Factors affecting modern contraceptive use among fecund young women in Bangladesh: does couples’ joint participation in household decision making matter?

Objective(s)Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.Study designA nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).SettingUganda.ParticipantsAll women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.Primary outcome measuresModern contraceptive use.ResultsOverall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).Conclusion(s)Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.

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The effect of Women’s decision-making autonomy on family Planning acces in Senegal in 2017

European Journal of Public Health ◽

10.1093/eurpub/ckz186.125 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

N M Sougou ◽

O Bassoum ◽

M M M M Leye ◽

A Tal-Dia

Keyword(s):

Decision Making ◽

Family Planning ◽

Contraceptive Method ◽

Contraceptive Use ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Modern Contraceptive Method ◽

Significant Difference ◽

Modern Contraceptive Use ◽

The Impact

Abstract Background The impact of access to decision-making on women’s health in the choice of fertility control has been highlighted by research. The aim of this study was to analyze the impact of access to decision-making for women’s health on access to family planning in Senegal in 2017. Methods The analyses of this study had been done on the Individual Records file of Senegal’s Demographic Health Survey 2017. This data covered 8865 women aged 15 to 49 years. The propensity scores matching method had been done. The variable access to the decision was considered as the variable of interest. Matching was done using variables that were not modified by the effect of the treatment. These were religion and socio-economic level. The outcome variables were modern contraceptive use, the existence of unmet needs and the type of modern contraceptive method used. Significance was at 5%. The condition of common support had been respected. The analysis was done with the STATA.15 software. Results Six percent (6.26%) of women could decide about their health on their own. Access to decision-making increased significantly with the woman’s age (p < 0.05). Fifteen percent (15.24%) women used a modern contraceptive method. Women using a contraceptive method were more numerous in the group with access to decision-making (29.43%) with a significant difference with the other group of 8% (p < 0.05). After matching, there was no significant difference between women in terms of modern contraceptive use and the existence of unmet needs. There was a significant difference in the type of contraceptive method used between the two groups of women. These differences were 23.17% for Intra Uterine Device, 52.98% for injections, 08.9% for implants and 10.79% for condoms. Conclusions Access to decision-making for health would facilitate women’s access to long-acting contraceptive methods. These findings show the importance of implementing gender transformative interventions in improving access to family planning. Key messages Access to decision-making for health would allow better access to modern contraceptive methods, especially those with a long duration of action. Better consideration of gender disparity reduction could improve access to family planning in Senegal.

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Male-Female Concordance in Reported Involvement of Women in Contraceptive Decision-Making and Its Association With Modern Contraceptive Use Among Couples in Rural Maharashtra, India.

10.21203/rs.3.rs-358822/v1 ◽

2021 ◽

Author(s):

Anvita Dixit ◽

Nicole E Johns ◽

Mohan Ghule ◽

Madhusudana Battala ◽

Shahina Begum ◽

...

Keyword(s):

Decision Making ◽

Partner Violence ◽

Contraceptive Use ◽

Unmet Need ◽

Married Couples ◽

Cross Sectional Study ◽

Modern Contraceptive ◽

Cross Sectional ◽

Lower Odds ◽

Modern Contraceptive Use

Abstract Objective: Women’s involvement in contraceptive decision-making increases contraceptive use and reduces unmet need, but study of this has been limited to women’s self-reports. Less research is available examining couple concordance and women’s involvement in contraceptive decision-making as reported by both men and women. Study Design: We carried out a cross-sectional study using data from rural India (N=961 young married couples). Using multivariable regression we examined the association between concordance or discordance in spousal reports of wife’s involvement in contraceptive decision-making and modern contraceptive use, adjusting for demographics, intimate partner violence, and contraceptive use discussion. Results: More than one third (38.3%) of women reported current modern contraceptive use. Report of women’s involvement in contraceptive decision-making showed 70.3% of couples agreed that women were involved, jointly or alone (categorized as Concordant 1), 4.2% agreed women were not involved (categorized at Concordant 2), 13.2% had women report involvement but men report women were uninvolved (categorized as Discordant 1), and 12.2% had women report uninvolvement but men report that women were involved (categorized as Discordant 2). Discordant 2 couples had lower odds of modern contraceptive use relative to Concordant 1 couples (adjusted RR=0.61, 95% CI 0.45-0.83). No other significant differences between Concordant 1 couples and other categories were observed. Conclusion: One in four couples indicated discordance on women’s involvement in contraceptive decision making, with Discordant 2 category having lower odds of contraceptive use. Couples’ concordance in women’s involvement in contraceptive decision-making offers a target for family planning research and interventions to better meet their needs.Trial registrationClinicalTrial.gov, NCT03514914. https://clinicaltrials.gov/ct2/show/NCT03514914

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Factors Influencing the Use of Reproductive Health Services among Young Women in Nepal: Analysis of the 2016 Nepal Demographic and Health Survey

10.21203/rs.2.23047/v3 ◽

2020 ◽

Author(s):

Naba Raj Thapa

Keyword(s):

Reproductive Health ◽

Health Services ◽

Young Women ◽

Contraceptive Use ◽

Modern Contraceptive ◽

Reproductive Health Services ◽

Skilled Birth Attendants ◽

Birth Attendants ◽

Factors Influencing ◽

Modern Contraceptive Use

Abstract Background: Utilization of reproductive health services is a key component for preventing young women from different sexual and reproductive health problems. Thus, the objective of this study is to determine the factors influencing the use of reproductive health services among young women in Nepal. Methods: Data have been extracted from the 2016 Nepal Demographic and Health Survey (NDHS) datasets wherein the weighted sample population size was restricted for modern contraceptive use to 1593 whereas for the antenatal care and skilled birth attendants to1606. This study has selected three reproductive health indicators as outcome variables of reproductive health service utilization for the analysis viz, modern contraceptive use, at least four antenatal care visits, and use of skilled birth attendants. Likewise, all calculations are based on standard sample weight of NDHS. Results: The study has found that 21% of young women used modern contraception, 71% attended at least four ANC visits, and 67% utilized a skilled birth attendant at delivery. Young Janajati women, women having 1-2, and 3 or more living children, women participating household decision-making, and the ones having exposure to media were more likely to use modern contraceptives, whereas the women who want more children were less likely to use them. Higher education attainments, higher wealth quintile, and lower birth order were associated with higher level of receiving at least four ANC visits and SBAs. However, the young women willing to have more children and having access to media have higher odds of receiving at least four ANC visits; and the women attending four and more ANC visits have higher odds of using SBAs. Conclusions: In order to improve the use of reproductive health services among young women, efforts should be made to enrich the young women of lower educational level, lower economic status, higher birth order, and lower exposure to media. Further research is required to detect the causes that affect the use of reproductive health services.

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Protocol for cluster randomized evaluation of reaching married adolescents - a gender-synchronized intervention to increase modern contraceptive use among married adolescent girls and young women and their husbands in Niger

Reproductive Health ◽

10.1186/s12978-019-0841-3 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 4

Author(s):

Sneha Challa ◽

Stephanie M. DeLong ◽

Nicole Carter ◽

Nicole Johns ◽

Holly Shakya ◽

...

Keyword(s):

Adolescent Girls ◽

Young Women ◽

Contraceptive Method ◽

Contraceptive Use ◽

Modern Contraceptive ◽

Post Intervention ◽

Modern Contraceptive Method ◽

Modern Contraceptive Use ◽

Randomized Control ◽

Cluster Randomized

Abstract Background Early marriage and early childbearing are highly prevalent in Niger with 75% of girls married before age 18 years and 42% of girls giving birth between ages 15 and 18 years. In 2012, only 7% of all 15–19-year-old married adolescents (male and female) reported use of a modern contraceptive method with barriers including misinformation, and social norms unsupportive of contraception. To meet the needs of married adolescents and their husbands in Niger, the Reaching Married Adolescents (RMA) program was developed with the goal of improving modern contraceptive method uptake in the Dosso region of Niger. Methods Using a four-arm cluster randomized control design, the RMA study seeks to assess whether household visits only (Arm 1), small group discussions only (Arm 2), or a combination of both (Arm 3), as compared to controls (no intervention – Arm 4), improve modern contraceptive method use among married adolescent girls and young women (AGYW), age 13–19 years-old, in three districts of the Dosso region. Intervention conditions were randomly assigned across the three districts, Dosso, Doutchi, and Loga. Within each district, eligible villages were assigned to either that intervention condition or to the control condition (12 intervention and 4 control per district). Across the three intervention conditions, community dialogues regarding modern contraceptive use were also implemented. Data for the study was collected at baseline (April – June 2016), at 24 months post-intervention (April – June 2018), and a final round of data collection will occur at 40 months post-intervention (October – December 2019). Discussion The RMA intervention is a gender-synchronized and community-based program implemented among married adolescent girls and their husbands in the context of rural Niger. The intervention is designed to provide education about modern contraception and to promote gender equity in order to increase uptake of modern contraceptive methods. Results from this cluster randomized control study will contribute to the knowledge base regarding the utility of male engagement as a strategy within community-level approaches to promote modern contraceptive method use in the high need context of West Africa. Trial registration Registered October 2017 - ClinicalTrials.gov NCT03226730.

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