scholarly journals Determinants of modern contraceptive use among postpartum women in two health facilities in urban Ghana: a cross-sectional study

Author(s):  
Jonathan Ian Coomson ◽  
Abubakar Manu

Abstract Background Postpartum contraception is important for spacing and limiting childbirth. Although the use of modern contraception has been shown to reduce maternal and child morbidities and mortalities, postpartum women have one of the highest unmet needs for family planning. Inter-birth intervals less than 24 months have adverse effects on both the mother and the child, yet very limited empirical evidence exist on contraceptive use among postpartum women in Ghana. This study sought to determine the prevalence and determinants of modern contraceptive use among postpartum women in the Tema Metropolis, Ghana. Methods A facility-based cross-sectional survey was conducted among 320 postpartum women with babies aged between three and 15 months. Participants were recruited from child welfare clinics in two government health facilities in the Tema metropolitan area using a simple random sampling technique. Data were analyzed using STATA version 15. Chi-square and multiple logistic regressions techniques were used to examine associations between postpartum contraceptive use and key independent variables. Statistical significance was set at p = 0.05. Adjusted odds ratios and their 95% confidence intervals were used to assess the strength of association. Results The prevalence rate of modern contraceptive use among postpartum women was 26.3%. Postpartum contraceptive use was significantly associated with past contraceptive use [AOR = 7.7 (95%CI: 3.4–17.5)]; return of menses [AOR = 4.3 (95%CI: 1.7–11.3)]; resumption of sexual activity [AOR = 4.7 (95%CI: 1.4–15.4)]; discussion of family planning with male partner [AOR = 3.1 (95%CI: 1.03–9.2)]; male partners’ approval of modern contraception [AOR = 18.1 (95%CI: 6.3–51.6)]; family planning counselling received during antenatal care [AOR = 3.5 (95%CI: 1.3–9.9)] and knowledge of at least one modern methods of contraception available at the health facility [AOR = 4.7 (95%CI: 1.9–11.5)]. Conclusions Postpartum contraceptive uptake is low among women in the Tema area. Factors that influence modern contraceptive uptake among postpartum women include past modern contraceptive use, resumption of sexual activity and menstruation, male partner involvement in contraception, family planning counselling during antenatal care and knowledge of the modern methods of contraception available at the health facility. Strengthening family planning education and counselling during antenatal care and using a multi-prong strategy to engage men as partners in family planning will improve postpartum contraceptive uptake.

2020 ◽  
Author(s):  
Natnael Atnafu Gebeyehu ◽  
Kelemu Abebe

Abstract Background: The postpartum period is an important transitional time for couples to put the decision on family planning utilization. However, women in Ethiopia are usually uncertain about the use of family planning during this period. This study was aimed to assess the intention of modern contraceptive use and associated factors among postpartum women attending the immunization clinic in Sodo Town.Method: Institutional based cross-sectional study design with a sample size of 416 was conducted from May 25 to June 20, 2019. The data were collected by using a systematic random sampling technique of interviewer-administered questionnaires. Those candidate variables at Bivariate analysis with a p-value<0.2 were moved to the Multivariate logistic regression model to control potential confounding variables and P-value<0.05 at multivariate analysis was considered as a cutoff pointResults: A total of 416 postpartum women participated in the study yielding a response rate of 98.1 % and 291 (70%) of them had an intention on modern contraceptive use. The odds of intention on modern contraceptive use was higher among respondents who had secondary school education (AOR=2.052, 95%CI: 1.064-3.958) than participants with no formal education. It was also higher among antenatal care visit attendees (AOR=1.736,95%CI:1.021-2.951) than those did not attend antenatal care visit. Knowledgeable participants on modern contraceptive use were more likely intend to use (AOR=2.535, 95%CI: 1.499-4.282) than their counterparts. Besides, the odds of the intention of modern contraceptive use among postpartum women who had menses resumption were higher (AOR=2.047,95%CI:1.141-3.675)than those whose menses not resumed.Participants who had husband approval were more likely to intend to use contraceptives (AOR=2.395,95%CI:1.501-5.458) than their counterparts.Conclusion: The intention of modern contraceptives among postpartum women was low. Family planning providers should emphasize reducing barriers of intention like lack of education, knowledge, male partner approval, antenatal care visit and advise the impact of menses on fertility.


2019 ◽  
Author(s):  
Getachew Andualem Belete ◽  
Almaz Aklilu Getu ◽  
Getahun Belay Gela

Abstract Background: The postpartum period is an important entry point for family planning service providers to reduce unintended and too closely spaced pregnancy. A postpartum modern contraceptive service is one of the recommended public health interventions for reducing maternal and child morbidity and mortalities. However, In Ethiopia modern contraceptive use during the postpartum period is low; resulting in unintended pregnancies and unwanted childbearing . there for this study was done to assess utilization and associated factors of modern contraceptives during the postpartum period among women who gave birth in the last 12 months in Injibara Town Awi Zone, North-Western Ethiopia. Methods: A Community based cross-sectional study design was conducted from March 01 to 15/2019 on 400 women who gave birth in the last 12 months preceding the survey. A simple random sampling technique was used to recruit study subjects. Data was collected using interviewer-administered pretested and structured questionnaires. Data were entered using Epi data 3.5 and exported to SPSS version 23 for analysis. The association between variables was analyzed using Bivariate and multivariable logistic regression models and p-value < 0.05 at 95% Confidence interval was considered as statistically significant. Result: The prevalence of modern contraceptive utilization was 58.5% (95% CI: 53.5- 63%) among postpartum mothers. Secondary school and higher educational levels [AOR= 5.02; 95% CI (1.53-16.47)],[AOR= 4.25; 95% CI:(1.32-13.64) respectively)], previous history of abortion [AOR= 3.93; 95%, CI: (1.43-10.84)], having three and four antenatal care visit [AOR= 4.74; 95%, CI: (1.94-11.54)] [AOR= 5.9; 95%, CI: (2.42-14.39) respectively], family planning counselling during antenatal care [AOR=2.81; 95% ,CI: (1.63- 4.86)], having postnatal care [AOR =1.79, 95%, CI: (1.09-2.96)], menses returning after birth [AOR=2.84, 95% CI: (1.77- 4.57)] and resuming sexual activity [AOR= 2.86, 95% CI: (1.71-4.78)] were factors affecting contraceptive use in postpartum period. Conclusion : The prevalence of modern contraceptive use among postpartum women was found to be high in Injibara town. Therefore, strengthen family planning counseling during antenatal care and postnatal care to reduce the missed opportunity of postpartum women to get family planning methods, especially long-acting reversible contraceptives.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Natnael Atnafu Gebeyehu ◽  
Eyasu Alem Lake ◽  
Kelemu Abebe Gelaw ◽  
Gedion Asnake Azeze

Background. The postpartum period is an important transitional time for couples to put the decision on family planning utilization. However, women in Ethiopia are usually uncertain about the use of family planning during this period. This cross-sectional study was, therefore, aimed at determining the intention of modern contraceptive use and associated factors among postpartum women attending the immunization clinic in Sodo town, Ethiopia. Method. This institution-based cross-sectional study was conducted among 416 study participants from May 25 to June 20, 2019. The data were collected by using a systematic random sampling technique of interviewer-administered questionnaires. Descriptive analysis was done, and results were presented in texts and tables. Variables at bivariate analysis with a p value < 0.2 were moved to the multivariate logistic regression model to control potential confounding variables. Statistical tests at p value < 0.05 during multivariate analysis were considered as a cutoff point to determine statistical significance. Results. A total of 416 postpartum women participated in the study yielding a response rate of 98.1%. The prevalence of intention on modern contraceptive use among study participants was 70%. The odds of intention on modern contraceptive use was higher among study participants who had secondary school education (AOR=2.052, 95% CI: 1.064-3.958), antenatal care visit (AOR=1.74; 95% CI: 1.02-2.95), knowledge on modern contraceptive use (AOR=2.54; 95% CI: 1.50-4.28), menses resumption (AOR=2.05; 95% CI: 1.14-3.68), and husband approval to use contraceptives (AOR=2.395, 95% CI: 1.501-5.458). Conclusion. The intention of modern contraceptive use among postpartum women was low. Family planning providers should emphasize reducing barriers of intention like lack of education, knowledge, male partner approval, antenatal care visit, and advise the impact of menses on fertility.


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.


2017 ◽  
Vol 19 (2) ◽  
pp. 320-333 ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Babatunde Raphael Ojebuyi

Contraceptive use in Nigeria at 15 per cent is low, despite a high human immunodeficiency virus (HIV) prevalence of 3.4 per cent and fertility rate of 5.7 per cent. We assessed the levels of spousal communication on family planning and contraception (FPC) and HIV/acquired immune deficiency syndrome (HIV/AIDS), influence of demographic characteristics on this communication and association between this communication and the respondents’ health behaviours. We used a cross-sectional and nationally representative data on reproductive health and HIV/AIDS-related issues from randomly selected 30,752 men and women of reproductive age. Descriptive statistics, Pearson chi-square (c2) and logistic regression were used to analyze the data at 5 per cent significance level. About 61 per cent of the respondents were 25–49 years old and mostly from rural areas (65 per cent). Only 20 per cent of the respondents discussed HIV/AIDS with their spouses within 12 months preceding the survey while 15 per cent discussed FPC. A discussion of both HIV/AIDS and FPC among spouses was reported among 9 per cent compared to 26 per cent who reported discussing either. Respondents aged 35–39 years had higher odds of discussing HIV/AIDS (Odds Ratios [OR] = 7.06:6.16–8.09) than those aged 15–19 years. Urban dwellers also had higher odds (OR = 1.24:1.16–1.31) of HIV/AIDS discussions than rural respondents. Modern contraceptive use was 35 per cent and 23 per cent among respondents who discussed FPC and HIV/AIDS compared to 8 per cent and 9 per cent, respectively, among those who did not. Spousal communication on FP and HIV/AIDS was low and has influenced contraceptive use and HIV positivity in Nigeria. There is a need to encourage spousal discussion on FP and HIV/AIDS, especially among the rural dwellers and the poor and uneducated as a strategy for improving modern contraceptive use.


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.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e030980 ◽  
Author(s):  
Joseph Lasong ◽  
Yuan Zhang ◽  
Simon Afewerki Gebremedhin ◽  
Sampson Opoku ◽  
Chrissie Stansie Abaidoo ◽  
...  

ObjectiveZambia is among the world’s top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women.DesignCross-sectional study.SettingRural Zambia.ParticipantsSecondary data of 4903 married or cohabiting rural women (15–49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson’s χ2and descriptive statistics were performed to examine factors associated with modern contraceptive use.ResultsFactors that were positively associated with contraceptive use were respondent’s education (secondary adjusted ORs (AOR = 1.61, p≤0.002); higher (AOR = 2.39, p≤0.050)), wealth index (middle class, (AOR = 1.35, p≤0.005); rich (AOR = 2.04, p≤0.001) and richest (AOR = 1.95, p≤0.034)), high parity (1–2 (AOR = 5.31, p≤0.001); 3–4 (AOR = 7.06, p≤0.001); 5+ (AOR = 8.02, p≤0.001)), men older than women by <10 years (AOR = 1.50, p≤0.026) and women sensitised about family planning at health facility (AOR = 1.73, p≤0.001). However, old age (40–49 years (AOR = 0.49, p≤0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR = 0.77, p≤0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR = 0.78, p≤0.026) and women without knowledge of number of children husband desires (AOR = 0.71, p≤0.001) were negatively associated with contraceptive use.ConclusionModern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Nancy L. Hancock ◽  
Carla J. Chibwesha ◽  
Marie C. D. Stoner ◽  
Bellington Vwalika ◽  
Sujit D. Rathod ◽  
...  

Introduction. Although increasing access to family planning has been an important part of the global development agenda, millions of women continue to face unmet need for contraception.Materials and Methods. We analyzed data from a repeated cross-sectional community survey conducted in Lusaka, Zambia, over an eight-year period. We described prevalence of modern contraceptive use, including long-acting reversible contraception (LARC), among female heads of household aged 16–50 years. We also identified predictors of LARC versus short-term contraceptive use among women using modern methods.Results and Discussion. Twelve survey rounds were completed between November 2004 and September 2011. Among 29,476 eligible respondents, 17,605 (60%) reported using modern contraception. Oral contraceptive pills remained the most popular method over time, but use of LARC increased significantly, from less than 1% in 2004 to 9% by 2011 (p<0.001). Younger women (OR: 0.46, 95% CI: 0.34, 0.61) and women with lower levels of education (OR: 0.70, 95% CI: 0.56, 0.89) were less likely to report LARC use compared to women using short-term modern methods.Conclusions. Population-based assessments of contraceptive use over time can guide programs and policies. To achieve reproductive health equity and reduce unmet contraceptive need, future efforts to increase LARC use should focus on young women and those with less education.


2017 ◽  
Vol 37 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Sarah R. Blackstone ◽  
Ucheoma Nwaozuru ◽  
Juliet Iwelunmor

The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women’s misconceptions of contraceptive side–effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.


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