scholarly journals Women’s empowerment, intrahousehold influences, and health system design on modern contraceptive use in rural Mali: a multilevel analysis of cross-sectional survey data

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Caroline Whidden ◽  
Youssouf Keita ◽  
Emily Treleaven ◽  
Jessica Beckerman ◽  
Ari Johnson ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
System Design ◽  
Contraceptive Use ◽  
Modern Method ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Primary Health ◽  
Paid Labor ◽  
Modern Contraceptive Use

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.

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
Keyword(s):  
Social Support ◽  
Contraceptive Use ◽  
Modern Method ◽  
Baseline Survey ◽  
Modern Contraceptive ◽  
Sexually Active ◽  
Cross Sectional ◽  
Modern Contraception ◽  
Contraception Use ◽  
Modern Contraceptive Use

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.

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

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.

scholarly journals 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.

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

scholarly journals Modern contraceptive use among female refugee adolescents in Northern Uganda: prevalence and associated factors

2020 ◽  
Author(s):  
Ritah Bakesiima ◽  
Amanda Cleeve ◽  
Elin Larsson ◽  
James K. Tumwine ◽  
Grace Ndeezi ◽  
...  
Keyword(s):  
Decision Making ◽  
Contraceptive Use ◽  
Analytical Techniques ◽  
Cross Sectional Study ◽  
Northern Uganda ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Modern Contraceptives ◽  
Fertility Decision ◽  
Modern Contraceptive Use

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.

scholarly journals Predictors of modern contraceptive use and fertility preferences among men in Myanmar: further analysis of the 2015-16 demographic and health survey

2019 ◽  
Vol 6 (10) ◽  
pp. 4209
Author(s):  
May S. Aung ◽  
Pa P. Soe ◽  
Myo M. Moh
Keyword(s):  
Reproductive Health ◽  
Health Survey ◽  
Contraceptive Use ◽  
Demographic And Health Survey ◽  
Modern Contraceptive ◽  
Fertility Preferences ◽  
Modern Contraception ◽  
Hilly Region ◽  
Married Men ◽  
Modern Contraceptive Use

Background: Men’s opposition to contraception and men’s fertility preferences can affect women’s unmet need for family planning. In Myanmar, there is limited research on men's reproductive health while women’s fertility, fertility preferences, and use of reproductive health services were well understood. A better understanding of men’s perceptions and preferences can support evidence-based male sexual and reproductive health programs and improve their effectiveness. This study focused on predictors of modern contraceptive use and fertility preferences among men age 15-49 years in Myanmar.Methods: A secondary data analysis was conducted using the 2015-16 Myanmar Demographic and Health Survey. Among 4,737 men age 15-49 years in the selected households, 3,248 men who ever had sex and 2,831 currently married men were selected as the sample for contraceptive use and fertility preferences respectively. Multiple logistic regression analysis was used with two separate models.Results: Among men who ever had sex, 39% were currently using modern contraception and 60% married men said they would like to have more than two children. Men from the coastal, and plain regions were more likely to use modern contraception and had higher fertility preferences compared with men living in the hilly region. The working men had higher levels of modern contraceptive use than jobless men and men from middle wealth index were significant current contraceptive users.Conclusions: The geographic region was a predictor of both current contraceptive use and fertility preferences, while occupation showed a significant correlation with contraceptive use.

scholarly journals Modern contraceptive use among sexually active women aged 15–19 years in North-Western Tanzania: results from the Adolescent 360 (A360) baseline survey

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030485 ◽  
Author(s):  
Mussa Kelvin Nsanya ◽  
Christina J Atchison ◽  
Christian Bottomley ◽  
Aoife Margaret Doyle ◽  
Saidi H Kapiga
Keyword(s):  
Marital Status ◽  
Contraceptive Use ◽  
Baseline Survey ◽  
Modern Contraceptive ◽  
Sexually Active ◽  
Modern Contraception ◽  
Adolescent Women ◽  
Modern Contraceptive Use ◽  
North Western ◽  
Western Tanzania

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.

scholarly journals Women’s Autonomy Decision Making Power on Postpartum Modern Contraceptive Use and Associated Factors in North West Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Samrawit Yonas Tadesse ◽  
Amanu Aragaw Emiru ◽  
Tadese Ejigu Tafere ◽  
Melash Belachew Asresie
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Immunization Service ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Autonomous Decision ◽  
Postpartum Family Planning ◽  
Modern Contraceptive Use

Background. Most postpartum women (95%) do not want pregnancy within 24 months after birth, however, 70% of them do not use modern contraceptives. In Ethiopia postpartum modern contraceptive use is low. Evidences show that women’s autonomy within the household is the most important thing in modern contraceptive use. Yet, there is dearth of information in Ethiopian context. Therefore, this study was aimed to assess women’s autonomy on modern contraceptive use and its associated factors among women who attended their children immunization service. Methods. Facility-based cross-sectional study was carried out from May 5 to Jone15, 2017 in sekota town and its surroundings among 415 women who attended immunization service for their children. Participants were selected by using a systematic sampling technique. The data were collected through face-to-face interviews using pre-tested structured questionnaires. The data were entered into epi.info version7 and analyzed using SPSS version 23. Both descriptive and logistic regression analyses were performed. A P-value less than or equal to 0.05 at 95% confidence interval was set to test statistical significance. Result. The proportion of women’s decision making power on postpartum modern contraceptive use was 77.3%. Being counseled on postpartum family planning (2.29, 95% CI: 1.27, 5.71), discussed on postpartum family planning with their husbands (AOR = 14.62, 95% CI: 6.52, 32.75), and had the index child within one year after previous birth (AOR = 7.98, 95% CI: 2.52, 30.65) were found positively associated with women’s autonomous decision making power on postpartum modern contraceptive use. In addition, those women who knew that pregnancy could happen during the postpartum period (AOR = 6.53, 95% CI: 3.2, 14.12) were more autonomous in decision to use postpartum contraception. Conclusion. The proportion of women’s autonomous decision making power on postpartum modern contraceptive use was low. Those women who were counseled on postpartum family planning, discussed with partners, and those who knew that pregnancy could happen during the postpartum period had higher odds of autonomous decision making power. Therefore, strengthening counseling, educating on postpartum family planning, and encouraging women to discuss postpartum family planning with their husbands may improve women’s power.

scholarly journals Quality of Family Planning Care as Enabling Factor for Modern Contraceptive Use in Indonesia: Evidence from PMA2020 Survey

2021 ◽  
Author(s):  
Nurjaeni Nurjaeni ◽  
Yothin Sawangdee ◽  
Umaporn Pattaravanich ◽  
Charamporn Holumyong ◽  
Aphichat Chamratrithirong
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Modern Method ◽  
Modern Contraceptive ◽  
Number Of Children ◽  
Modern Family ◽  
Modern Contraceptive Use ◽  
Ideal Number ◽  
Modern Family Planning

Abstract BackgroundThe utilization of modern family planning methods is a key pointer that mirrors universal access to reproductive health cares. Fulfilling unmet needs for modern contraceptives may decrease the level of maternal mortality by almost a third. This research employed the 2016 PMA2020 survey to assess multilevel variables related to modern family planning method use among women of reproductive age in Indonesia. MethodData from interviews of female and Service Delivery Point (SDP) of the 2016 Performance Monitoring and Accountability 2020 (PMA2020) survey were linked to generate a merged dataset comprising women’s individual, cluster and SDP factors (N=10,210). Multilevel analysis was done to assess the influence of contextual factors including a summary index of SDP quality FP care on woman’s modern family planning practice. Adjusted odds ratios and 95% CIs were analysed and interpreted.ResultsModern contraceptive prevalence among women of childbearing age was 42.3% in 2016. There was a considerable variation in the likelihood of modern method use across the 372 clusters/EAs. Age, education, marital status, parity, residency, region, woman’s FP decision autonomy, cluster’s average ideal number of children, percentage of females dissatisfied with FP, and percent of females visited by CHVs were significant factors for modern FP use after adjusting for multilevel characteristics. Quality of FP care was revealed to be a significant enabling factor for modern contraceptive use in Indonesia. ConclusionsModern contraceptive prevalence among females aged 15-49 years was relatively low in 2016. The findings indicate that an advancement in modern method use can be gained by improving quality of family planning care. Likewise, an enhancement in women’s FP decision autonomy and their level of education, decline in women’s ideal number of children and diminution of the dissatisfaction with family planning are all major concerns to be addressed. Family planning policies must tackle adverse cultural norms and inequities in quality of family planning care and women’s education that would produce welfares to women, children, and communities.

Sign in / Sign up

Export Citation Format

Share Document