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

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 and factors associated with modern contraceptive use among female refugee adolescents in Northern Uganda. Methods: This was a cross sectional study using 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 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% (95% CI: 31.5 to 54.3)], 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 could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.

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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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Male-Female Concordance in Reported Involvement of Women in Contraceptive Decision-Making and Its Association With Modern Contraceptive Use Among Couples in Rural Maharashtra, India.

10.21203/rs.3.rs-358822/v1 ◽

2021 ◽

Author(s):

Anvita Dixit ◽

Nicole E Johns ◽

Mohan Ghule ◽

Madhusudana Battala ◽

Shahina Begum ◽

...

Keyword(s):

Decision Making ◽

Partner Violence ◽

Contraceptive Use ◽

Unmet Need ◽

Married Couples ◽

Cross Sectional Study ◽

Modern Contraceptive ◽

Cross Sectional ◽

Lower Odds ◽

Modern Contraceptive Use

Abstract Objective: Women’s involvement in contraceptive decision-making increases contraceptive use and reduces unmet need, but study of this has been limited to women’s self-reports. Less research is available examining couple concordance and women’s involvement in contraceptive decision-making as reported by both men and women. Study Design: We carried out a cross-sectional study using data from rural India (N=961 young married couples). Using multivariable regression we examined the association between concordance or discordance in spousal reports of wife’s involvement in contraceptive decision-making and modern contraceptive use, adjusting for demographics, intimate partner violence, and contraceptive use discussion. Results: More than one third (38.3%) of women reported current modern contraceptive use. Report of women’s involvement in contraceptive decision-making showed 70.3% of couples agreed that women were involved, jointly or alone (categorized as Concordant 1), 4.2% agreed women were not involved (categorized at Concordant 2), 13.2% had women report involvement but men report women were uninvolved (categorized as Discordant 1), and 12.2% had women report uninvolvement but men report that women were involved (categorized as Discordant 2). Discordant 2 couples had lower odds of modern contraceptive use relative to Concordant 1 couples (adjusted RR=0.61, 95% CI 0.45-0.83). No other significant differences between Concordant 1 couples and other categories were observed. Conclusion: One in four couples indicated discordance on women’s involvement in contraceptive decision making, with Discordant 2 category having lower odds of contraceptive use. Couples’ concordance in women’s involvement in contraceptive decision-making offers a target for family planning research and interventions to better meet their needs.Trial registrationClinicalTrial.gov, NCT03514914. https://clinicaltrials.gov/ct2/show/NCT03514914

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Associated factors of modern contraceptive use among women infected with human immunodeficiency virus in Enemay District, Northwest Ethiopia: a facility-based cross-sectional study

BMC Public Health ◽

10.1186/s12889-019-7675-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Yibeltal Bimrew Kebede ◽

Tesfahun Taddege Geremew ◽

Yohannes Mehretie ◽

Ayenew Negesse Abejie ◽

Liknaw Bewket ◽

...

Keyword(s):

Associated Factors ◽

Contraceptive Use ◽

Clinical Stage ◽

Cross Sectional Study ◽

Modern Contraceptive ◽

Cross Sectional ◽

Modern Contraceptives ◽

Resource Limited ◽

Family Planning Counseling ◽

Modern Contraceptive Use

Abstract Background The prevention of unplanned pregnancy among women infected with human immunodeficiency virus (HIV) is critical for the prevention of mother-to-child transmission (PMTCT) of HIV. Of the prevention strategies, deployment of modern contraceptives is principal one. However, there were limited facts on utilization of modern contraceptives and associated factors among HIV infected women, in particular of resource-limited settings in Ethiopia. Hence, we aimed to quantify the proportion of modern contraceptive utilization and the possible related factors among women infected HIV. Methods A facility-based cross-sectional study was conducted on randomly selected 632 women infected with HIV from 05 February to 25 March 2018. Data on their treatment, socio-economic, and demographic background were collected through a structured interviewer administered questionnaire. Binary logistic regression model was fitted to identify the associated factors of modern contraceptive use among women infected with HIV. Result We found 61.4% (95% CI, 57.6–65.2) were using modern contraceptives. Greater than four family size (AOR:2.17; 95%CI: 1.31–3.59), family planning counseling service (AOR: 2.37; 95% CI: 1.44–3.91), discussing contraceptive issues with sexual partner (AOR: 1.76; 95% CI: 1.12–2.77), history of giving birth (s) (AOR:2.21; 95%CI:1.20–4.05) and World Health Organization (WHO) clinical stage III or IV (AOR: 3.59; 95%CI: 1.37, 9.44) were positively associated with modern contraceptives use, whereas, older age (AOR: 0.45; 95% CI: 0.24–0.81) and being widowed (AOR: 0.34; 95% CI: 0.14–0.83), abridged the chances of modern contraceptives use. Conclusion The prevalence of modern contraceptive use among women infected with HIV is low. Higher family size, counseling on contraceptives, discussing contraceptives issues with partner, history of giving births and WHO clinical stage III/IV were positively related with contraceptives use, whereas, older age and being widowed abridged the chances of contraceptives use among HIV infected women. Therefore, our findings support calls for the district health office and the antiretroviral treatment clinics of the resource-limited settings to work more on family planning counseling services and promoting more dialogues with sexual partners on modern contraceptives use.

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Male–female concordance in reported involvement of women in contraceptive decision-making and its association with modern contraceptive use among couples in rural Maharashtra, India

Reproductive Health ◽

10.1186/s12978-021-01187-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Anvita Dixit ◽

Nicole E. Johns ◽

Mohan Ghule ◽

Madhusudana Battala ◽

Shahina Begum ◽

...

Keyword(s):

Decision Making ◽

Partner Violence ◽

Contraceptive Use ◽

Unmet Need ◽

Married Couples ◽

Cross Sectional Study ◽

Modern Contraceptive ◽

Cross Sectional ◽

Lower Odds ◽

Modern Contraceptive Use

Abstract Objective Women’s involvement in contraceptive decision-making increases contraceptive use and reduces unmet need, but study of this has been limited to women’s self-reports. Less research is available examining couple concordance and women’s involvement in contraceptive decision-making as reported by both men and women. Study design We carried out a cross-sectional study using data from rural India (N = 961 young married couples). Using multivariable regression we examined the association between concordance or discordance in spousal reports of wife’s involvement in contraceptive decision-making and modern contraceptive use, adjusting for demographics, intimate partner violence, and contraceptive use discussion. Results More than one third (38.3%) of women reported current modern contraceptive use. Report of women’s involvement in contraceptive decision-making showed 70.3% of couples agreed that women were involved, jointly or alone (categorized as Concordant 1), 4.2% agreed women were not involved (categorized at Concordant 2), 13.2% had women report involvement but men report women were uninvolved (categorized as Discordant 1), and 12.2% had women report uninvolvement but men report that women were involved (categorized as Discordant 2). Discordant 2 couples had lower odds of modern contraceptive use relative to Concordant 1 couples (adjusted RR = 0.61, 95% CI 0.45–0.83). No other significant differences between Concordant 1 couples and other categories were observed. Conclusion One in four couples indicated discordance on women’s involvement in contraceptive decision making, with Discordant 2 category having lower odds of contraceptive use. Couples’ concordance in women’s involvement in contraceptive decision-making offers a target for family planning research and interventions to better meet their needs. Trial registration ClinicalTrial.gov, NCT03514914. https://clinicaltrials.gov/ct2/show/NCT03514914

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