scholarly journals Spatial distribution and factors associated with modern contraceptive use among women of reproductive age in Nigeria: A multilevel analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0258844
Author(s):  
Obasanjo Afolabi Bolarinwa ◽  
Zemenu Tadesse Tessema ◽  
James Boadu Frimpong ◽  
Abdul-Aziz Seidu ◽  
Bright Opoku Ahinkorah
Keyword(s):  
Spatial Distribution ◽  
Multilevel Analysis ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
High Fertility ◽  
Modern Contraceptive ◽  
Women Of Reproductive Age ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
The Individual

Background Evidence suggests that in countries with high fertility and fecundity rates, such as Nigeria, the promotion of modern contraceptive use prevents approximately 32% and 10% of maternal and child mortality, respectively. Therefore, this study aimed to assess the spatial distribution of modern contraceptive use and its predictors among women of reproductive age in Nigeria. Methods The study employed a cross-sectional analysis of population-based data involving 24,281 women of reproductive age in Nigeria. The study adopted both multilevel and spatial analyses to identify the predictors of modern contraceptive use and its spatial clustering among women in Nigeria. Results Modern contraceptive use among the study population in Nigeria ranged from 0% to 75%, with regional variations. The spatial analysis showed that areas with a low proportion of modern contraceptive use were Sokoto, Yobe, Borno, Katsina, Zamfara, Kebbi, Niger, Taraba and Delta. Areas with a high proportion of modern contraceptive use were Lagos, Oyo, Osun, Ekiti, Federal capital territory, Plateau, Adamawa, Imo, and Bayelsa. The multilevel analysis revealed that at the individual level, women with secondary/higher education, women from the Yoruba ethnic group, those who had four children and above, and those exposed to mass media had higher odds of using modern contraceptives. On the other hand, women who were 35 years and above, those who were married, and women who were practicing Islam were less likely to use modern contraceptives. At the household/community level, women from the richest households, those residing in communities with medium knowledge of modern contraceptive methods, and women residing in communities with a high literacy level were more likely to use modern contraceptives. Conclusion There were major variations in the use of modern contraception across various regions in Nigeria. As a result, areas with low contraceptive rates should be given the most deserving attention by promoting contraceptive education and use as well as considering significant factors at the individual and household/community levels.

scholarly journals Coverage and Determinants of Modern Contraceptive Use in Sub-saharan Africa: Further Analysis of Demographic and Health Surveys

2021 ◽  
Author(s):  
Isaac Boadu
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Women Of Reproductive Age ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age in Sub-Saharan Africa (SSA). Methods: Data for the study was obtained from the latest Demographic and Health Surveys (DHS) conducted between 1995-2020 across 37 SSA countries. Women of reproductive age (15-19 years) was the unit of analysis. Analyses of data was done using STATA version 16 for windows. A bivariate Rao Scott’s chi-square test of independence was done to determine factors associated with the use of modern contraceptives. Factors that showed significance (p<0.05) were included in a multilevel logistic regression to determine significant predictors of modern contraceptives. Clustering, stratification and sample weighting were accounted for in the analyses. Results: The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of contraceptives used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use contraceptive if they: had no education (aOR = 0.4, 95% CI: 0.38-0.44), had no children (aOR=0.27-0.42), not told of family planning at a health facility (aOR = 0.69, 95% CI: 0.67-0.71), not heard of family planning in the media (aOR = 0.77, 95% CI: 0.74-0.79) and being poor (aOR=0.76, 95%CI: 0.73-0.79). On the other hand, women were more likely to use modern contraceptive if they were between the age of 35-39 years (aOR=1.69, 95%CI: 0.73-0.79), married (aOR=2.66, 95%CI: 2.50-2.83), had seven or more children (aOR=1.27, 95%CI:1.17-0.38), had knowledge of any method of contraceptives (aOR=303.8, 95%CI: 89.9-1027.5) and when field worker visited and talked about family planning (aOR=1.53, 95%CI: 1.39-0.68).Conclusion: The study showed a low prevalence of modern contraceptive use in Sub-Sahara Africa. Findings from the study highlight the need to provide education to women to increase uptake of contraceptive use and also re-enforce contraceptive interventions to improve women’s health and well-being.

scholarly journals The role of empowerment in the use of modern contraceptives among women in need of family planning in Burkina Faso: A multilevel analysis

2020 ◽  
Author(s):  
Sylvain Y. M. SOME ◽  
Christy Pu ◽  
Song-Lih Huang
Keyword(s):  
Secondary Education ◽  
Family Planning ◽  
Burkina Faso ◽  
Gender Equality ◽  
Multilevel Analysis ◽  
Contraceptive Use ◽  
Community Level ◽  
Modern Contraceptive ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use

Abstract Background In Burkina Faso, women still have difficulty satisfying their family planning demand because of the patriarchal and gender-unequal society. Despite evidence that women’s empowerment can help, few studies have measured its impact at both community and household levels. Taking into account these two parameters, we looked into the association between women’s empowerment and modern contraception use among Married Women of Reproductive Age (MWRA) with no desire for having children in Burkina Faso. Methods Using the 2010 Demographic and Health Survey (DHS), we analyzed data from 4714 MWRA with family planning needs from 573 communities. Indicators of gender equality at the community level were composed of aggregated variables for each primary sampling unit, and domains of women’s agency in households matters were derived with principal component analysis. A multilevel logistic regression model was used to gauge the effects of empowerment on modern contraceptives use adjusted for household socioeconomic status and demographics of women. Results Among MWRA, 30.8% satisfied their demand for family planning using modern methods. At the community level, higher women’s assets ownership (aOR 1.26, CI 1.04 - 1.54), secondary education (aOR 1.45, OR 1.08 - 1.64), and exposure to family planning messages (aOR 1.33, CI 1.08 - 1.64) were associated with more modern contraceptive use; higher ideal number of children was negatively associated (aOR 0.76, CI 0.61 - 0.95). Unexpectedly, higher community prevalence of female genital mutilation was positively associated with contraceptive use (aOR 1.25, CI 1.03-1.52). Women’s agency in household matters, including opposing domestic violence, involved with decisions and enjoying freedom in seeking healthcare were positively associated with use, but only the last domain remained significant in multilevel analysis (aOR 1.29, CI 1.08 - 1.54). Living in richer household, being older, and having secondary education level were also positively associated with modern contraceptive use. Conclusion Gender equality at the community level and women’s situation in the household constitute the context in which women’s demand for family planning is determined. Therefore, promoting gender equality and ensuring women’s entitlement to make life choices have the potential to increase modern contraceptive coverage along with improved life conditions.

scholarly journals Predictors of modern contraceptive use among adolescent girls and young women in sub-Saharan Africa: a mixed effects multilevel analysis of data from 29 demographic and health surveys

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah
Keyword(s):  
Multilevel Models ◽  
Contraceptive Use ◽  
Contextual Factors ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Chi Square ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use ◽  
The Individual

Abstract Background The use of modern contraceptives among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) remains an issue that needs urgent attention. This present study assesses the individual and contextual factors associated with modern contraceptive use among AGYW in SSA. Methods Data for this study was obtained from the latest Demographic and Health Surveys (DHS) conducted between January 2010 and December 2018 across 29 countries in SSA. Data were analysed with Stata version 14.2 by employing both Pearson’s chi-square test of independence and a multilevel binary logistic regression. The selection of variables for the multilevel models was based on their statistical significance at the chi-square test at a p < 0.05. Model fitness for the multilevel models was checked using the log likelihood ratios and Akaike’s Information Criterion (AIC) and the results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results It was found that 24.7% of AGYW in SSA use modern contraceptives. In terms of the individual level factors, the study showed that AGYW aged 15–19 [aOR = 0.86, CI = 0.83–0.90], those who were married [aOR = 0.83, CI = 0.79–0.87], Muslims [aOR = 0.59, CI = 0.57–0.62], working [aOR = 0.92, CI = 0.89–0.95], those who had no child [aOR = 0.44, CI = 0.42–0.47], those who had no exposure to newspaper/magazine [aOR = 0.44, CI = 0.63–0.71] and radio [aOR = 0.82, CI = 0.78–0.86] had lower odds of using modern contraceptives. Conversely, the use of modern contraceptives was high among AGYW whose age at first sex was 15–19 years [aOR = 1.20, CI = 1.12–1.28]. With the contextual factors, the odds of using modern contraceptives was low among AGYW who lived in rural areas [aOR = 0.89, CI = 0.85–0.93] and in communities with low literacy level [aOR = 0.73, CI = 0.70–0.77] and low socio-economic status [aOR = 0.69, CI = 0.65–0.73]. Conclusion Several individual and contextual factors are associated with modern contraceptive use among AGYW in SSA. Therefore, Governments in the various countries considered in this study should intensify mass education on the use of modern contraceptives. This education should be more centered on AGYW who are in socio-economically disadvantaged communities, those who are not married, Muslims, those with high parity and high fertility preferences and those who are working.

Contraceptive use in Eswatini: do contextual influences matter?

2020 ◽  
Vol 53 (1) ◽  
pp. 20-37
Author(s):  
Clifford Odimegwu ◽  
Garikayi B. Chemhaka
Keyword(s):  
Rural Women ◽  
Socioeconomic Development ◽  
Contraceptive Use ◽  
Community Level ◽  
High Fertility ◽  
Modern Contraceptive ◽  
Community Factors ◽  
Individual Level ◽  
Modern Contraceptives ◽  
The Individual

AbstractThis study sought to investigate the determinants of current use of modern contraceptives beyond the individual level in Eswatini (formerly Swaziland). Previous studies have overlooked the role of community characteristics such as socioeconomic development, women’s empowerment and fertility norms in shaping contraceptive use. Hierarchical structured subsample data of 4112 sexually experienced women from the 2007 Eswatini Demographic Health Survey were analysed using multilevel logistic regression to identify factors contributing to community/cluster variations in women’s current use of modern contraceptives. Less than half (44.2%) of the sexually active women were using modern contraceptive methods in 2007. At the community level, the odds of contraceptive use decreased for rural women (AOR = 0.82, 95% CI: 0.68–0.98) and among women residing in communities with high-fertility norms (AOR = 0.77, 95% CI: 0.66–0.89). After adjusting for both individual- and community-level factors, no community-level variables considered for the study were significantly associated with contraceptive use. The findings highlight in all four models, from the empty to full model, that there is a small and decreasing significant variation in women’s contraceptive use across communities (MOR, 1.37–1.17). In 2007, the findings suggest individual rather than community factors account for some contextual variability in contraceptive use. The study proposes the use of ethnographic techniques to unravel community factors that promote modern contraceptive use in Eswatini.

scholarly journals Spatial variations and associated factors of modern contraceptive use in Ethiopia: a spatial and multilevel analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037532
Author(s):  
Teketo Kassaw Tegegne ◽  
Catherine Chojenta ◽  
Peta Michelle Forder ◽  
Theodros Getachew ◽  
Roger Smith ◽  
...  
Keyword(s):  
Health Facility ◽  
Contraceptive Use ◽  
Addis Ababa ◽  
Married Women ◽  
Spatial Variations ◽  
High Fertility ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Modern Contraceptives ◽  
Modern Contraceptive Use

ObjectiveTo assess spatial variations in modern contraceptive use and to identify factors associated with it among married women in Ethiopia.DesignCross-sectional analysis of population-based and health facility data.SettingEthiopia Demographic and Health Survey data linked to Service Provision Assessment data.Population8473 married women and 1020 facilities that reported providing family planning services.MethodsA linked secondary data analysis of population and health facility data was carried out. Both multilevel and spatial analyses were conducted to identify key determinants of women’s use of modern contraceptive and spatial clustering of modern contraceptive use.Main outcome measureModern contraceptive use.ResultsAbout 24% of the variation in the use of modern contraception was accounted for by location. A one-unit increase in the mean score of health facilities’ readiness to provide short-term modern contraceptives in a typical region was associated with a 20-fold increase in the odds of modern contraceptive use (adjusted OR (AOR) 20.49, 95% CI 1.44 to 29.54). In the spatial analysis, it was found that Addis Ababa and the Amhara region had high clusters of modern contraceptive use rates. On the other hand, low rates of contraceptive use were clustered in the Afar and Somali regions.ConclusionThere were significant variations in the use of modern contraceptives across the different regions of Ethiopia. Therefore, regions with low contraceptive rates and high fertility rates should be targeted for scaling up and tailoring of services to the culture and lifestyles of the population of those regions.

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

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.

scholarly journals Factors associated with modern contraceptive use: a comparative analysis between younger and older women in Umlazi Township, KwaZulu-Natal, South Africa

2021 ◽  
Vol 17 ◽  
pp. 174550652110606
Author(s):  
Mbuzeleni Hlongwa ◽  
Chester Kalinda ◽  
Karl Peltzer ◽  
Khumbulani Hlongwana
Keyword(s):  
Older Women ◽  
Contraceptive Use ◽  
Unplanned Pregnancy ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Women Of Reproductive Age ◽  
Level Of Education ◽  
Factors Associated ◽  
Kwazulu Natal ◽  
Modern Contraceptive Use

Introduction: Unplanned pregnancy continues to be a global reproductive and public health concern among women. This study aimed to investigate whether factors associated with modern contraceptive use differ by age-group among young and older women of reproductive age. Methods: This was a cross-sectional study conducted among 433 women of reproductive age, with the median age of 25 years (interquartile range: 21–28), and aged between 18 and 49. Data were collected from 10 public health care clinics in Umlazi Township, KwaZulu-Natal, using a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson’s chi-square test and logistic regression models were employed to assess the level of the association between the predictor and outcome variables, and the p-value of 0.05 or lower was considered statistically significant. Results: Most women in the sample (n = 351, 81%) had obtained a secondary level of education, while 53% (n = 230) were unemployed and 89% (n = 387) were single. We found that women with secondary level of education (AOR: 2.89, 95% CI: 0.99–5.38) or a tertiary level of education (AOR 3.80, 95% CI: 1.07–3.53) were more likely to use contraceptive methods compared to women with lower education. Women who experienced unplanned pregnancy (AOR 0.51, 95% CI: 0.22–3.79) were more likely to use contraceptives. Women aged 25–49 years who experienced pregnancy, whether planned (AOR 3.87, 95% CI: 1.08–3.89) or unplanned (AOR 3.60, 95% CI: 2.15–4.19), were more likely to use a contraceptive method. Results showed that the level of education (p = 0.942) and whether one experienced unplanned pregnancy (p = 0.913) were not significant predictors of contraceptive use among women aged 18–24 years. Conclusion: Concerted educational efforts to addressing existing barriers deterring women from accessing contraception among young women are necessary. Different groups of women should be targeted with family planning interventions specific to their needs.

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