scholarly journals Individual and community level associates of contraceptive use in Ethiopia: a multilevel mixed effects analysis

2019 ◽  
Vol 77 (1) ◽  
Author(s):  
Masrie Getnet Abate ◽  
Amare Abera Tareke
Keyword(s):  
Fixed Effects ◽  
Contraceptive Use ◽  
Household Wealth ◽  
Mixed Effects ◽  
Community Level ◽  
Reproductive Age ◽  
Safe Motherhood ◽  
Sampled Data ◽  
Individual Level ◽  
Factors Associated

Abstract Background Family planning is one of the four pillars of safe motherhood initiative to reduce maternal death in developing countries. Despite progress in contraceptive use, unmet needs are wide open and fertility remains high. Ethiopia have a higher fertility rate which contributes to maternal and child health destitution, putting pressure on the already weak health system. This study examined individual and community-level factors associated with contraceptive use in Ethiopia. Methods Data from Ethiopian Demographic and Health Survey 2016 were used to identify individual and community level associated factors among reproductive-age women. Non-pregnant, fecund and sexually active women aged 15–49 were included. Six hundred forty-two communities and 6854 women were involved from this two-stage cluster sampled data. The analysis was done using two-level mixed-effects logistic regression to determine fixed effects of individual and community-level factors and random intercept of between characteristics. Results From the total eligible women for contraceptive use 2393 (34.9%) of them were users. Injectables were the commonest of all contraceptive methods. Various individual-level variables were associated with contraceptive use. Household wealth index, women’s age, number of living children, husband’s occupation, ever experience of a terminated pregnancy, current working status of the women, number of births in the last 3 years, and hearing of FP messages through different media were significantly associated individual-level variables after adjusting other factors. Community characteristics like region, place of residence, religion, and community-level wealth were the factors associated with contraceptive use. Conclusion Both individual and community-level characteristics were significant predictors of use of contraceptives in Ethiopian women. Besides the individual-level factors, interventions should also consider community-level associates.

scholarly journals Less than one-fifth of the mothers practised exclusive breastfeeding in the emerging regions of Ethiopia: a multilevel analysis of the 2016 Ethiopian demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu
Keyword(s):  
Health Survey ◽  
Exclusive Breastfeeding ◽  
Household Wealth ◽  
Community Level ◽  
Wealth Status ◽  
Individual Level ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
The Individual ◽  
Low Coverage

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.

scholarly journals Individual and community-level factors associated with modern contraceptive use among adolescent girls and young women in Mali: a mixed effects multilevel analysis of the 2018 Mali demographic and health survey

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Francis Appiah ◽  
Eugene Budu ◽  
Collins Adu ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Contraceptive Use ◽  
Wealth Quintile ◽  
Mixed Effects ◽  
Community Level ◽  
Modern Contraceptive ◽  
Factors Associated ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use

Abstract Background Unintended pregnancy constitutes a significant public health challenge in sub-Saharan Africa and particularly among young people, who are more likely to closely space births and experience adverse obstetric outcomes. Studies on modern contraceptive use have mostly focused on women of reproductive age in general with limited attention to factors associated with modern contraceptive use among adolescents and young women (aged 15–24) in Mali. We examined the individual and community-level factors associated with modern contraceptive use among this age cohort using the 2018 Mali demographic and health survey data. Methods We analyzed data from 2639 adolescent girls and young women, and our outcome of interest was current use of modern contraceptives. We performed descriptive analysis using frequencies and percentages and inferential analysis using mixed-effects multilevel logistic regression. The results of the mixed-effects multilevel logistic regression were presented as adjusted odds ratios with their corresponding 95% confidence intervals. Results The prevalence of modern contraceptive use among adolescent girls and young women in Mali was 17.1% [95% CI, 15–19%]. Adolescent girls and young women who were married [aOR = 0.20, CI = 0.09–0.41], had no formal education [aOR = 0.43, CI = 0.32–0.59], in the poorest wealth quintile [aOR = 0.38, CI = 0.19–0.79] and had no children [aOR = 0.38, CI = 0.27–0.53] were less likely to use modern contraceptives. Similarly, those who had low knowledge of modern contraception [aOR = 0.60, CI = 0.42–0.85] and whose ideal number of children was six or more [aOR = 0.66, CI = 0.43–0.99] were less likely to use modern contraceptives. However, those with four or more births were more likely to use modern contraceptives [aOR = 1.85, CI = 1.24–2.77]. Conclusion Modern contraceptive use among adolescent girls and young women in Mali has improved slightly relative to the prevalence of 2012, though the prevalence is still low, compared to the prevalence in other sub-Saharan African countries and the prevalence globally. Individual-level factors such as marital status, educational level, wealth quintile, parity, ethnicity and ideal number of children were associated with the use of modern contraceptive among adolescent girls and young women in Mali. Community knowledge of modern contraceptives was found as a community-level factor associated with modern contraceptive use among adolescent girls and young women. Therefore, Mali’s Ministry of Health and Public Hygiene's Health Promotion and Education unit should prioritise and intensify contraceptive education to increase coverage of modern contraceptive use and address disparities in the use of modern contraceptives. Such education should be done, taking into consideration factors at the individual and community-level of the target population.

scholarly journals Individual and community level factors associated with delayed first postnatal care attendance among reproductive age group women in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Achamyeleh Birhanu Teshale ◽  
Getayeneh Antehunegn Tesema ◽  
Yigizie Yeshaw ◽  
Ayenew Kassie Tesema ◽  
Adugnaw Zeleke Alem ◽  
...  
Keyword(s):  
Health Facility ◽  
Postnatal Care ◽  
Community Level ◽  
Reproductive Age ◽  
Multilevel Logistic Regression ◽  
Age Group ◽  
Individual Level ◽  
Factors Associated ◽  
Multilevel Logistic Regression Analysis ◽  
Reproductive Age Group

Abstract Background Postnatal care (PNC) visits provide a huge benefit for ensuring appropriate breastfeeding practices, to monitor the overall health status of the newborn, to timely diagnose and intervene birth-related complications, and to plan future family planning options. Despite delayed PNC attendance have a great impact on the survival of the mother and the newborn it still receives less emphasis. As a result, most mothers do not receive PNC services early. We, therefore, aimed to determine individual and community level factors associated with delayed first Postnatal Care attendance among reproductive age group women in Ethiopia. Methods We used the most recent Ethiopian Demographic and Health Survey (EDHS 2016) data to determine associated factors of delayed first PNC in Ethiopia. A weighted sample of 4308 women with a live birth in the two years preceding the survey was included. A multilevel logistic regression analysis was used to analyze the data. Variables with p-value < 0.05 in the multivariable multilevel logistic regression analysis were declared significantly associated with delayed first PNC attendance. Results In this study, both individual level and community level factors were associated with delayed PNC attendance. Among the individual level factors: having four or more antenatal care visit [Adjusted Odd Ratio (AOR) = 0.73; 95% CI: 0.59, 0.92], delivery at a health facility [AOR = 0.04; 95% CI: 0.03, 0.05], and perceiving distance from the health facility as not a big problem [AOR = 0.73; 95% CI: 0.58, 0.91] were associated with lower odds of delayed first PNC attendance. Of community level factors: being in Oromia [AOR = 2.31; 95% CI: 1.38, 3.83] and Gambela [AOR = 2.01; 95% CI: 1.13, 3.56] regions were associated higher odds of delayed first PNC attendance. Conclusions Both individual level and community level factors were found to be associated with delayed PNC attendance. Strengthening antenatal care utilization, institutional delivery, and appropriate distributions of maternal health services in each region and areas far apart from the health facility are recommended.

Factors associated with highly effective contraceptive use among reproductive-age women in Peru: Evidence from a nationwide survey

2020 ◽  
Vol 245 ◽  
pp. 114-120
Author(s):  
David R. Soriano-Moreno ◽  
Anderson N. Soriano-Moreno ◽  
Angela Mejia-Bustamante ◽  
Cristhian A. Guerrero-Ramirez ◽  
Carlos J. Toro-Huamanchumo
Keyword(s):  
Contraceptive Use ◽  
Nationwide Survey ◽  
Reproductive Age ◽  
Factors Associated ◽  
Reproductive Age Women ◽  
Highly Effective ◽  
Effective Contraceptive

scholarly journals Factors associated with the compliance of recommended first postnatal care services utilization among reproductive age women in Benin Republic: an analysis of 2011/2012 BDHS data

2017 ◽  
Vol 6 (4) ◽  
pp. 1161 ◽  
Author(s):  
Justin Dansou ◽  
Adeyemi O. Adekunle ◽  
Ayodele O. Arowojolu
Keyword(s):  
Postnatal Care ◽  
Multinomial Logistic Regression ◽  
Household Wealth ◽  
Reproductive Age ◽  
Special Focus ◽  
Wealth Status ◽  
Services Utilization ◽  
Factors Associated ◽  
To Receive ◽  
Benin Republic

Background: High maternal and neonatal mortality persist in Benin republic. Rates of decline are slow and factors influencing PNC services utilization are not well known. This study aims to assess factors associated with PNC services utilization among mothers and their newborns with special focus on the recommendation 2 of WHO guidelines on postnatal care of the mother and the newborn.Methods: This study analysed Benin’s 2011/2012 DHS data. A total of 16,599 women were interviewed where 8,275 eligible for the present study. Multinomial logistic regression was applied.Results: While 68.42% of mothers and their newborns received at least one PNC visit over postnatal period, the percent of newborns and their mothers with appropriate first PNC check-up was low, 19.95%. Factors explaining PNC uptake were place of residence, ethnic group, occupation, ANC attendance, place of delivery, baby birth size, household wealth status, mass media use, and to a lesser extent education attainment. Accessibility, number of living children followed by the birth order number, and desire for pregnancy appeared to be specific determinants to appropriate first PNC check-up. Mothers who attended more frequently ANC services were more likely to receive PNC check-ups. Mothers who delivered at private health facility were more likely to receive PNC check-ups.Conclusions: To increase the achievement of the recommended WHO PNC frequency, there is a need to: address unmet needs for Family Planning in Benin; to expend health education and counselling to encourage ANC attendance supervise by skilled personnel.

scholarly journals Hepatitis E in Bangladesh: Insights from a National Serosurvey

2021 ◽  
Author(s):  
Andrew Azman ◽  
Kishor Kumar Paul ◽  
Taufiqur Rahman Bhuiyan ◽  
Aybuke Koyuncu ◽  
Henrik Salje ◽  
...  
Keyword(s):  
Urban Areas ◽  
Case Fatality ◽  
Population Level ◽  
Hepatitis E ◽  
Community Level ◽  
Reproductive Age ◽  
Serum Samples ◽  
Household Level ◽  
Individual Level ◽  
Geostatistical Models

Background Hepatitis E virus, typically genotypes 1 and 2, is a major cause of avoidable morbidity and mortality in South Asia. Although case fatality risk among pregnant women can reach as high as 25%, a lack of population-level disease burden data has been cited as a primary factor in key global policy recommendations against the routine use of licensed hepatitis E vaccines, one of the only effective tools available for preventing disease and death. Methods We tested serum from a nationally-representative serosurvey in Bangladesh for anti-HEV IgG. We estimated the proportion of the population with evidence of historical HEV infection and used Bayesian geostatistical models to generate high resolution national maps of seropositivity. We examined variability in seropositivity by individual-level, household-level, and community-level risk factors using spatial logistic regression. Results We tested serum samples from 2924 individuals from 70 communities representing all divisions of Bangladesh and estimated a national seroprevalence of hepatitis E of 20% (95% CI 17-24%). Seropositivity increased with age and male sex (OR: 2.2, 95% CI: 1.8-2.8). Community-level seroprevalence ranged from 0-78% with the seroprevalence in urban areas being higher, including Dhaka, the capital, with 3-fold (95%CrI 2.3-3.7) higher seroprevalence than the rest of the country. Conclusion Hepatitis E infections are common throughout Bangladesh, though 90% of women reach reproductive age without any evidence of previous exposure to the virus, thus likely susceptible to infection and disease. Strengthening clinical surveillance for hepatitis E, especially in urban areas may help generate additional evidence needed to appropriately target interventions like vaccines to the populations most likely to benefit.

scholarly journals Knowledge and factors influencing long acting reversible contraceptive use among women of reproductive age in Nigeria

2019 ◽  
Vol 3 ◽  
pp. 7 ◽  
Author(s):  
Obasanjo Afolabi Bolarinwa ◽  
Olalekan Seun Olagunju
Keyword(s):  
Logistic Regression ◽  
Human Error ◽  
Contraceptive Use ◽  
Target Population ◽  
Household Wealth ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Unintended Pregnancies ◽  
Long Acting ◽  
Long Acting Reversible Contraceptive

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.

scholarly journals INFLUENCE OF INDIVIDUAL AND COMMUNITY-LEVEL ASSOCIATES OF CONTRACEPTIVE USE IN PAKISTAN: A MULTI-LEVEL MIXED EFFECT ANALYSIS (PDHS 2017-18)

2021 ◽  
Vol 9 (3) ◽  
pp. 764-775
Author(s):  
Asifa Kamal ◽  
Sadaf Malik ◽  
Hafsa Batool ◽  
Afza Rasul
Keyword(s):  
Mass Media ◽  
Women's Education ◽  
Contraceptive Use ◽  
Media Exposure ◽  
Married Women ◽  
Community Level ◽  
Women’S Empowerment ◽  
Individual Level ◽  
The Individual ◽  
Mass Media Exposure

Purpose of the study: This research aims to investigate the impact of mass media exposure and women's autonomy on the use of contraceptives, along with other potential determinants at the individual level and community level among women in Pakistan. Methodology: Data was extracted from Pakistan Demographic & Health Surveys 2017-18. The sample size included 10,461 non-pregnant and married women from a total of 15,068 ever-married women. The analysis was done using two-level mixed-effects logistic regression for the binary outcome variable, i.e., current contraceptive use (yes/no). Main Findings: Significant factors positively associated with contraceptive use at the individual level were women's education, wealth index, parity, age at first cohabitation, child mortality experience, and mass media exposure. Community attributes like region (Sindh, KPK, Balochistan as compared to Punjab), residence (rural as compared to urban) had an inverse relationship with contraceptive use. At the same time, women's education and an ideal number of children were the significant positive associates. Women's empowerment has though insignificant, but it has a positive impact on the use of contraceptives at both individual and community levels. Applications of this study: Family planning programs can be extended by focusing on women residing in rural settings or in high fertility intentions communities, less educated and unprivileged younger women who had reduced the uptake of contraceptives. An increase in women's access to education, media exposure, employment, and women's empowerment can help attain Pakistan's contraceptive prevalence targets. Novelty/Originality of this study: The current study's effect of individual and community-level factors was investigated using National-level data, mainly focusing on the role of mass media and women's autonomy.

scholarly journals Knowledge and factors influencing long acting reversible contraceptive use among women of reproductive age in Nigeria

2020 ◽  
Vol 3 ◽  
pp. 7
Author(s):  
Obasanjo Afolabi Bolarinwa ◽  
Olalekan Seun Olagunju
Keyword(s):  
Logistic Regression ◽  
Contraceptive Use ◽  
Target Population ◽  
Household Wealth ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Unintended Pregnancies ◽  
Factors Influencing ◽  
Long Acting ◽  
Long Acting Reversible Contraceptive

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.

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