scholarly journals Modern contraceptive use among unmarried girls aged 15–19 years in South Western Nigeria: results from a cross-sectional baseline survey for the Adolescent 360 (A360) impact evaluation

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Emily E. Crawford ◽  
Christina J. Atchison ◽  
Yewande P. Ajayi ◽  
Aoife M. Doyle

Abstract Purpose Adolescents 360 (A360) is an initiative being rolled out across Nigeria with the aim of increasing voluntary modern contraception use among women aged 15 to 19 years. Using evaluation study baseline data, we identified sexuality, fertility and contraceptive use characteristics of young unmarried girls in South Western Nigeria. Methods A cross-sectional baseline survey of unmarried girls aged 15 to 19 years was conducted in Ogun state, Nigeria in August 2017. A clustered sampling design was used. We identified determinants of modern contraceptive use in this subpopulation using logistic regression. Results Of 12,024 women interviewed, 15.3% reported sexual intercourse in the past year. The majority of respondents (79.6%, 9525/11,967) had heard of contraception. 45.3% of sexually active respondents were using a modern contraceptive method. Of those using any method of contraception, male condoms (50.3%) were the most widely used modern method followed by the emergency contraceptive pill (16.7%). Following adjustment for socio-demographic characteristics, there was evidence that the use of modern contraception was positively associated with having never given birth, living in an urban area, current enrolment in education, high level of education, high socioeconomic status, exposure to information about contraception, perceived social support for contraception, and self-efficacy for contraception. Conclusions In South Western Nigeria, unmarried sexually active adolescent girls have relatively low levels of modern contraceptive use. Programmes should aim to increase access to modern contraception and to increase social support and acceptability of contraceptive use.

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030485 ◽  
Author(s):  
Mussa Kelvin Nsanya ◽  
Christina J Atchison ◽  
Christian Bottomley ◽  
Aoife Margaret Doyle ◽  
Saidi H Kapiga

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.


Author(s):  
Julia M. Fleckman ◽  
Martha Silva ◽  
Jeni Stolow ◽  
Kendra LeSar ◽  
Kathryn Spielman ◽  
...  

Zika virus (ZIKV) can be sexually transmitted and can lead to severe neonatal and child health issues. The current study examines whether ZIKV-related ideational factors, including awareness of ZIKV and associated birth defects, are related to modern contraceptive use among women and men with sexual partners in four Latin American and Caribbean (LAC) countries. Data used are from cross-sectional household surveys conducted in 2018 in the Dominican Republic, El Salvador, Guatemala, and Honduras with representative samples of men and women aged 18–49 (N = 1,100). The association between self-reported use of modern contraception and measures of Zika knowledge, risk perceptions and social norms, and contraceptive self-efficacy was examined via sex disaggregated multivariate logistic regression models. Both men (OR 3.70, 95% CI 1.36–10.06, P < 0.05) and women (OR 3.71, 95% CI 2.30–5.99, P < 0.0001), who reported discussing family planning with their partner in the last year were more likely to use modern contraception compared with those who did not. Contrary to our hypothesis, knowledge that ZIKV can affect a fetus was negatively associated with modern contraceptive use for women (OR 0.49, 95% CI 0.29–0.85, P < 0.05). Given the cross-sectional nature of the survey, women not using contraception may be more likely to remember that ZIKV can affect a fetus. In the event of a related outbreak, future health promotion and communication efforts in LAC should focus on known determinants of modern contraceptive use, such as knowledge and partner communication, and knowledge of the health effects of ZIKV if pregnant, to influence family planning decision-making behavior.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Caroline Whidden ◽  
Youssouf Keita ◽  
Emily Treleaven ◽  
Jessica Beckerman ◽  
Ari Johnson ◽  
...  

Abstract Background Persistent challenges in meeting reproductive health and family planning goals underscore the value in determining what factors can be leveraged to facilitate modern contraceptive use, especially in poor access settings. In Mali, where only 15% of reproductive-aged women use modern contraception, understanding how women’s realities and health system design influence contraceptive use helps to inform strategies to achieve the nation’s target of 30% by 2023. Methods Using household survey data from the baseline round of a cluster-randomized trial, including precise geolocation data from all households and public sector primary health facilities, we used a multilevel model to assess influences at the individual, household, community, and health system levels on women’s modern contraceptive use. In a three-level, mixed-effects logistic regression, we included measures of women’s decision-making and mobility, as well as socio-economic sources of empowerment (education, paid labor), intrahousehold influences in the form of a co-residing user, and structural factors related to the health system, including distance to facility. Results Less than 5% of the 14,032 women of reproductive age in our study used a modern method of contraception at the time of the survey. Women who played any role in decision-making, who had any formal education and participated in any paid labor, were more likely to use modern contraception. Women had three times the odds of using modern contraception if they lived in a household with another woman, typically a co-wife, who also used a modern method. Compared to women closest to a primary health center, those who lived between 2 and 5 km were half as likely to use modern contraception, and those between 5 and 10 were a third as likely. Conclusions Despite chronically poor service availability across our entire study area, some women—even pairings of women in single households—transcended barriers to use modern contraception. When planning and implementing strategies to expand access to contraception, policymakers and practitioners should consider women’s empowerment, social networks, and health system design. Accessible and effective health systems should reconsider the conventional approach to community-based service delivery, including distance as a barrier only beyond 5 km.


2019 ◽  
Vol 9 (6-s) ◽  
pp. 93-102 ◽  
Author(s):  
Alfoalem Araba Abiye ◽  
Bethel Fekede ◽  
Ayenew Mulualem Jemberie ◽  
Bereket Abraha Molla ◽  
Beruk Ketema Tolla ◽  
...  

Introduction: - Amongst the family planning program is the use of modern contraception. It is one of the key fundamentals of health services whose benefits are wellbeing’s of mothers, husbands, families, and their country in general. According to the world fertility rate report 2015, Ethiopia is expected to achieve a TFR of 2.4 children per woman between the years 2025-2030. Objective: - the principal objective of the current study was to determine the prevalence of modern contraception use and factors that affect utilization. Methods: - a quantitative community based cross-sectional study was done in three peri-urban communities of Batu, Eastern Shewa zone of Oromia region of Ethiopia from October to November 2017. A total of 351 women in the reproductive age group were interviewed with a questionnaire in the form of a house-to-house survey. Statistical analysis was done using the statistical package for social sciences (SPSS) software version 21.0. Results: - the study showed that the contraception prevalence was 37.9%. Forty-seven percent of the users were in the age group 21-29. Knowledge, formal education and religion were associated with contraception utilization. It was found that knowledge and formal education were the enhancing factors for utilization whereas the Muslim religion was an inhibiting factor for modern contraceptive use. Conclusion: - the contraceptive prevalence was higher than the national result for the rural community but lower than the urban community was. Both governmental and non-governmental organizations should continue the good work of building community awareness of modern contraceptive methods. Keywords: - Contraceptives, knowledge, attitude, practice, Batu


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Setegn Muche Fenta ◽  
Shewayiref Geremew Gebremichael

Abstract Background Ethiopia is one of the Sub-Saharan Africa countries with the lowest modern contraceptive prevalence rate and the highest fertility rate. This study aimed to assess individual and community-level predictors of modern contraceptive use among sexually active rural women in Ethiopia. Data and methods A sample of 9450 sexual active rural women aged 15-49 was extracted from the 15, 683 nationally representative samples of 2016 Ethiopian Demographic and Health Survey (EDHS). Multi-level logistic regression model was considered to identify determinant factors of modern contraceptive use among sexually active rural women in Ethiopia. Result The prevalence of modern contraceptive use among respondents was 20% in rural Ethiopia. Injection (66.35%) was the most common type of modern contraceptive use. In the last full model of the multilevel analysis, individual and community-level factors accounted for 86.69% of the variation in the use of modern contraceptive methods. Secondary and above-educated women (AOR = 1.39, 95%CI: 1.06, 2.81), having 1-4 living children (AOR = 2.70, 95%CI: 2.07, 3.53), rich wealth status (AOR = 2.26, 95%CI: 1.96, 2.60), married women (AOR = 17.31, 95%CI: 10.72, 27.94), having primary educated husband (AOR = 1.45, 95%CI: 1.27, 1.67) and being working husband (AOR = 2.26, 95%CI: 1.96, 2.60) were significantly positively associated with individual-level factors of the use of modern contraceptive methods. Besides, modern contraceptive use was negatively associated with Muslim women (AOR = 0.29, 95%CI: 0.25, 0.33). Compared to the Tigray region, women living in the Afar, Somali, Harari, and Dire Dawa regions had lower use of modern contraceptive methods. Women who had access to mass media (AOR = 1.35, 95%CI: 1.16, 1.57) were more likely to use contraceptives than their counterparts. Conclusion The prevalence of modern contraceptive use among rural women has very low. Both individual and community-level factors were significant predictors of modern contraceptive use. Consequently, the government and other stakeholders need to address educational opportunities; creating awareness about modern contraception and valuable counseling would increase modern contraceptive methods utilization.


BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e019006 ◽  
Author(s):  
Issifou Yaya ◽  
Akouda Akessiwè Patassi ◽  
Dadja Essoya Landoh ◽  
Essodjèlouna Manani Bignandi ◽  
Kanfitine Kolani ◽  
...  

2020 ◽  
Author(s):  
Alemi Kebede ◽  
Sena Belina ◽  
Yonas Biratu ◽  
Ayantu Kebede

Abstract Background The sexual and reproductive health of young people is a global priority. Access to sexual and reproductive health information and services will determine, the burden of adolescent pregnancies and unwanted pregnancies. Teenage pregnancy that has profound effects on the health and wellbeing of young women across their life course is a burning public health and a demographic challenge in Ethiopia. Contraceptive use allows girls to postpone motherhood and space births. However, little is known about the trends in contraceptive use and its determinant among girls aged 15 to 19 in Ethiopia. Therefore, this study was designed to identify factors associated with modern contraceptive methods use among sexually active adolescent girls in Ethiopia. Methods Four Ethiopian demographic and health survey data were used to examine trends of contraceptive methods use among sexually active adolescent girls. To identify factors associated with contraceptive use, the 2016 Ethiopian demographic and health survey data was used. The data was accessed from the demographic and health survey program data base and data for sexually active adolescent girls were extracted. Data analysis was done using SPSS version 21. Data were weighted for analysis. Descriptive analysis was used to describe independent variables of the study participants. And design effect was considered during analysis. Multivariable logistic regression model was used to identify factors associated with contraceptive use. Results Modern contraceptive use increased significantly from 5.9% in 2000 to 39.3% in 2016. The odds of contraceptive use were lower among female adolescent who had no education (AOR: .038; 95%CI: (.007 to 0.216), primary education (AOR: 0.112; 95%CI: 0.026 to 0.483). But the odds of contraceptive methods use were higher among adolescent living in rich wealth status AOR: 5.131; 95%CI: (1.795 to 14.669) and those told about family planning during their health facility visit (A0R: 3.700; 95%CI: 1.517 to 9.020) Conclusion Modern contraceptive use increased significantly among sexually active adolescent girls in Ethiopia. Wealth index, education, told about family planning during their health facility visit and partner occupation were factors associated with contraceptive use. Improving economic and educational status of young women may help improve contraceptive use in Ethiopia.


BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034675 ◽  
Author(s):  
Amrita Namasivayam ◽  
Sarah Lovell ◽  
Sarah Namutamba ◽  
Philip J Schluter

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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