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 ◽  
...  

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.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ronald Wasswa ◽  
Allen Kabagenyi ◽  
Paulino Ariho

Abstract Background In spite of the universal right for women to decide freely for themselves when, and how many children they want to have in life, married women in Uganda are less likely to use modern contraceptives as compared to other marital categories. This study examines the individual and community factors associated with modern contraceptive use among married women in Uganda. Methods The study used data from the 2016 Uganda Demographic and Health Survey which comprised of 8671 married women aged 15–49 years who were fecund and non-pregnant at the time of the survey. Analysis was done using a multilevel mixed-effects logistic regression model. Results Findings showed that married women who were; Muslims (AOR = 0.78, CI = 0.66–0.91), had more than five children (AOR = 0.76, CI = 0.61–0.98), staying in communities with high poverty (AOR = 0.78, CI = 0.65–0.93), with older age at first birth (AOR = 0.94, CI = 0.92–0.96) as well as having spousal age difference of more than 9 years (AOR = 0.86, CI = 0.76–0.98) were associated with low modern contraceptive use. Women living in communities with higher age at first marriage (AOR = 0.93, CI = 0.88–0.98) or higher sexual debut (AOR = 0.91, CI = 0.85–0.98) were also associated with reduced odds of modern contraception. In addition, older women (AOR = 1.03, CI = 1.01–1.04), having secondary/higher education (AOR = 1.93, CI = 1.58–2.37), living in a rich household (AOR = 1.32, CI = 1.14–1.53), short distance to health facility (AOR = 1.18, CI = 1.06–1.31), high community education (AOR = 1.38, CI = 1.17–1.62), high community exposure to family planning messages (AOR = 1.24, CI = 1.08–1.42), and communities with high proportion of women working (AOR = 1.22, CI = 1.06–1.39) were more likely to use modern contraceptives. Conclusion The study revealed that both individual and community factors were important in explaining the factors associated with modern contraceptive use among married women in Uganda. Therefore, there is need to invest in community based programs like: family planning outreach services, mass media campaigns and community mobilization activities to help in dissemination of family planning information, increase awareness and promotion in use of modern contraceptives. Also, expansion of higher education and the need to make family planning services available and accessible to areas with limited physical access to health facilities will lead to sustained increase in uptake of modern contraceptives.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Farhan Asif ◽  
Zahid Pervaiz ◽  
Jawad Rahim Afridi ◽  
Ghulam Abid ◽  
Zohra S. Lassi

Abstract Background Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. Method The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. Results The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. Conclusions Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Nabamallika Dehingia ◽  
Anvita Dixit ◽  
Sarah Averbach ◽  
Vikas Choudhry ◽  
Arnab Dey ◽  
...  

Abstract Background We examine the association between the quality of family planning (FP) counseling received in past 24 months, and current modern contraceptive use, initiation, and continuation, among a sample of women in rural Uttar Pradesh, India. Methods This study included data from a longitudinal study with two rounds of representative household survey (2014 and 2016), with currently married women of age 15–49 years; the analysis excluded women who were already using a permanent method of contraceptive during the first round of survey and who reported discontinuation because they wanted to be pregnant (N = 1398). We measured quality of FP counseling using four items on whether women were informed of advantages and disadvantages of different methods, were told of method(s) that are appropriate for them, whether their questions were answered, and whether they perceived the counseling to be helpful. Positive responses to every item was categorized as higher quality counseling, vs lower quality counseling for positive response to less than four items. Outcome variables included modern contraceptive use during the second round of survey, and a variable categorizing women based on their contraceptive use behavior during the two rounds: continued-users, new-users, discontinued-users, and non-users. Results Around 22% had received any FP counseling; only 4% received higher-quality counseling. Those who received lower-quality FP counseling had 2.42x the odds of reporting current use of any modern contraceptive method (95% CI: 1.56–3.76), and those who received higher quality FP counseling at 4.14x the odds of reporting modern contraceptive use (95% CI: 1.72–9.99), as compared to women reporting no FP counseling. Women receiving higher-quality counseling also had higher likelihood of continued use (ARRR 5.93; 95% CI: 1.97–17.83), as well as new use or initiation (ARRR: 4.2; 95% CI: 1.44–12.35) of modern contraceptives. Receipt of lower-quality counseling also showed statistically significant associations with continued and new use of modern contraceptives, but the effect sizes were smaller than those for higher-quality counseling. Conclusions Findings suggest the value of FP counseling. With a patient-centered approach to counseling, continued use of modern contraceptives can be supported among married women of reproductive age. Unfortunately, FP counseling, particularly higher-quality FP counseling remains rare.


2017 ◽  
Vol 6 (10) ◽  
pp. 5513
Author(s):  
Vijayasree L.

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.


SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110246
Author(s):  
Himani Sharma ◽  
S. K. Singh ◽  
Shobhit Srivastava

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.


2018 ◽  
Vol 18 (17) ◽  
pp. 33-42
Author(s):  
Ramesh Babu Kafle

This paper examines the dynamics of contraceptive use of currently married young women (age 15-24) in Nepal by analyzing the trends and differentials in contraceptive use, the changes in method mix and the determinants of contraceptive use by selected socioeconomic and demographic characteristics. The reasons of non-use of contraception are also assessed. Data from the three rounds of nationally representative Nepal Demographic and Health Survey (NDHS) 2001, 2006 and 2011 are used. Currently married women aged 15-24 are selected and included in analysis. Study sample constitute 2573, 2398 and 2552 eligible women in NDHS 2001, 2006 and 2011 respectively. Use of contraception among young couples is gradually increasing in almost all subgroups of population in Nepal, with narrowing differentials by education and economic condition of household. Tendency of starting contraceptives before having a child is also emerging. There is declining share of sterilization among youth indicating either a probable shifting in age at sterilization or more favour towards temporary methods. Injection has the highest share in all the three surveys. The share of long acting temporary methods (IUD and Implants) is quite small and almost same in all the three surveys. Couples still feel safe to start using contraceptives after having at least one son however, the differences are declining. Reasons for non-use like fear of side effects and opposition to use are sharply declining over time but that due to husband’s absence is emerging as almost a sufficient reason for non-use of contraception among young married women in Nepal. The family planning program should focus on meeting the family planning needs of young couples of all strata of population with special thrust on those women whose husbands are currently in foreign country so that they would be able to avoid unintended pregnancy on their husband’s come back.


2017 ◽  
Vol 1 (5) ◽  
pp. 232 ◽  
Author(s):  
James Flint ◽  
Margaret Morisause

<p><strong>Introduction</strong></p><p>Family Planning is central to the empowerment of women and a key factor reducing poverty. However, millions of women around the world are not accessing safe and effective family planning methods. This study determined contraceptive prevalence and identified barriers to using modern contraception in the Maprik district of East Sepik Province, Papua New Guinea.</p><p><strong> </strong></p><p><strong>Methods</strong></p><p>Data from the National Health Information System (NHIS) and a survey of women presenting to outpatient clinics was used to estimate contraceptive prevalence. The in-person interviews, which also sought to understand barriers to using modern contraceptives, included women aged 15-49 years from three different health facility catchments. A population based awareness campaign promoting family planning was undertaken through mass media (local radio) and targeted information sessions.</p><p><strong> </strong></p><p><strong>Findings</strong></p><p>The retrospective review of NHIS data indicated a contraceptive prevalence of 38% while the survey indicated a prevalence of 30%. Of the women interviewed, 46% indicated having an unintended pregnancy and 16% had sought to end a pregnancy. Of those women who were not using modern contraceptives, 19% lacked knowledge on methods to avoid pregnancy and 13% were concerned about side effects from using modern contraceptives. A family planning awareness program resulted in a notable increase in the number of men having a vasectomy.</p><p><strong> </strong></p><p><strong>Conclusion</strong></p><p>This study confirmed low contraceptive prevalence estimates in Maprik District and identified the key barriers to contraceptive use that can be effectively addressed. Continued awareness campaigns are necessary to address key knowledge gaps and alleviate fears about the side effects of contraceptive use.   </p>


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Fernanda Ewerling ◽  
Lotus McDougal ◽  
Anita Raj ◽  
Leonardo Z. Ferreira ◽  
Cauane Blumenberg ◽  
...  

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.


1970 ◽  
Vol 19 (1) ◽  
pp. 11-15 ◽  
Author(s):  
SK Ferdousi ◽  
MA Jabbar ◽  
SR Hoque ◽  
SR Karim ◽  
AR Mahmood ◽  
...  

Objective: This study aims to find out the unmet need of family planning among the rural women. To explore the obstacles to use family planning methods and to estimate the prevalence of contraceptive use. Study design: Cross-sectional type of descriptive study. Settings: The study was conducted at Sreepur upazila under Gazipur district. Subjects: All the married women of reproductive age, residing in a selected village of Sreepur upazila, were selected as the study subject. Results: The study revealed that unmet need was (22.4%). Most of the respondents (72.1%) were using contraceptive methods. Among those who used contraceptives, OCP was the most commonly used method (61.7%). About 28% were not using any method. The main reason was fear of side effects (46.1%). Conclusion: The study concluded that a nationwide contraceptive prevalence study may be carried out to explore the problem in detail. Key words: Unmet need; family planning; contraceptive prevalence rate. DOI: 10.3329/jdmc.v19i1.6244 J Dhaka Med Coll. 2010; 19(1) : 11-15.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Yibeltal Mesfin ◽  
Abraham Wallelign

Abstract Background Postpartum long-acting reversible contraceptive is important to prevent unintended and closed spaced pregnancy following the first 12 months of childbirth. Few data were available on postpartum long-acting reversible contraceptive use in Ethiopia. So, this study aimed to assess the long-acting reversible contraception use and associated factors among women who gave birth in the last 12 months. Methods A community-based cross-sectional study was conducted from October 1st to November 2019. Systematic random sampling was applied to recruit a total of 416 study participants. Data were collected using a structured questionnaire. Data were entered using Epidata 4.6 and exported to SPSS version 25 for analysis. P-value < 0.05 with 95% confidence interval (CI) used to declare statistical significance. Result In this study, long acting contraceptive utilization among women in the extended postpartum period was 22.6%. Maternal age ≤ 24 years (AOR = 3.7, 95% CI: 1.5, 8.9), being married (AOR =3.5 95% CI: (1.17–10.28)), menses resumption (AOR = 4.9 95% CI: (2.92, 8.20)), sexual intercourse resumption (AOR = 7.1 95% CI: (4.03, 12.56)) and received postpartum family planning counseling (AOR = 3.2 95% (1.95, 5.28)) were the factors associated with Long-acting reversible contraception use. Conclusion This finding showed postpartum women’s long-acting reversible contraceptive use during the extended postpartum period was low. The factors significantly associated with extended postpartum modern contraceptive use were women’s age, being married, menses resumption, sexual intercourse resumption, and got postnatal family planning counseling. Strengthening Antenatal and postnatal counseling of postpartum family planning would improve long-acting reversible contraception use.


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