scholarly journals Women’s post-abortion contraceptive use: Are predictors the same for immediate and future uptake of contraception? Evidence from Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261005
Author(s):  
Esinam Afi Kayi ◽  
Adriana Andrea Ewurabena Biney ◽  
Naa Dodua Dodoo ◽  
Charlotte Abra Esime Ofori ◽  
Francis Nii-Amoo Dodoo
Keyword(s):  
Family Planning ◽  
Older Women ◽  
Contraceptive Use ◽  
Secondary Data ◽  
Binary Logistic Regression ◽  
Counselling Services ◽  
Weighted Data ◽  
Contraceptive Prevalence ◽  
Facility Level ◽  
Post Abortion

This study seeks to identify the socio-demographic, reproductive, partner-related, and facility-level characteristics associated with women’s immediate and subsequent use of post-abortion contraception in Ghana. Secondary data from the 2017 Ghana Maternal Health Survey were utilized in this study. The weighted data comprised 1,880 women who had ever had an abortion within the five years preceding the survey. Binary logistic regression analyses were performed to examine the associations between the predictor and outcome variables. Health provider and women’s socio-demographic characteristics were significantly associated with women’s use of post-abortion contraception. Health provider’s counselling on family planning prior to or after abortion and place of residence were associated with both immediate and subsequent post-abortion uptake of contraception. Among subsequent post-abortion contraceptive users, older women (35–49), women in a union, and women who had used contraception prior to becoming pregnant were strong predictors. Partner-related and reproductive variables did not predict immediate and subsequent use of contraception following abortion. Individual and structural/institutional level characteristics are important in increasing women’s acceptance and use of contraception post abortion. Improving and intensifying family planning counselling services at the health facility is critical in increasing contraceptive prevalence among abortion seekers.

Assessing (in) equalities in contraceptives use and family planning demand satisfied with modern contraceptives in Kenya

2020 ◽  
Author(s):  
Peter Gichangi ◽  
Alfred Agwanda ◽  
Mary Thiongo ◽  
Michael Waithaka ◽  
Amy Tsui ◽  
...  
Keyword(s):  
Higher Education ◽  
Family Planning ◽  
Older Women ◽  
Contraceptive Use ◽  
Wealth Quintile ◽  
Married Women ◽  
Modern Contraceptives ◽  
Contraception Use ◽  
Contraceptive Prevalence ◽  
Long Acting

Abstract Background: Family planning plays an important role in reducing high-risk and unwanted pregnancies and associated complications. Kenya has made progress increasing the use of modern contraceptives. We assessed inequalities in contraceptive use and family planning demand satisfied.Methods: We used data from seven rounds of Performance, Monitoring and Accountability 2020 cross-sectional surveys, 2014-2018. Women aged 15-49 years were interviewed after informed consent was obtained. Contraceptive prevalence and demand for family planning satisfied standard definitions were used. Data were stratified by type of contraception (long-acting/permanent, short-acting, or traditional); wealth, residence, education, age, and wealth. Data were analysed using Stata v14.Results: Modern contraceptive prevalence has increased from 58.7% in 2014 to 64.2% in 2018 among sexually active married women. Total demand for family planning satisfied (DFPS) has increased from 70.5% in 2014 to 79.0% in 2018. There was a significant increase in long acting/permanent methods from 27.1% in 2014 to 42.9% in 2018 and a decrease in short acting methods from 71.6% in 2014 to 54.0% in 2018. The odds of contraception use among older women was 1.48 times higher than among adolescents (aOR=1.48; 95% CI: 1.21, 1.81); among married women 0.74 times compared to the unmarried women (aOR 0.74; 95% CI: 0.63, 0.86). The odds of contraception use increased with increasing education (secondary or higher education: aOR 3.78; 95% CI: 2.90, 4.92) and wealth quintiles (highest wealth quintile: aOR = 1.36; 95% CI: 1.12, 1.65). There were significant differences in DFPS by modern methods: older women vs adolescents (aOR = 2.40; 95% CI: 1.96, 2.93); married vs unmarried women (aOR = 1.53; 95% CI: 1.32, 1.78); secondary or higher education vs no education: aOR 2.39 (95% CI: 1.95, 2.94); and highest vs lowest wealth quintile: aOR = 1.53 (95% CI: 1.24, 1.89).Conclusion: Contraceptive use and specifically long-acting reversible contraceptives are on the rise in Kenya. However, persistent inequities need to be addressed if no women are going to be left behind to access and use family planning/contraceptives. Current achievements should be maintained while targeting women who are poor, uneducated/illiterate, young, and living in rural areas.

scholarly journals Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034675 ◽  
Author(s):  
Amrita Namasivayam ◽  
Sarah Lovell ◽  
Sarah Namutamba ◽  
Philip J Schluter
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Secondary Data ◽  
Population Level ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Logistic Regression Models ◽  
Modern Contraceptive Use

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.

Post-abortion fertility desires, contraceptive uptake and unmet need for family planning: voices of post-abortion care clients in Tanzania

2020 ◽  
pp. 1-16
Author(s):  
Colin Baynes ◽  
Erick Yegon ◽  
Grace Lusiola ◽  
Japhet Achola ◽  
Rehema Kahando
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Pregnancy Intentions ◽  
Middle Income ◽  
Fertility Desires ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Post Abortion ◽  
Contraceptive Uptake

Abstract Post-abortion care (PAC) integrates elements of care that are vital for women’s survival after abortion complications with intervention components that aid women in controlling their fertility, and provides an optimal window of opportunity to help women meet their family planning goals. Yet, incorporating quality family planning services remains a shortcoming of PAC services, particularly in low- and middle-income countries. This paper presents evidence from a mixed method study conducted in Tanzania that aimed at explaining factors that contribute to this challenge. Analysis of data obtained through client exit interviews quantified the level of unmet need for contraception among PAC clients and isolated the factors associated with post-abortion contraceptive uptake. Qualitative data analysis of interviews with a subset of these women explored the multi-level context in which post-abortion pregnancy intentions and contraceptive behaviours are formed. Approximately 30% of women interviewed (N=412) could recall receiving counselling on post-abortion family planning. Nearly two-thirds reported a desire to either space or limit childbearing. Of those who desired to space or limited childbearing, approximately 20% received a contraceptive method before discharge from PAC. The factors significantly associated with post-abortion contraceptive acceptance were completion of primary school, prior use of contraception, receipt of PAC at lower level facilities and recall of post-abortion family planning counselling. Qualitative analysis revealed different layers of contextual influences that shaped women’s fertility desires and contraceptive decision-making during PAC: individual (PAC client), spousal/partner-related, health service-related and societal. While results lend support to the concept that there are opportunities for services to address unmet need for post-abortion family planning, they also attest to the synergistic influences of individual, spousal, organizational and societal factors that influence whether they can be realized during PAC. Several strategies to do so emerged saliently from this analysis. These emphasize customized counselling to enable client–provider communication about fertility preferences, structural intervention aimed at empowering women to assert those objectives in family and health care settings, availability of information and services on post-abortion fertility and contraceptive eligibility in PAC settings and interventions to facilitate constructive spousal communication on family planning and contraceptive use, after abortion and in general.

scholarly journals Contraceptive prevalence and factors influencing utilization among women in Pakistan: a focus on gender-based violence

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Thao Thi Nguyen ◽  
Sarah Neal
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Gender Based Violence ◽  
Contraceptive Methods ◽  
Content Type ◽  
Modern Contraception ◽  
Factors Influencing ◽  
Contraceptive Prevalence ◽  
Gender Based

PurposeIn this study, the authors determined the prevalence of contraceptive use among Pakistani women and assessed factors influencing the utilization of contraception with a particular focus on the experience of gender-based violence.Design/methodology/approachThe dataset used in this study was the Pakistan Demographic Health Survey 2018, which includes married women only. Bivariate analysis and multivariate logistic regression were used to investigate the association between contraceptive use and a number of explanatory variables including experience of gender-based violence.FindingsFrom 2006 to 2018, the contraceptive prevalence rate (CPR) and the use of modern contraceptive methods increased slowly. The findings of this study demonstrated that higher educational level and wealth index increased the likelihood of contraceptive uptake and the use of modern contraception. Media exposure to family planning and spousal communication were protective factors that encouraged women to use contraception, including modern contraception, to avoid unwanted pregnancy. Women who experienced gender-based violence (GBV) were more likely to use contraception than women who did not experience GBV.Research limitations/implicationsThe use of secondary data limited the variety of important variable that should be investigated including knowledge of women on SRH, the attitude of women toward SRH and family planning, the skills of a healthcare provider on counseling family planning, and other barrier variables such as transportation and willingness to pay for contraceptive methods. 10;The sensitivity of the topic is considered as another challenge when collecting data. Women might be hesitant to share about their GBV experience. The experience to GBV is also hard to define and depends on the feeling of each person, especially emotional violence.Originality/valueThis paper is one of the very few studies to examine the association between GBV and contraceptive use, and thus is valuable in opening up debate about the links between these two factors.

A study on prevalence of contraception and estimate unmet need of family planning among married women in the rural Shamirpet, Ranga Reddy District, T.S, India.

2017 ◽  
Vol 6 (10) ◽  
pp. 5513
Author(s):  
Vijayasree L.
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Contraceptive Use ◽  
Family Planning Program ◽  
Unmet Need ◽  
Married Women ◽  
Mortality And Morbidity ◽  
The Family ◽  
Contraceptive Prevalence ◽  
Population Stabilization

The study on contraceptive use and unmet need for family planning is the key to understanding the change in fertility and improving reproductive health. Family planning program aims to not only achieve population stabilization but also to promote reproductive health and reduce maternal, infant & child mortality and morbidity. In this study an attempt has been made to assess the family planning practices adopted in the rural Shamirpet. Probability proportion sampling was done and 402 women were selected from 13 villages. Prevalence of contraception was found to be 61.7%. Permanent methods were preferred over temporary methods. Total unmet need for family planning was 11.7%. The contraceptive prevalence rate found in the present study is higher than the district figures and is on par with the state statistics. Unmet needs also are low compared to state figures.

Barriers to contraceptive use in South Tarawa, Kiribati

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Jacob Daube ◽  
Viktoria Chamberman ◽  
Eliza Raymond
Keyword(s):  
Family Planning ◽  
Service Delivery ◽  
Contraceptive Use ◽  
Service Providers ◽  
Community Survey ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Men And Women ◽  
Contraceptive Prevalence Rate ◽  
Contraceptive Prevalence

<p><strong>Background</strong>: Improving access to family planning in the Pacific region has been slow, especially for those living in remote and rural areas. Pacific countries consistently report contraceptive prevalence rates well below the United Nations’ global averages for ‘less developed’ regions.  The most recent data available on family planning usage in Kiribati from 2009 reported that the modern contraceptive prevalence rate was just 18.0% and total contraceptive prevalence rate just 22.3%.</p><div><p>The aim of the study was to investigate knowledge and use of family planning and identify barriers to contraceptive uptake for men and women of reproductive age in South Tarawa, Kiribati, to inform future approaches aimed at increasing access to family planning.</p><p><strong>Methods:</strong> A mixed methods approach was used. A community survey of men and women of reproductive age (15-49 years) (n=500) was carried out to identify current levels of knowledge, contraceptive use and barriers to use. Focus groups (n=4) of target populations (men 15-24, men 25-49, women 15-24, women 25-49) were undertaken and in-depth interviews (n=14) were conducted with health professionals and government officials to interpret survey results, further investigate barriers and generate ideas for improving service delivery.</p><p><strong>Findings:</strong> Considerable barriers to family planning use were observed in the community survey and explored in the interviews and focus groups. They can be categorised into four thematic groups: disinterest in family planning; knowledge gaps; personal, family and social objections; and unsuitable service delivery.<strong><em></em></strong></p></div><p><strong>Conclusion:</strong> A broad range of solutions were identified and fourteen service delivery recommendations were made for family planning service providers in South Tarawa. The recommendations may also hold relevance to other Pacific countries, however we encourage service providers to consider their country context before initiating any recommendations provided in this study. </p>

scholarly journals Spatial heterogeneity and major correlates of Unmet Need of family planning among young married women aged 15-24 in India: An Exploratory Study

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110246
Author(s):  
Himani Sharma ◽  
S. K. Singh ◽  
Shobhit Srivastava
Keyword(s):  
Family Planning ◽  
Spatial Heterogeneity ◽  
Young Women ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Married Women ◽  
Moran's I ◽  
Contraceptive Prevalence ◽  
Women In India ◽  
Auto Regression

For young women aged 15 to 24, unintended pregnancies remain very common, reflecting lower contraceptive use. Given the socio-cultural and traditional beliefs and practices, the unmet need for family planning is a crucial indicator for tracking the progress in contraceptive prevalence, ensuring young women’s reproductive and sexual rights. This article aims to analyze spatial heterogeneity in the unmet need for family planning among young women age 15 to 24 and their mesoscale correlates. Using data from the recent round of Indian DHS (2015–2016), commonly known as the National Family Health Survey (NFHS), this study identifies the significant correlates of unmet need of contraception among young married women in India. The statistical methods range from multinomial logistic regression, spatial autocorrelation in terms of Moran’s I statistics, to spatial auto regression, to understand the spatial dependence and clustering in the unmet need across India’s districts. The contraceptive prevalence rate among young married women age 15 to 24 in India was 24%, while almost the same proportion of them (23%) had an unmet need for contraception. Current age, education, religion, poverty, number of children, media exposure, awareness about family planning, and birth occurred in the last 3 years were significant predictors of unmet need. The univariate Moran’s I for unmet need was 0.50, suggesting strong spatial heterogeneity in India. The auto regression models become much more influential after including the spatial weights in the model, where illiteracy, unawareness, poverty, and rural residence were statistically significant predictors of unmet need of family planning among young married women in India. Findings of the study providing complex cultural ecologies of contraceptive use dynamics may give vital inputs in designing gender-sensitive interventions that can create a suitable support system and enabling environment for increasing use of contraception and reducing the unmet need of family planning.

scholarly journals Determinants of contraceptive use among married women in Indonesia

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 193
Author(s):  
Alfian Gafar ◽  
Dewi Elizadiani Suza ◽  
Ferry Efendi ◽  
Eka Mishbahatul Mar’ah Has ◽  
Ahmad Putro Pramono ◽  
...  
Keyword(s):  
Family Planning ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Contraceptive Use ◽  
Binary Logistic Regression ◽  
Wealth Index ◽  
Education Level ◽  
Married Women ◽  
Living Children ◽  
Children Education

Background: Contraceptives in family planning are used to control the timings between pregnancies. Although the number of those using family planning has increased, determinants of contraceptive use among married women in Indonesia remain insufficient. This research aimed to identify the factors associated with contraceptive use among married women in Indonesia. Methods: This study employed data from the Indonesian Demographic and Health Survey 2017. We selected 35,621 married women aged 15–49 years. Then, the determinants of contraceptive use among married women in Indonesia were examined by binary logistic regression. Results: Women’s age (Adjusted Odds Ratio (AOR)=0.529; 95% CI=0.470–0.597), the number of living children (AOR=44.024; 95% CI=33.193–58.390), education level (adjusted odds ratio=2.800; 95% CI=2.181–3.594), wealth index (AOR=1.104; 95% CI=0.978–1.246), frequency of watching television (AOR=1.555; 95% CI=1.321–1.829), and frequency of using the Internet (AOR=0.856; 95% CI=0.794–0.924) were significantly associated with contraceptive use among married women. Conclusions: This study highlights the determinants of contraceptive use among married women in Indonesia. Women’s age, the number of living children, education level, wealth index, and access to information may influence contraceptive use among these women. This study emphasizes that health education and promotion on the importance of using contraception should be initiated in innovative ways.

scholarly journals Individual and facility-level factors associated with women’s receipt of immediate postpartum family planning counseling in Ethiopia: results from national surveys of women and health facilities

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexandria K. Mickler ◽  
Celia Karp ◽  
Saifuddin Ahmed ◽  
Mahari Yihdego ◽  
Assefa Seme ◽  
...  
Keyword(s):  
Family Planning ◽  
Performance Monitoring ◽  
Multilevel Models ◽  
Contraceptive Use ◽  
Delivery Care ◽  
Lower Odds ◽  
Health Officer ◽  
Postpartum Family Planning ◽  
Facility Type ◽  
Facility Level

Abstract Background Immediate postpartum family planning (IPPFP) helps prevent unintended and closely spaced pregnancies. Despite Ethiopia’s rising facility-based delivery rate and supportive IPPFP policies, the prevalence of postpartum contraceptive use remains low, with little known about disparities in access to IPPFP counseling. We sought to understand if women’s receipt of IPPFP counseling varied by individual and facility characteristics. Methods We used weighted linked household and facility data from the national Performance Monitoring for Action Ethiopia (PMA-Ethiopia) study. Altogether, 936 women 5–9 weeks postpartum who delivered at a government facility were matched to the nearest facility offering labor and delivery care, corresponding to the facility type in which each woman reported delivering (n = 224 facilities). We explored women’s receipt of IPPFP counseling and individual and facility-level characteristics utilizing descriptive statistics. The relationship between women’s receipt of IPPFP counseling and individual and facility factors were assessed through multivariate, multilevel models. Results Approximately one-quarter of postpartum women received IPPFP counseling (27%) and most women delivered government health centers (59%). Nearly all facilities provided IPPFP services (94%); most had short- and long-acting methods available (71 and 87%, respectively) and no recent stockouts (60%). Multivariate analyses revealed significant disparities in IPPFP counseling with lower odds of counseling among primiparous women, those who delivered vaginally, and women who did not receive delivery care from a doctor or health officer (all p < 0.05). Having never used contraception was marginally associated with lower odds of receiving IPPFP counseling (p < 0.10). IPPFP counseling did not differ by age, residence, method availability, or facility type, after adjusting for other individual and facility factors. Conclusion Despite relatively widespread availability of IPPFP services in Ethiopia, receipt of IPPFP counseling remains low. Our results highlight important gaps in IPPFP care, particularly among first-time mothers, women who have never used contraception, women who delivered vaginally, and those who did not receive delivery care from a doctor or health officer. As facility births continue to rise in Ethiopia, health systems and providers must ensure that equitable, high-quality IPPFP services are offered to all women.

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