitamin alpha tocopherol significant reduction. Reproductive health of women with CVH needs special attention. The objectives of this study was to determine the frequency of menstrual disorders in the group of women with CVH with marked alpha tocopherol insufficiency. Study Design:  A case-control study. Place and Duration of Study: A study was conducted at Scientific Centre for Family Health and Human Reproduction Problems and in the hepatological department of the Irkutsk clinical hospital of infectious diseases from 2010 to 2014. This work was performed with the use of equipment of Collective research centre “Center for the development of progressive personalized technologies for health” SC FHHRP, Irkutsk. Methods and Results: Our study included 44 reproductive age women with CVH and comparable age 28 healthy women. All women underwent clinical examination and questionary survey. We found alpha tocopherol insufficiency in 95.5% cases of patients with CVH and menstrual disorders. Conclusion: Our results suggest that menstrual disorders in patients with CVH may be associated with alpha tocopherol insufficiency.


2019 ◽  
Vol 3 ◽  
pp. 7 ◽  
Author(s):  
Obasanjo Afolabi Bolarinwa ◽  
Olalekan Seun Olagunju

Background: Over a month when contraception is used, approximately 48% of unintended pregnancies occur as a result of human error, which is largely due to incorrect use, poor adherence and/or technology failure. Long-acting reversible contraceptive (LARC) methods have been developed to bridge this gap because it’s not dependent on compliance with a pill-taking regimen; remembering to change patch or ring; or fixing an appointment with physicians. The main aim of this study is to examine the characteristics of women associated with use of LARC and also to examine the relationship between knowledge of LARC and its current use. Methods: This study assessed the PMA2020 secondary dataset using female datasets from PMA 2016 (Round 3) exercise. PMA 2016 was a survey carried out in seven states of Nigeria. The target population for this study was women of reproductive age (15-49 years) currently using any method of contraception prior to the survey. The weighted sample size of women meeting inclusion criteria in this study is 1927. The data were analyzed using frequency distribution, chi-square and logistic regression. Results: The results showed that 21.0% of women were using traditional methods. Concerning LARC methods, the table showed that 14.8% of the sampled women were using LARC methods. Findings further revealed that at both levels of analysis there is a significant relationship (P<0.05 and P=0.00 for binary and multivariable logistic regression, respectively) between knowledge of LARCs and uses in this study. This means that the use of LARC is being influenced by its knowledge among women of reproductive age in Nigeria. Conclusions: This study concludes that 14.8% of women using any methods of contraceptive were using LARC. Additionally, after controlling for other confounding factors, level of education, age of women, household wealth and number of living children were significantly associated with using LARC.


2020 ◽  
Vol 3 ◽  
pp. 7
Author(s):  
Obasanjo Afolabi Bolarinwa ◽  
Olalekan Seun Olagunju

Background: Approximately 48% of unintended pregnancies occur as a result of contraceptive failure around the world, which is largely due to incorrect use, poor adherence and/or technology failure. Long-acting reversible contraceptive (LARC) methods have been developed to close this gap because it’s not dependent on compliance with a pill-taking regimen; remembering to change patch or ring; or fixing an appointment with physicians. The main aim of this study is to identify the factors influencing the women associated with use of LARC and to examine the relationship between knowledge of LARC and its current use. Methods: This study assessed the PMA2020 methodology and secondary dataset using female datasets from PMA 2016 (Round 3) exercise. PMA 2016 was a survey carried out in seven states of Nigeria. The target population for this study was women of reproductive age (15-49 years) currently using contraception prior to the survey. The sample size of women meeting inclusion criteria in this study was 1927. The data were analyzed using frequency distribution, chi-square and logistic regression at 5% level of significant. Results: The results showed that 21.0% of women were using traditional methods. Concerning LARC methods, the table showed that 14.8% of the sampled women were using LARC methods. Findings further showed that at both levels of analyses there is a significant relationship (P<0.05 and P=0.00 for binary and multivariable logistic regression, respectively) between knowledge of LARCs and uses in this study. This means that knowledge of LARC & other socio-demographic variables among women of reproductive age in Nigeria can influence the use of it. Conclusions: From the result of the study we concluded that 14.8% of women using contraception were using LARC. Additionally, level of education, age of women, household wealth and number of living children were significantly associated with using LARC.


2020 ◽  
Author(s):  
Ganesh Kumar Saya ◽  
Kariyarath Cheriyath Premarajan ◽  
Gautam Roy ◽  
Sonali Sarkar ◽  
Sitanshu Sekhar Kar ◽  
...  

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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