scholarly journals Discontinuation and Switching of Postpartum Contraceptive Methods Over Twelve Months in Burkina Faso and the DRC: A Secondary Analysis of the Yam-Daabo trial

2020 ◽  
Author(s):  
Abou Coulibaly ◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
Rachel Yodi ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction: Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

scholarly journals Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial

2020 ◽  
Author(s):  
Abou Coulibaly ◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
Rachel Yodi ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction : Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

scholarly journals Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the Democratic Republic of the Congo: a secondary analysis of the Yam Daabo trial

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Abou Coulibaly ◽  
◽  
Tieba Millogo ◽  
Adama Baguiya ◽  
Nguyen Toan Tran ◽  
...  
Keyword(s):  
Contraceptive Method ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Modern Method ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Modern Methods ◽  
Contraceptive Discontinuation ◽  
Equal Effectiveness

Abstract Introduction Women who use contraceptive methods sometimes stop early, use methods intermittently, or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use. Methods We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching. Results In total, 637 out of the 1120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. One hundred seventy-nine women of the control group used modern methods compared to 279 women of the intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, modern methods’ discontinuation was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8–8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p < 0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women. Conclusion The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also essential to set up specific actions targeting women’s partners and influential people in the community to counter inhibiting beliefs. Trial registration Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

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

BMJ Open ◽  
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.

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

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.

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

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.

scholarly journals Modern Contraceptive Use Among Women in Need of Family Planning in India: an Analysis of the Inequalities Related to the Mix of Methods Used

2021 ◽  
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 ◽  
Region Of Residence ◽  
Centered Care ◽  
Long Acting

Abstract ObjectiveTo 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.MethodsUsing data from the Indian National Family and Health Survey-4 (2015-16), 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.ResultsThe 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.ConclusionIndian family planning policy should prioritize women-centered care, making reversible contraceptive methods widely available and promoted.

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

2021 ◽  
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

Objectives The study aimed to assess the determinants of modern contraceptive method use among young women in Benin. Design A mixed-methods design. Setting and participants We used the Benin 2017-18 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. The participants were purposively selected. Outcomes Contraceptive 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 utilization of modern methods were assessed in the qualitative part. Results Overall, 8.5% (95%CI: 7.7-9.5%) among young women ages 15 to 24 were using modern contraceptives and 13% (95%CI: 12.1-14.0%) among women ages 25 or more. Women 15-24 had a higher unmet need, and a lower demand satisfied by modern contraceptive methods compared to women aged 25 or more. 60.8% (56.9-64.7%) 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. Conclusion Contraceptive use is low among young women in Benin. The use of modern contraceptives is influenced by socio-demographic factors and social norms. Appropriate interventions might promote comprehensive sexuality education, increase community engagement, provide youth-friendly services, and address gender inequalities.

scholarly journals Prevalence and inequalities in contraceptive use among adolescents and young women: data from a birth cohort in Brazil

2021 ◽  
Vol 37 (10) ◽  
Author(s):  
Adriana Kramer Fiala Machado ◽  
Débora Dalmas Gräf ◽  
Fabiane Höfs ◽  
Franciele Hellwig ◽  
Karoline Sampaio Barros ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Contraceptive Use ◽  
Public Policies ◽  
Early Adulthood ◽  
Wealth Index ◽  
Modern Method ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Barrier Methods ◽  
Modern Methods

Monitoring trends of contraceptive use and identifying the groups with less coverage are needed to guide public policies and make them more efficient. But, in Brazil, recent data about these aspects are limited. This study aimed to investigate the prevalence of contraceptive use and its inequalities during adolescence and early adulthood. Data from the 1993 Pelotas birth cohort, Rio Grande do Sul State, Brazil, were used. At 15, 18 and 22 years, respectively, 335, 1,458 and 1,711 women reported having started their sexual lives and were included in analysis. Prevalence and 95% confidence intervals were obtained to describe the most used contraceptive methods. Inequalities in modern contraceptive use were evaluated according to wealth index, scholastic backwardness and ethnicity. In all follow-ups, more than 80% of women used at least one modern method. The use of barrier methods decreased with age; at 22 this prevalence was 36.3%. Such use concomitant with other modern methods was lower than 50% in all follow-ups. We observed inequalities in the use of modern contraceptive methods, mainly in barrier methods used with other modern methods. These findings may contribute and improve the public policies in family planning.

scholarly journals Predictors of contraceptive method discontinuation among adolescent and young women in three West African countries (Burkina Faso, Mali, and Niger)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adja Mariam Ouédraogo ◽  
Adama Baguiya ◽  
Rachidatou Compaoré ◽  
Kadari Cissé ◽  
Désiré Lucien Dahourou ◽  
...  
Keyword(s):  
Marital Status ◽  
Burkina Faso ◽  
Young Women ◽  
Contraceptive Method ◽  
Occupation Number ◽  
Education Level ◽  
Demographic And Health Surveys ◽  
Contraceptive Methods ◽  
Unintended Pregnancies ◽  
Contraceptive Discontinuation

Abstract Background The effective use of contraception among adolescents and young women can reduce the risk of unintended pregnancies. However, the prevalence of contraceptive use remains low in this age group. The objective of this study was to estimate the rate of contraceptive method discontinuation among adolescents and young women and to identify its associated factors in Burkina Faso, Mali, and Niger. Method This was a secondary analysis of data from Demographic and Health Surveys of Burkina Faso (2010), Mali (2012–2013), and Niger (2012). The dependent variable was the time to discontinuation of contraceptive methods. Independent variables were represented by sociodemographic, socioeconomic, and cultural characteristics. Mixed-effects survival analysis with proportional hazards was used to identify the predictors. Results A total of 2,264 adolescents and young women aged 15 to 24 years were included in this analysis, comprising 1,100 in Burkina Faso, 491 in Mali, and 673 in Niger. Over the last five years, the overall contraceptive discontinuation rate was 68.7% (50.1% in Burkina Faso, 59.6% in Mali, and 96.8% in Niger). At the individual level, in Burkina Faso, occupation (aHR = 0.33), number of living children (aHR = 2.17), marital status (aHR = 2.93), and region (aHR = 0.54) were associated with contraceptive discontinuation. Except for education and marital status, we found the same factors in Mali. In Niger, a women's education level (aHR = 1.47) and her partner (aHR = 0.52) were associated with discontinuation. At the community level, the region of origin was associated with discontinuation of contraceptive methods. Conclusion Most adolescents and young women experienced at least one episode of discontinuation. Discontinuation of contraceptive methods is associated with the level of education, occupation, number of children, marital status, and desire for children with the spouse. Promotion of contraceptive interventions should target adolescents, young women, and their partners, as well as those with a low education level or in a union.

scholarly journals Free contraception and behavioural nudges in the postpartum period: evidence from a randomised control trial in Nairobi, Kenya

2018 ◽  
Vol 3 (5) ◽  
pp. e000888 ◽  
Author(s):  
Margaret McConnell ◽  
Claire Watt Rothschild ◽  
Allison Ettenger ◽  
Faith Muigai ◽  
Jessica Cohen
Keyword(s):  
Postpartum Period ◽  
Randomised Control Trial ◽  
Control Group ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Birth Intervals ◽  
Financial Barriers ◽  
Maternity Hospitals ◽  
Sms Reminder ◽  
The Impact

BackgroundShort birth intervals are a major risk factor for poor maternal and newborn outcomes. Utilisation of modern contraceptive methods during the postpartum period can reduce risky birth intervals but contraceptive coverage during this critical period remains low.MethodsWe conducted a randomised controlled experiment to test whether vouchers for free contraception, provided with and without behavioural ‘nudges’, could increase modern contraceptive use in the postpartum period. 686 pregnant women attending antenatal care in two private maternity hospitals in Nairobi, Kenya, were enrolled in the study. The primary outcomes were the use of modern contraceptive methods at nearly 3 months and 6 months after expected delivery date (EDD). We tested the impact of a standard voucher that could be redeemed for free modern contraception, a deadline voucher that expired 2 months after delivery and both types of vouchers with and without a short message service (SMS) reminder, relative to a control group that received no voucher and no SMS reminder.ResultsBy nearly 6 months after EDD, we find that the combination of the standard voucher with an SMS reminder increased the probability of reporting utilisation of a modern contraceptive method by 25 percentage points (pp) (95% CI 6 pp to 44 pp) compared with the control group. Estimated impacts in other treatment arms were not statistically significantly different from the control group.ConclusionsReducing financial barriers to postpartum contraception alone may not be enough to encourage take-up. Programmes targeting the postpartum period should consider addressing behavioural barriers to take-up.

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