scholarly journals Predictors of contraceptive method discontinuation among adolescent and young women in three West African countries (Burkina Faso, Mali, and Niger)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adja Mariam Ouédraogo ◽  
Adama Baguiya ◽  
Rachidatou Compaoré ◽  
Kadari Cissé ◽  
Désiré Lucien Dahourou ◽  
...  
Keyword(s):  
Marital Status ◽  
Burkina Faso ◽  
Young Women ◽  
Contraceptive Method ◽  
Occupation Number ◽  
Education Level ◽  
Demographic And Health Surveys ◽  
Contraceptive Methods ◽  
Unintended Pregnancies ◽  
Contraceptive Discontinuation

Abstract Background The effective use of contraception among adolescents and young women can reduce the risk of unintended pregnancies. However, the prevalence of contraceptive use remains low in this age group. The objective of this study was to estimate the rate of contraceptive method discontinuation among adolescents and young women and to identify its associated factors in Burkina Faso, Mali, and Niger. Method This was a secondary analysis of data from Demographic and Health Surveys of Burkina Faso (2010), Mali (2012–2013), and Niger (2012). The dependent variable was the time to discontinuation of contraceptive methods. Independent variables were represented by sociodemographic, socioeconomic, and cultural characteristics. Mixed-effects survival analysis with proportional hazards was used to identify the predictors. Results A total of 2,264 adolescents and young women aged 15 to 24 years were included in this analysis, comprising 1,100 in Burkina Faso, 491 in Mali, and 673 in Niger. Over the last five years, the overall contraceptive discontinuation rate was 68.7% (50.1% in Burkina Faso, 59.6% in Mali, and 96.8% in Niger). At the individual level, in Burkina Faso, occupation (aHR = 0.33), number of living children (aHR = 2.17), marital status (aHR = 2.93), and region (aHR = 0.54) were associated with contraceptive discontinuation. Except for education and marital status, we found the same factors in Mali. In Niger, a women's education level (aHR = 1.47) and her partner (aHR = 0.52) were associated with discontinuation. At the community level, the region of origin was associated with discontinuation of contraceptive methods. Conclusion Most adolescents and young women experienced at least one episode of discontinuation. Discontinuation of contraceptive methods is associated with the level of education, occupation, number of children, marital status, and desire for children with the spouse. Promotion of contraceptive interventions should target adolescents, young women, and their partners, as well as those with a low education level or in a union.

scholarly journals Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial

2020 ◽  
Author(s):  
Abou Coulibaly ◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
Rachel Yodi ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction : Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

scholarly journals Discontinuation and Switching of Postpartum Contraceptive Methods Over Twelve Months in Burkina Faso and the DRC: A Secondary Analysis of the Yam-Daabo trial

2020 ◽  
Author(s):  
Abou Coulibaly ◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
Rachel Yodi ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction: Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

scholarly journals An interactive website to aid young women’s choice of contraception: feasibility and efficacy RCT

2020 ◽  
Vol 24 (56) ◽  
pp. 1-44
Author(s):  
Judith Stephenson ◽  
Julia V Bailey ◽  
Ann Blandford ◽  
Nataliya Brima ◽  
Andrew Copas ◽  
...  
Keyword(s):  
Young Women ◽  
Contraceptive Method ◽  
Randomised Trial ◽  
Informed Choice ◽  
Feasibility Trial ◽  
Control Group ◽  
Contraceptive Methods ◽  
Efficacy Trial ◽  
Long Acting

Background Effective use of contraception can reduce numbers of unintended pregnancies, but misunderstandings and concerns about contraception abound. Increasingly, women seek health-care information online. Objectives To develop an interactive website to aid informed choice of contraceptive method, including long-acting reversible contraception (Phase I), and test its effectiveness in a parallel, single-blind randomised trial (Phase II). Approval came from London – Camden & King’s Cross Research Ethics Committee (reference 17/LO/0112). Setting and participants For both phases, women aged 15–30 years were recruited from general practice, sexual health services, maternity services, community pharmacies and an abortion service. Design In Phase I, we conducted three systematic literature reviews, a review of YouTube (YouTube, LLC, San Bruno, CA, USA) videos about contraception, and focus groups and interviews with young women to explore barriers to and concerns and misperceptions about contraception. We then iteratively co-designed an interactive website, Contraception Choices [URL: www.contraceptionchoices.org (accessed June 2020)], with young women and a software company. In Phase II, we evaluated the website through a randomised trial that began as a feasibility trial. Early demand for Contraception Choices stimulated a design change from a feasibility to an efficacy trial, with follow-up for clinical outcomes at 3 and 6 months. A randomisation list was incorporated into the trial software program to allocate participants to the intervention (website) or control group (standard care). Intervention Contraception Choices is a co-designed, evidence-based, interactive website to aid informed choice of contraception. It provides information about different methods, addresses common concerns and offers tailored contraceptive options in response to individual preferences. Main outcome measures Qualitative – participant views and experience of the intervention, assessed through qualitative interviews. Quantitative primary outcomes – follow-up rate at 6 months in the initial feasibility trial, using a long-acting reversible contraception method, and satisfaction with contraceptive method at 6 months in the efficacy trial. Results A total of 927 women were randomised online to the website (n = 464) or control group (n = 463), of whom 739 (80%) provided follow-up data at 6 months [786 women (85%) provided data at 3 and/or 6 months that were included in the analysis of primary outcomes]. There was little difference between groups in the proportion using long-acting reversible contraception at 6 months [30.4% intervention vs. 31.0% control, adjusted odds ratio after imputation 0.87 (95% confidence interval 0.60 to 1.27)] or in satisfaction with contraceptive method [proportion being ‘satisfied’ or ‘very satisfied’, 82.6% intervention vs. 82.1% control, adjusted odds ratio 0.93 (95% confidence interval 0.69 to 1.25)]. Qualitative evaluation indicated highly positive views about the website and increased knowledge of contraceptive methods that could dispel misperceptions. Women appreciated having information tailored to their specific needs and felt better prepared before consultations. Limitations We did not include intermediate measures, such as knowledge of contraceptive methods, intention to change method or confidence in discussing contraception with a health-care professional, which may have indicated other benefits of using the website. In future, the website should be studied in different settings (e.g. schools and in routine practice) to see whether or not it improves the quality or efficiency of contraceptive consultations. Conclusions Our systematic review indicated wide-ranging influences on women’s use of contraception globally. The website, Contraception Choices, was very popular with young women and contraception service providers. It was not associated with statistically significant differences in use of long-acting reversible contraception or satisfaction with contraceptive method at 6 months. Trial registration Current Controlled Trials ISRCTN13247829. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 56. See the NIHR Journals Library website for further project information.

Contraceptive use and its determinants among adolescent women in Tigray, Ethiopia: a multilevel modeling

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Haftom Temesgen Abebe ◽  
Abate Bekelle Belachew ◽  
Letekirstos Gebreegziabher Gebretsadik ◽  
Yodit Zewdie Berhe ◽  
Haftu Berhe Gebru ◽  
...  
Keyword(s):  
Marital Status ◽  
Health Facility ◽  
Educational Level ◽  
Contraceptive Method ◽  
Contraceptive Use ◽  
Contraceptive Methods ◽  
Factors Affecting ◽  
Adolescent Women ◽  
Visit Duration ◽  
History Of

AbstractBackgroundAdolescent women are central for intergenerational health of human populations. Adolescent women are the most vulnerable to a range of reproductive health problems. One of the leading causes of death for adolescent women is complications from childbirth and pregnancy. Contraceptive prevents the occurrence of unwanted pregnancies and its complications, thus potentially lower the death rate for adolescent women. However, contraceptive use assumed to be affected by multilevel factors thus needs statistical modeling that account the effect of these factors. Understanding multilevel factors affecting contraceptive use among adolescent women is important for improving the access to and quality of health services.ObjectiveThe aim of this study was to assess the contraceptive use and its multilevel determinants among adolescent women in Tigray region.MethodsA community based cross-sectional study was conducted. Women who were 15–19 years of age residing in the selected households at the time of data collection were included in the survey. Multi-stage cluster sampling was used to select study units. A multivariable two-level mixed effect binary logistic regression model was fitted to assess the effect of the explanatory variables on contraceptive use.ResultsA total of 1,755 adolescent women were participated. Of these 12.3% were contraceptive users. Pills (40%) and intrauterine device (30%) were commonly used contraceptive methods. Educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media were the most important determinants for use of contraceptive among adolescent women. Study participants who were not at school currently had more likely to use contraceptive methods compared to those who were at school (Adjusted odds ratio [AOR]=2.05; 95% confidence interval [CI]: 1.502, 4.183). Similarly, adolescent women who had no history of health facility visit had less likely to use contraceptive methods than those have history of health facility visit (AOR=0.057; 95% CI: 0.034, 0.096). Adolescent women who heard of contraceptive through median had two times (AOR=2.103; 95% CI: 1.207, 3.664) more likely to use contraceptive methods than those not heard contraceptive through media.Conclusion and recommendationThe factors affecting use of contraceptive method among adolescent women were educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media. This study recommends that in order to increase use of contraceptive method among adolescent women, interventions should continue like the promotion of contraceptive methods through media.

scholarly journals Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the Democratic Republic of the Congo: a secondary analysis of the Yam Daabo trial

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Abou Coulibaly ◽  
◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction Women who use contraceptive methods sometimes stop early, use methods intermittently, or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use. Methods We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching. Results In total, 637 out of the 1120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. One hundred seventy-nine women of the control group used modern methods compared to 279 women of the intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, modern methods’ discontinuation was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8–8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p < 0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women. Conclusion The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also essential to set up specific actions targeting women’s partners and influential people in the community to counter inhibiting beliefs. Trial registration Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

scholarly journals Use of Contraceptive Methods among Young Married Women in Nepal

2018 ◽  
Vol 32 (2) ◽  
pp. 75-96 ◽  
Author(s):  
Kamala Devi Lamichhane
Keyword(s):  
Young Women ◽  
Contraceptive Use ◽  
Economic Status ◽  
Married Women ◽  
Contraceptive Methods ◽  
Wealth Status ◽  
Fertility Preference ◽  
Number Of Children ◽  
Unintended Pregnancies ◽  
Living Children

Nepal has a fairly high adolescent fertility rate and low use of contraception. Lack of contraceptive use is a major contributor to the high rates of unintended pregnancies amongst youth. There is also lack of specific studies dealing with contraceptive behavior among young married women. This study examines the use and determinants of contraceptive methods over the time period of 15 years (2001-2016) among young women in Nepal. Trend and bi-vatiate analysis of this study is based on the Nepal Demographic and Health Survey (NDHS), 2001, 2006, 2011 and 2016 data. The multivariate analysis is based on NDHS 2016 data of 2059 currently married non-pregnant young women aged 15-24 years. Logistic regression is used to assess the net effect of independent variables on dependent variable. The study shows that the contraceptive prevalence rate of young women is only 34 percent. Number of living children, spousal separation, husband education, women, occupation, wealth status, caste/ethnic affiliation, fertility preference, decision making status, ideal number of children they prefer and media exposure, are statistically associated to the use of contraception among young women in Nepal. There is a need to strengthen income generating activities so as to improve young women's socio-economic status which will translate into female economic and social empowerment hence ability to discuss sexuality related issues. Family planning programmes should be designed so as to address the contraceptive need of young women especially the low parity and Muslim adolescents.

scholarly journals Contraceptive Method Utilization and Determinant Factors among Young Women (15-24) in Ethiopia: A Mixed-Effects Multilevel Logistic Regression Analysis of the Performance Monitoring for Action 2018 Household Survey

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Gurmesa Tura Debelew ◽  
Mahilet Berhanu Habte
Keyword(s):  
Logistic Regression ◽  
Young Women ◽  
Contraceptive Method ◽  
Performance Monitoring ◽  
Unmet Need ◽  
Mixed Effects ◽  
Multilevel Logistic Regression ◽  
Contraceptive Methods ◽  
Determinant Factors ◽  
The Status

Despite highly effective modern contraceptive methods (both short and long acting) are made widely available and accessible globally, their utilization remains low among young women in low- and middle-income countries, including Ethiopia. Hence, this study is aimed at determining its status and identifying the determinant factors by using nationally representative data. A multilevel analysis of the nationwide Performance Monitoring for Action 2018 of Ethiopia round 6 data, collected from June to July, 2018, was conducted. A total of 982 both married and unmarried young women (15-24) were included in the analysis. Descriptive statistics was used to describe the status of contraceptive method utilization and unmet need across regions. A mixed-effects multilevel logistic regression model was used to identify the determinants of the contraceptive method utilization. Adjusted odds ratios with corresponding 95% confidence intervals were used to show the significance of the associations at p < 0.05 . The status of contraceptive method utilization was 54.8% (95% CI: 51.7%, 57.9%), and 18.6% (95% CI: 16.3%, 21.2%) had unmet need. Afar (12.3%), Harari (12.5%), and Ethiopian Somali (20.0%) regions had the lowest contraceptive method utilization. Wealth quintiles and religion were the higher level variables affecting contraceptive method utilization among the young women. Age, marital status, parity, future birth intention, and knowledge of contraceptive methods were the individual level factors identified as determinants of contraceptive method use among the young women. In conclusion, the status of contraceptive method utilization among the young women in Ethiopia is promising as compared to the national target of 55% for 2020; however, still high unmet need exists. The factors also exist both at the contextual and at individual levels. Hence, multilevel interventions need to be in place giving special emphasis to the low performing regions. Besides, region-specific behavioral interventions and family planning services that will be able to reach the young women need to be designed.

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