The Prevalence and Determinants of Using Withdrawal to Avoid Pregnancy in Tabriz, Iran

Objectives: Despite the increasing knowledge about family planning and modern contraceptive methods, as well as high failure rates of the traditional method, a significant percentage of couples use withdrawal for contraception. Accordingly, the present study mainly aimed to investigate the determinants of using withdrawal to avoid pregnancy in Tabriz. Materials and Methods: The sample of the study included 383 married women aged 15-49 years. Multivariate logistic regression analyses were employed to determine factors associated with using withdrawal as a contraceptive method. Results: Based on the results, about 19.5% of the women were relying on withdrawal. In addition, 55% reported that they were currently using a modern method to avoid pregnancy while the remaining 25.5% used no method in order to prevent contraception. The results of multivariate logistic regression demonstrated that university-educated couples with no child who were within the age range of 15-24 and born in urban areas were more likely to use withdrawal rather than modern contraceptive methods (P<0.05). Conclusions: In general, the rate of employing the traditional method in Iran and, especially in Tabriz is increasing. Regarding higher proportion of withdrawal use among higher educated women due to the fear of side effects resulted from other methods, family planning providers and reproductive health services should be sensitive to the women’s concern and provide programs to decrease the unmet need of family planning.

Download Full-text

Share of current unmet need for modern contraceptive methods attributed to past users of these methods in India

Journal of Biosocial Science ◽

10.1017/s0021932020000279 ◽

2020 ◽

pp. 1-12

Author(s):

Ankita Shukla ◽

Anrudh K. Jain ◽

Rajib Acharya ◽

F. Ram ◽

Arupendra Mozumdar ◽

...

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Unmet Need ◽

Family Health ◽

Modern Method ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

The Past ◽

Modern Methods ◽

Reversible Method

Abstract Despite persistent efforts, unmet need for contraceptives in India has declined only slightly from 14% to 13% between 2005–06 and 2015–16. Many women using a family planning method discontinue it without switching to another method and continue to have unmet need. This study quantified the share of current unmet need for modern contraceptive methods attributed to past users of these methods in India. Data were drawn from two rounds of the National Family Health Survey conducted in 2005–06 and 2015–16. Using information on women with current unmet need, and whether they used any modern method in the past, the share of past users with current unmet need for modern methods was calculated. Bivariate and multivariate analyses were performed. Among 46 million women with unmet need, 11 million were past users of modern methods in 2015–16. The share of current unmet need attributed to past users of modern contraceptive methods declined from 27% in 2005–06 to 24% in 2015–16. Share of current unmet need attributed to past users was associated with reversible method use. This share rose with increased use of modern reversible methods. With the Indian family planning programme’s focus on increasing modern reversible method use, the share of unmet need attributed to past users of modern methods is likely to increase in the future. The programme’s emphasis on continuation of contraceptive use, along with bringing in new users, could be one of the key strategies for India to achieve the FP2020 goals.

Download Full-text

Factors that affect the discontinuation of family planning methods in Myanmar: analysis of the 2015–16 Myanmar Demographic and Health Survey

Contraception and Reproductive Medicine ◽

10.1186/s40834-020-00126-5 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Khaing Nwe Tin ◽

Thae Maung Maung ◽

Thiri Win

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Health Survey ◽

Unmet Need ◽

Contraceptive Methods ◽

Multivariable Logistic Regression ◽

Unplanned Pregnancies ◽

Contraceptive Discontinuation ◽

Voluntary Choice

Abstract Background Access to family planning contributes up to a 44% reduction in maternal deaths. Since the majority of unplanned pregnancies and abortions occur in women who were either not using contraception or not using it consistently, greater access to contraception and more consistent use of contraception are crucial in the reduction of unplanned pregnancies and abortions. This study aims to determine which types of contraceptives are most often discontinued, the reasons for discontinuation, and the factors that influence contraceptive discontinuation for women in Myanmar. Methods This study is a secondary data analysis of calendar data from the 2015–16 Myanmar Demographic Health Survey. The dependent variable is discontinuation of contraception within 12 months among episodes of contraceptive use in the 5 years before the survey among women age 15–49. Multivariable logistic regression was used to identify the predictors of contraceptive discontinuation. Results The 12-month discontinuation rate for all contraceptive methods was 39%. The discontinuation rates for short-term methods were remarkably high (43% for pills and 42% for injectables), while the rate for long-term methods was very low (7% for intrauterine devices and 0.2% for implants). Discontinuation while still in need of contraception was high (55%) although 28% of those women switched to other modern methods. Multivariable logistic regression showed the factors associated with contraceptive discontinuation were a woman’s age, location (state/region), wealth, and number of births within the past 5 years. Conclusions The high rate of discontinuation while in need is very alarming given goals to reduce the unmet need for family planning in Myanmar. Family planning programs must ensure timely, informed method-switching by women who discontinue contraception, especially among women for whom discontinuation is the highest (age 45–49, middle and richest wealth quintile, regions where high discontinuation and multiparity); increase the availability of long-term contraceptive methods, and improve counseling that ensures clients’ informed and voluntary choice of family planning services.

Download Full-text

Modern contraceptive use among adolescent girls and young women in Benin: a mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2021-054188 ◽

2022 ◽

Vol 12 (1) ◽

pp. e054188

Author(s):

Noudéhouénou Crédo Adelphe Ahissou ◽

Lenka Benova ◽

Thérèse Delvaux ◽

Charlotte Gryseels ◽

Jean-Paul Dossou ◽

...

Keyword(s):

Mixed Methods ◽

Young Women ◽

Contraceptive Use ◽

Unmet Need ◽

Modern Method ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Modern Contraceptives ◽

Modern Methods ◽

Qualitative Part

ObjectivesThe study aimed to assess the determinants of modern contraceptive method use among young women in Benin.DesignA mixed-methods design.Setting and participantsWe used the Benin 2017–2018 Demographic and Health Survey datasets for quantitative analysis. Data collection was conducted using multiple-cluster sampling method and through household survey. Qualitative part was conducted in the city of Allada, one of the Fon cultural capitals in Benin. The participants were purposively selected.OutcomesContraceptive prevalence rate, unmet need for modern method and percentage of demand satisfied by a modern method for currently married and sexually active unmarried women were measured in the quantitative part. Access barriers and utilisation of modern methods were assessed in the qualitative part.ResultsOverall, 8.5% (95% CI 7.7% to 9.5%) among young women ages 15–24 were using modern contraceptives and 13% (12.1% to 14.0%) among women ages 25 or more. Women 15–24 had a higher unmet need, and a lower demand satisfied by modern contraceptive methods compared with women ages 25 or more. 60.8% (56.9% to 64.7%) of all unmarried young women had unmet need for modern contraceptives. Young women were more likely to use male condoms which they obtain mainly from for-profit outlets, pharmacies and relatives. The factors associated with demand satisfied by a modern method were literacy, being unmarried, knowing a greater number of modern contraceptive methods and experiencing barriers in access to health services. On the other hand, the qualitative study found that barriers to using modern methods include community norms about pre-marital sexual intercourse, perceptions about young women’s fertility, spousal consent and the use of non-modern contraceptives.ConclusionContraceptive use is low among young women in Benin. The use of modern contraceptives is influenced by sociodemographic factors and social norms. Appropriate interventions might promote comprehensive sexuality education, increase community engagement, provide youth-friendly services and address gender inequalities.

Download Full-text

IMPROVING DESIGN AND DELIVERY OF FAMILY PLANNING SERVICES TO MEET THE UNMET NEED FOR CONTRACEPTION IN QUETTA BALOCHISTAN

Pakistan Journal of Public Health ◽

10.32413/pjph.v8i4.245 ◽

2019 ◽

Vol 8 (4) ◽

pp. 213-218

Author(s):

Naiha Sagheer ◽

Saleem Ullah ◽

Noureen Latif ◽

Tabinda Zaman

Keyword(s):

Family Planning ◽

Mass Media ◽

Health Workers ◽

Unmet Need ◽

Monitoring And Evaluation ◽

Cross Sectional Study ◽

Reproductive Age ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Cross Sectional

Background: Approximeately 24 percent of married women of reproductive age in Pakistan would like to adopt family planning, but are unable to avail the means to practice contraception. This study has been conducted to find out frequency and perception about family planning practices and further to explore and analyze the causes of failure to meet the demand for contraception. Methods: A cross-sectional study was conducted on married females of reproductive age group and married males while visiting the outpatient departments of two hospitals of Quetta from January to September 2017. They were interviewed by researchers through a structured, reliable and pretested questionnaire. The data obtained and analyzed by using SPSS 21 version. Results: 76% of participants were in favour of practicing yet only 33.8% had actually practiced it sometime during their reproductive years. The major reasons for not using family planning were the apprehension of harmful effects of contraceptive methods (52.6%), non-supportive partner (30%), unavailability of services (11.4%) and religious constraints (6%). The mass media was the main source of motivational information(69%) followed by Lady health workers. Conclusion: The current prevalence of family planning is still not at the expected level, There is a dire need of the continued use of mass media and services of community health workers to raise awareness. The practice of modern contraceptive methods can be enhanced by provision of client-centered quality services.. An increase in the number of family planning centers along with an efficient functioning, monitoring, and evaluation are also required to address unmet needs of the community near their doorstep.

Download Full-text

Analysing the factors favoring the use of modern contraceptive methods among Kinoise women in the Democratic Republic of Congo

International Journal of Research in Business and Social Science (2147-4478) ◽

10.20525/ijrbs.v9i4.713 ◽

2020 ◽

Vol 9 (4) ◽

pp. 304-313

Author(s):

Lukau Matezo Espoir ◽

Malimingi Muhole Amantha

Keyword(s):

Family Planning ◽

Urban Areas ◽

Democratic Republic Of Congo ◽

Family Health ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Attitudes And Practices ◽

Provincial City ◽

Level Of Knowledge ◽

The City

This study aims to identify the factors that favor the use of modern contraceptive methods in non-pregnant women who need to space or limit births. The analyzes were made using SPSS software (statistical package for social sciences) version 25. The data used in this publication comes from a TRAC survey on family planning carried out by the Family Health Association / Population Service international (ASF / PSI) in DRC. Continuously Tracking Results surveys are knowledge surveys, attitudes, and practices of women in matters of family planning but with the introduction of questions on scales as mentioned above. This survey concerned 1965 women aged 15 to 49 selected in urban and peri-urban areas of the provincial city of Kinshasa. Our results show that the discussion between partner or spouse on the use of modern contraceptive methods positively influences the majority of women (OR = 4.28; p <0.001),being part of a social norm (OR = 3.30; p <0.01) and having a high socioeconomic level (OR = 2.54; p <0.01), also favor positively the use of modern contraceptives. The paper concludes that any effort to increase contraceptive prevalence should target attitude, level of knowledge of methods, and spousal support to optimize the use of modern contraception in the city of Kinshasa.

Download Full-text

Spatial Heterogeneity and Socio-economic Correlates of Unmet Need for Spacing in India: Evidences From National Family Health Survey, 2015-16

10.21203/rs.3.rs-882681/v1 ◽

2021 ◽

Author(s):

Margubur Rahaman ◽

MD Juel Rana ◽

Avijit Roy ◽

Pradip Chouhan

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Spatial Heterogeneity ◽

Health Survey ◽

Unmet Need ◽

Married Women ◽

Multivariate Logistic Regression ◽

Natural Break ◽

National Family ◽

Unmet Need For Contraception

Abstract Background:The high unmet need for contraception among women who wants to delay their subsequent births for two or more years is a challenging issue in India. Therefore, the present study aims to display spatial heterogeneity and determine the associated factors underlying the unmet need for contraception among the currently married women aged 15-49 years with a demand for spacing births in India.Methods:The present study used data from the National Family and Health Survey, 2015-16. Unmet need for spacing (UNS) used as outcomes and socio-cultural and demographic factors as explanatory variables. Among the comprehensive family planning, 16.7% (56742 women) of currently married women had demand for spacing births were used for analysis. Univariate, bivariate with chi-square significance test, spatial natural break technique, and multivariate logistic regression were used to accomplish the study objectives. Results:Almost 17% of women had demand spacing out of total demand for family planning in India. High unmet need for contraception found among them except the women with higher-level education and wealth status. District level spatial heterogeneity of UNS shows 119 districts had very high unmet for spacing (69% and above). Results from multivariate logistic regression show that UNS's likelihood was noticeably high among the women with parity three or more (AOR: 1.42 [1.3-1.55]) compared to their counterparts. Similarly, 44% (AOR: 1.44[1.38-1.51]) more likely found among the OBC than General caste. Rural (AOR: 1.24[1.19-1.30]) women compared to urban, women living in South (AOR: 6.19 [5.76-6.65]), Central (AOR: 1.52 [1.43-1.61]), and West (AOR: 1.80 [1.68-1.92]) region compared to those from North had higher odds of UNS. Conclusion:Deal with the UNS in India requires scaling up women education, client choice-based services, campaign on benefits of spacing births and available contraception, and socio-economically backward group centric policies.

Download Full-text

Geospatial Distribution of Family Planning Services in Kira Municipality, Wakiso District, Uganda

Frontiers in Global Women's Health ◽

10.3389/fgwh.2020.599774 ◽

2021 ◽

Vol 1 ◽

Author(s):

Moses Tetui ◽

Tonny Ssekamatte ◽

Pierre Akilimali ◽

Judith Sirike ◽

Osvaldo Fonseca-Rodríguez ◽

...

Keyword(s):

Family Planning ◽

Local Governments ◽

Unmet Need ◽

Quality Data ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Cross Sectional ◽

Unintended Pregnancies ◽

Long Acting ◽

Privately Owned

Introduction: Access to family planning (FP) services remains a challenge, particularly in informal urban settlements. The unmet need for FP in these settings is high, with a correspondingly high prevalence of unintended pregnancies that may lead to unsafe abortions. However, there is a paucity of quality data on the distribution of FP services in such settings in Uganda. This paper described the geospatial distribution of FP services in Kira Municipality, Wakiso District, Uganda.Methods: This was a cross-sectional study in which we determined the availability and distribution of FP services in Kira Municipality. Community mapping and analysis were conducted using ArcGIS (version 10.1) and ArcGIS Online. Stata version 13.1 was used for data analysis. Chi-square test was used to compare the contraceptive provision and availability among facilities from informal and formal settlements.Results: Of the 176 healthcare facilities surveyed, only 42% (n = 74) offered contraceptives in informal settlements. The majority of the facilities were privately owned small clinics (95%). At least 80% of the facilities provided three or more modern contraceptive methods, with no difference (p = 0.107) between facilities in informal and formal settlements. Only 30.7% (p = 0.001) of the facilities provided at least one long-acting contraceptive. Similarly, 20 and 12% (p = 0.001) of the facilities had implants and intrauterine devices (IUDs) on the day of the survey. Almost 25% of the facilities did not offer contraceptive services (counseling and commodities) to unmarried adolescents.Conclusions: Most facilities were small privately-owned clinics, offering at least three modern contraceptive methods. The unavailability of long-acting reversible methods in the informal settings may affect the quality of FP services due to limited choice. The inequity in service provision that disfavors the unmarried adolescent may increase unwanted/unintended pregnancies. We recommend that local governments and partners work toward filling the existing commodities gap and addressing the discrimination against unmarried adolescents in such settings.

Download Full-text

Modern contraceptive use among women in need of family planning in India: an analysis of the inequalities related to the mix of methods used

Reproductive Health ◽

10.1186/s12978-021-01220-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Fernanda Ewerling ◽

Lotus McDougal ◽

Anita Raj ◽

Leonardo Z. Ferreira ◽

Cauane Blumenberg ◽

...

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Wealth Quintile ◽

Modern Method ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Modern Methods ◽

Centered Care ◽

Using Data ◽

Long Acting

Abstract Objective To evaluate the type of contraceptives used by women in need of family planning in India and the inequalities associated with that use according to women's age, education, wealth, subnational region of residence and empowerment level. Methods Using data from the Indian National Family and Health Survey-4 (2015–2016), we evaluated the proportion of partnered women aged 15–49 years with demand for family planning satisfied (DFPS) with modern contraceptive methods. We also explored the share of each type of contraception [short- (e.g., condom, pill) and long-acting (i.e., IUD) reversible contraceptives and permanent methods] and related inequalities. Results The majority (71.8%; 95% CI 71.4–72.2) of women in need of contraception were using a modern method, most (76.1%) in the form of female sterilization. Condom and contraceptive pill were the second and third most frequently used methods (11.8% and 8.5%, respectively); only 3.2% reported IUD. There was a nearly linear exchange from short-acting to permanent contraceptive methods as women aged. Women in the poorest wealth quintile had DFPS with modern methods at least 10 percentage points lower than other women. We observed wide geographic variation in DFPS with modern contraceptives, ranging from 23.6% (95% CI 22.1–25.2) in Manipur to 93.6% (95% CI 92.8–94.3) in Andhra Pradesh. Women with more accepting attitudes towards domestic violence and lower levels of social independence had higher DFPS with modern methods but also had higher reliance on permanent methods. Among sterilized women, 43.2% (95% CI 42.7–43.7) were sterilized before age 25, 61.5% (95% CI 61.0–62.1) received monetary compensation for sterilization, and 20.8% (95% CI 20.3–21.3) were not informed that sterilization prevented future pregnancies. Conclusion Indian family planning policy should prioritize women-centered care, making reversible contraceptive methods widely available and promoted.

Download Full-text

Spatial Heterogeneity and Socio-economic Correlates of Unmet Need for Spacing Contraception in India: Evidences from National Family Health Survey, 2015-16

10.21203/rs.3.rs-882665/v1 ◽

2021 ◽

Author(s):

Margubur Rahaman ◽

Md Juel Rana ◽

Avijit Roy ◽

Pradip Chouhan

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Spatial Heterogeneity ◽

Health Survey ◽

Unmet Need ◽

Married Women ◽

Multivariate Logistic Regression ◽

Natural Break ◽

National Family ◽

Unmet Need For Contraception

Abstract Background:The high unmet need for contraception among women who wants to delay their subsequent births for two or more years (UNS) is a challenging issue in India. Therefore, the present study aims to display spatial heterogeneity and determine the associated factors underlying the UNS among the currently married women aged 15-49 years with a demand for spacing births in India.Methods:The present study used data from the National Family and Health Survey, 2015-16. Unmet need for spacing (UNS) used as outcomes and socio-cultural and demographic factors as explanatory variables. Among the comprehensive family planning, 16.7% (56742 women) of currently married women had demand for spacing births were used for analysis. Univariate, bivariate with chi-square significance test, spatial natural break technique, and multivariate logistic regression were used to accomplish the study objectives. Results:Almost 17% of women had demand spacing out of total demand for family planning in India. High unmet need for contraception found among them except the women with higher-level education and wealth status. District level spatial heterogeneity of UNS shows 248 districts had remarkably high unmet for spacing (68% and above). Results from multivariate logistic regression show that UNS's likelihood was noticeably high among the women with parity three or more (AOR: 1.42 [1.3-1.55]) compared to their counterparts. Similarly, 44% (AOR: 1.44[1.38-1.51]) more likely found among the OBC than General caste. Rural (AOR: 1.24[1.19-1.30]) women compared to urban, women living in South (AOR: 6.19 [5.76-6.65]), Central (AOR: 1.52 [1.43-1.61]), and West (AOR: 1.80 [1.68-1.92]) region compared to those from North had higher odds of UNS. Conclusion:Deal with the UNS in India requires scaling up women education, client choice-based services, campaign on benefits of spacing births and available contraception, and socio-economically backward group centric policies.

Download Full-text

Determinants of Family Planning and Child Immunization Services Integration in Urban Areas of Nigeria: A Longitudinal Analysis

10.21203/rs.3.rs-44776/v1 ◽

2020 ◽

Author(s):

Kate Sheahan ◽

Ilene Speizer ◽

Jennifer Orgill-Meyer ◽

Sian Curtis ◽

Morris Weinberger ◽

...

Keyword(s):

Family Planning ◽

Urban Areas ◽

Contraceptive Use ◽

Unmet Need ◽

Modern Contraceptive ◽

Child Immunization ◽

Period 2 ◽

Immunization Services ◽

Facility Level ◽

The Impact

Abstract Background: Unmet need for contraception is high in the postpartum period. Research has identified the role that integration of family planning into child immunization services can have in addressing this need. However, evidence about the effects of family planning and immunization integration has been inconsistent and more evidence is required to determine whether and how to invest in integration. This study applies continuous facility-level family planning and child immunization integration index scores to: (1) determine whether facility-level integration changes over time, (2) assess the impact of the Nigerian Urban Reproductive Health Initiative (NURHI) - a program that aimed to increase modern contraceptive use - on integration, and (3) identify determinants of integration across facilities in urban areas of Nigeria. Methods: Longitudinal data from health facilities in six urban areas of Nigeria are available from 400 facilities at baseline and 385 facilities at endline. Difference-in-differences models are used to assess the impact of NURHI on Provider Integration and Facility Integration Index scores, and to identify facility-level determinants of integration. The two outcome measures, Provider and Facility Integration Index scores, measure attributes that support integrated service delivery. The independent variables are (1) time period (2) whether the facility received the NURHI intervention, and (3) facility-level characteristics. Results: Our results show that the Provider Integration Index scores increased significantly only among non-intervention facilities while Facility Integration Index scores did not increase significantly in either group. We find that NURHI did not have a significant effect on integration index scores. Results also pinpoint facility characteristics that influence integration, including public ownership and the proportion of providers who have received family planning training. Conclusion: Programs aiming to increase integration of family planning and immunization services should monitor and provide targeted support for the implementation of a well-defined integration strategy that considers the influence of facility characteristics and concurrent initiatives.

Download Full-text