The effect of women’s bargaining power within couples on contraceptive use in Cameroon

Background: The prevalence of contraception among married women, evaluated at 23%, is low in Cameroon. Maternal death rates, estimated at 782 deaths per 100,000 live births, are very worrying. The National Strategic Plan for Reproductive, Maternal, Newborn and Child Health (2015-2020) and the Health Sector Strategy (2016-2027) focuses on increasing modern contraceptive prevalence as a means to reduce maternal death. This paper identifies women’s bargaining power as a factor that may stimulate contraceptive use. The objective of this study is to analyze the association between women's bargaining power within couples and modern contraceptive use. Methods: The data used come from the fifth Demographic and Health Survey (DHS) conducted in 2018. Women’s bargaining power within couple is measured by a Woman Bargaining Power Composite Index (WBPCI) built through a multiple correspondence analysis. The logistic regression model was used to analyze the relationship between WBPCI and modern contraceptive use. Results: The results of the descriptive statistics show that women's bargaining power is higher among women who use contraception than for those who do not. The results of the logistic regression model show that an increase of WBPCI was significantly associated with higher chances of using a modern contraceptive method (OR = 1.352; 95% CI: 1.257, 1.454; p <0.01). The education of women is also a key determinant since educated women were at least two times more likely to use a modern contraceptive method than uneducated women. Conclusions: To reduce high maternal death rates in Cameroon, public health policies should not only focus on the health system itself, but should also focus on social policies to empower women in the household.

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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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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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Bivariate Multilevel Modeling of Modern Contraceptive Use and Knowledge of HIV/AIDS Prevention of Women in Ethiopia

10.21203/rs.3.rs-524447/v1 ◽

2021 ◽

Author(s):

Daniel Bekele ◽

Essey Kebede

Keyword(s):

Hiv Prevention ◽

Contraceptive Method ◽

Contraceptive Use ◽

Spillover Effect ◽

Wealth Index ◽

Modern Contraceptive ◽

Modern Contraceptive Method ◽

Modern Contraceptive Use ◽

Women's Knowledge ◽

Women’S Knowledge

Abstract Background: Ethiopia is one of the most populous countries in Africa and has the highest number of new HIV infections. Therefore, the main objectives of this study were to demonstrate the joint predictors and association between modern contraceptive use and knowledge of HIV prevention in women aged 15-49 across clusters in Ethiopia.Methods: This study considered a weighted sample of 10,223 married women aged 15-49 years, extracted from the 2016 EDHS data. The bivariate multilevel logistics regression model was used in this study.Results: In Ethiopia, 64.75%, 54.58% of the women didn’t use the modern contraceptive method and didn’t know about HIV prevention, respectively. A positive relationship between the use of modern contraceptives and knowledge of HIV prevention of women across the clusters was found, which implies that modern contraceptive use has positive implications on women's knowledge of HIV prevention techniques across the clusters.Conclusions: Predictor visiting a health facility, wealth index, media exposure, religion, place of residence, and the contextual region are statistically related with the use of modern contraceptive use and knowledge of HIV prevention of women across the clusters. Those women who use the modern contraceptive method have more likelihood of knowing about HIV prevention. The study result confirmed that modern contraceptive use has a spillover effect on women's knowledge of HIV prevention across the clusters. Therefore, the integration of the two programs with taking into account their joint predictors was an advantage in terms of clinical benefit, cost, and for seeking care individuals in the communities. The integration of two programs with due consideration of community-specific was recommended.

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Non-use of Contraceptive Methods Among Married: Analysis of the 2018 Guinea Demographic and Health Survey

10.21203/rs.3.rs-80086/v1 ◽

2020 ◽

Author(s):

Sidikiba Sidibe ◽

Bienvenu Salim Camara ◽

Nafissatou Dioubaté ◽

Fassou Mathias Grovogui ◽

Alexandre Delamou ◽

...

Keyword(s):

Health Survey ◽

Contraceptive Method ◽

Contraceptive Use ◽

Demographic And Health Survey ◽

Modern Contraceptive ◽

Community Perception ◽

Contraceptive Methods ◽

Modern Contraceptive Method ◽

Tests Of Association ◽

Modern Contraceptive Use

Abstract Background: Modern contraceptive prevalence in Guinea was low in 2018. This study aimed to examine current modern contraceptive non-use among 1086 married women in Guinea who have used a contraceptive method. Methods: We used the dataset of the 2018 Guinea Demographic and Health Survey (GDHS). The analysis included descriptive statistics, tests of association, and logistic regression of women who are not currently using modern contraceptive methods among ever users. Results: Among the sampled women, 454 (42%) did not use modern contraceptive methods. Three out of five non-users made the decision to not use contraceptives. The factors associated with modern contraceptive non-use included living in the administrative regions of Boké (adjusted odds ratio [AOR]: 2.87; 95% confidence interval [CI]: 1.46–5.56) and Mamou (AOR: 3.56; 95% CI: 1.38–9.19); age 25–29 years (AOR: 2.80; 95% CI: 1.25–6.30), 30–34 years (AOR: 3.10; 95% CI: 1.31–7.38), and 45–49 years (AOR: 3.49; 95% CI: 1.22–10.00); and husband’s desire for more children (AOR: 1.58; 95% CI: 1.02–2.46). Conclusions: Interventions that focus on contraceptive non-users among ever users who are currently not using any modern contraceptive method could lead to the resumption of modern contraceptive use among these women. Furthermore, community-level family planning interventions such as male or couple sensitisation or men’s involvement in reproductive issues could improve community perception about contraception and women’s rights for reproductive health.

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The effect of women’s bargaining power within couples on contraceptive use in Cameroon

Gates Open Research ◽

10.12688/gatesopenres.13100.1 ◽

2020 ◽

Vol 4 ◽

pp. 20

Author(s):

Dimitri Tchakounté Tchuimi ◽

Benjamin Fomba Kamga

Keyword(s):

Maternal Death ◽

Bargaining Power ◽

Contraceptive Use ◽

Multiple Correspondence Analysis ◽

Composite Index ◽

Probit Model ◽

Target Population ◽

Descriptive Statistics ◽

Chi Square ◽

Death Rates

Background: The prevalence of contraception among married women, evaluated at 23%, is low in Cameroon. Maternal death rates, estimated at 782 deaths per 100,000 live births, are very worrying. The National Strategic Plan for Reproductive, Maternal, Newborn and Child Health (2015-2020) focuses on increasing contraceptive prevalence as a means to reduce maternal death. This paper identifies women’s bargaining power as a factor that may stimulate contraceptive use. The objective of this study is to measure the effect of women's bargaining power within couples on contraceptive use. Methods: The data used come from the Demographic and Health Survey and Multiple Indicators (DHS-MICS) conducted in 2011. Women’s bargaining power within couples is measured by a Woman Bargaining Power Composite Index (WBPCI) built through a multiple correspondence analysis. Descriptive statistics (frequency distribution, cross tabulation, chi-square test) and the probit model were used to analyze the relationship between WBPCI and contraceptive use. Additionally, since the target population for this study is couples in which women were not pregnant, a Heckman probit model was also estimated to address the potential selection bias. Results: The results of the descriptive statistics show that women's bargaining power is higher among women who use contraception than for those who do not. The results of the probit model show that women's bargaining power significantly increases the probability of contraceptive use by 3.4%. In addition, the probability of using contraception also increases with the education of women. The estimation of the Heckman probit model illustrates that the effect of women's bargaining power on the probability of contraceptive use remains virtually unchanged. Conclusions: To reduce high maternal death rates in Cameroon, public health policies should not only focus on the health system itself but should also focus on social policies to empower women in the household.

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EFFECT OF FAMILY PLANNING SERVICES ON MODERN CONTRACEPTIVE METHOD CONTINUATION IN VIETNAM

Journal of Biosocial Science ◽

10.1017/s0021932006001453 ◽

2006 ◽

Vol 39 (2) ◽

pp. 201-220 ◽

Cited By ~ 10

Author(s):

MAI P. DO ◽

MICHAEL A. KOENIG

Keyword(s):

Family Planning ◽

Contraceptive Method ◽

Contraceptive Use ◽

Quality Of Services ◽

Modern Contraceptive ◽

Family Planning Services ◽

Modern Contraceptive Method ◽

Health Centres ◽

Outreach Programme

Summary.Access to and quality of services have increasingly been the focus of family planning programme managers, implementers and researchers in the developing world. In Vietnam, a country characterized by recent significant achievements in family planning, not much is known about the linkages between service accessibility and quality and contraceptive behaviour. Data for this study come from the Vietnam 1997 Demographic and Health Survey, with individual contraceptive use information recorded in the calendar section. Measures of access to and quality of services come from the Community/Health Facility Questionnaire, with key informant interviews and facility visits. The study focuses on the effects of the outreach programme and commune health centres on contraceptive method discontinuation for three modern, temporary methods: the IUD, oral pills and condoms. Longer travel time to commune health centres is found to be associated with significantly increased risks of first- and all-method discontinuation for any reason, while residence in communities with higher quality health centres is associated with significantly lower risks of method discontinuation. Access to and quality of the outreach programme are, in contrast, not significant determinants of method discontinuation for any reason. Similar results are found for first- and all-method discontinuation for service-related reasons. The effects of programmatic factors are more pronounced among older women and during the first three months of method use. This study provides evidence for the importance of family planning services for contraceptive method continuation in Vietnam. The results also highlight the need for a thorough evaluation of the family planning outreach programme in terms of its facilitation of women’s continued use of contraception.

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Modern contraceptive use among married women: the case of Aleta Chuko district, Southern Ethiopia

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20204030 ◽

2020 ◽

Vol 6 (10) ◽

pp. 388

Author(s):

Andualem Zenebe ◽

Abayneh Ayele ◽

Tesfaye Woltamo ◽

Kaleab Tesfaye Tegegne

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Contraceptive Use ◽

Married Women ◽

Reproductive Age ◽

Southern Ethiopia ◽

Cluster Sampling ◽

Modern Contraceptive ◽

District Health ◽

Modern Contraceptive Use

Background: Family planning is one of the factors which have a great role in the reduction of global poverty by positively contributing to socio-economic development. Additionally controlling both the number and timing of births through utilization of contraception is associated with improved maternal and neonatal health outcomes. The aim of the study was to assess utilization of modern contraception among married women.Methods: A community based cross- sectional study with quantitative and qualitative study methods was conducted from February 15 to March 15, 2016 in Aleta Chuko district, Southern Ethiopia. Multistage cluster sampling procedure was used to select a total of 364 married women of reproductive age (18-49). Descriptive statistics, Bivariate and multivariate logistic regression analyses were performed using SPSS version 20.0. On the other hand, qualitative data were analyzed thematically and the result was presented in narration.Results: Contraceptive prevalence rate among married women in Aleta Chuko district was 45.5%. Results of Multiple Binary Logistic Regression revealed that residence, educational level of the respondents, discussion about modern contraceptives with husband, partner’s approval of modern contraceptive use and joint decision on the number of children were significantly associated with modern contraceptive use.Conclusions: Therefore, district health office and concerned stakeholders should focus on couples to encourage girl’s education, communication between couples, and male involvement for family planning.

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Social networks and their effects on the choice of contraceptive use and method in Bangladesh

International Journal of Human Rights in Healthcare ◽

10.1108/ijhrh-07-2018-0045 ◽

2019 ◽

Vol 13 (1) ◽

pp. 58-71 ◽

Cited By ~ 1

Author(s):

Md Shahidul Islam

Keyword(s):

Social Networks ◽

Logistic Regression ◽

Social Network ◽

Contraceptive Use ◽

Multinomial Logistic Regression ◽

Binary Logistic Regression ◽

Modern Method ◽

Modern Contraceptive ◽

Content Type ◽

Modern Contraceptive Method

Purpose The purpose of this paper is to examine the effects of social networks on contraceptive adoption in Bangladesh. Design/methodology/approach Data were collected from 430 couples; the age of men was between 15 and 49 years. χ2 test was applied to test the association between independent variables and current contraceptive use. Binary logistic regression was applied to examine the effects of social network on contraceptive use, and multinomial logistic regression was applied to examine the effect of social network on the choice of method. Findings Results from binary logistic regression reveal that social networks of both men (OR=2.71, 95% CI=1.371−5.354) and women (OR= 3.597, 95% CI=1.754−7.380) had a strong positive effect on current contraceptive use. The result from multinomial logistic regression also shows that men’s social network (OR= 2.74, 95% CI= 1.356−5.548) and women’s social network (OR=4.165,95% CI=1.958−8.860) were also associated with choosing a modern contraceptive method. Originality/value Social networks have a significant effect on current contraceptive use and modern method choice in Bangladesh. A social network approach should be included in family planning program in Bangladesh.

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A Multilevel Analysis of Predictors of Modern Contraceptive Use among Reproductive Age Women in Sierra Leone: Insight from Demographic and Health Surveys.

10.31235/osf.io/vu5ag ◽

2019 ◽

Author(s):

Pascal Agbadi ◽

Eunice Tagoe ◽

Agyemang Florence Akosua ◽

Seth Owusu

Keyword(s):

Logistic Regression ◽

Sierra Leone ◽

Health Surveys ◽

Contraceptive Use ◽

Reproductive Age ◽

Demographic And Health Surveys ◽

Modern Contraceptive ◽

Reproductive Age Women ◽

Modern Contraceptives ◽

Modern Contraceptive Use

Background: Variations in the effect of predictors of Sierra Leone women’s use of modern contraceptive from one community to another is unknown. The identified gap was addressed using multilevel logistic regression models.Methods: Pooled 2008 and 2013 Sierra Leone Demographic and Health Surveys datasets were used. Single level logistic regression analyses were conducted on 24,032 women, and multilevel logistic regression models were performed on 23,329 women. Statistical significance was pegged at p≤0.01 and p≤0.05.Results: About 22.1% of the reproductive age women ever used a modern contraceptive. The best-fitted model indicated that the effects of individual, household, and geo-residential level factors on the use of modern contraceptives among Sierra Leone Women vary from one community to another. The woman’s age, marital status, educational qualification, listening to the radio, recent sexual activity, household wealth, place of residence, and region of residence were the statistically significant predictors of modern contraceptive use among reproductive-age Sierra Leone women.Conclusion: The study provided in-depth insight into the significant factors that account for the variability in women use of contraceptives in Sierra Leone. The study underscored the need for community-based intervention programs to address the low use of modern contraceptives among Sierra Leone women.

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

10.21203/rs.2.24713/v1 ◽

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 Contraceptive Method ◽

Modern Contraceptives ◽

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 of and factors associated with modern contraceptive use among female refugee adolescents in Northern Uganda. Methods This was a cross sectional study employing 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 consenting 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%), 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 would shape decision-making and increase modern contraceptive use among refugee adolescents.

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