scholarly journals Unmet Need For Family Planning Among Married Women In Sub-Sahara Africa: A Meta-Analysis of DHS Data (1995 – 2020)

Author(s):  
Million Phiri ◽  
Clifford Odimegwu ◽  
Chester Kalinda

Abstract Background: Closing the gap of unmet needs for family planning (FP) in sub-Saharan Africa remains critical in improving maternal and child health outcomes. Determining the prevalence of unmet needs for family planning among married women in the reproductive age is vital for designing effective sexual reproductive health interventions and programmes. Here, we use nationally representative data drawn from sub-Saharan countries to estimate and examine heterogeneity of unmet needs for family planning among currently married women of reproductive age. Methods: This study used secondary data from Demographic and Health Surveys (DHS) conducted between January 1, 1995 to December 31, 2020 from 37 countries in sub-Saharan African. An Inverse Heterogeneity model (IVhet) in MetaXL application was used to estimate country and sub-regional level pooled estimates and confidence intervals of unmet needs for FP in SSA. Results: The overall prevalence of unmet need for family planning among married women of reproductive age in the sub-region for the period under study was 22.9% (95% CI: 20.9–25.0). The prevalence varied across countries from 10% (95% CI: 10–11%) in Zimbabwe to 38% (95% CI: 35–40) and 38 (95% CI: 37–39) (I2 = 99.8% and p-value < 0.0001) in Sao Tome and Principe and Angola, respectively. Unmet needs due to limiting ranged from 6%; (95% CI: 3–9) in Central Africa to 9%; (95% CI: 8–11) in East Africa. On the other hand, the prevalence of unmet needs due to spacing was highest in Central Africa (Prev: 18; 95% CI: 16–21) and lowest in Southern Africa (Prev: 12%; 95% CI: 8–16). Our study indicates that there was no publication bias because the Luis Furuya-Kanamori index (0.79) was within the symmetry range of -1 and +1. Conclusion: The prevalence of unmet need for FP remains high in sub-Saharan Africa suggesting the need for health policymakers to consider re-evaluating the current SRH policies and programmes with the view of redesigning the present successful strategies to address the problem.

1970 ◽  
Vol 9 (3) ◽  
pp. 148-151 ◽  
Author(s):  
IS Paudel ◽  
SS Budhathoki

Introduction: The unmet need for family planning is a very useful tool in measuring and predicting the contraceptive needs of a population. Seventeen percent of all married women would prefer to avoid pregnancy but are not using any form of family planning. In less developed countries, about one forth of pregnancies is unintended. Objective: To determine the level of unmet need for family planning and evaluate the factors that influences the unmet needs in Married Women of Reproductive Age (MRWA). Methods: A cross-sectional study of 410 women attending the immunization clinic of B.P.Koirala Institute of Health Sciences, a teaching hospital in Dharan was carried out over 3 months. Results: MRWA had 22%, 15% and 8% unmet needs for family planning, spacing and limiting births respectively. Health concerns and side effects (30.5%), husband and family opposition (14%), uncertainty about child bearing (12.2%) and inconvenience (10%) were among the major constraints to the use of contraception. Unmet need has significant association between parity & education. Age and family type had no significant effect on unmet needs. Conclusion: In spite of high level of awareness about family planning method, a significant level of unmet need exists among women of reproductive age. Keywords: unmet needs; family planning; married women of reproductive age; MRWA DOI: http://dx.doi.org/10.3126/hren.v9i3.5581   HR 2011; 9(3): 148-151


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jumaine Gahungu ◽  
Mariam Vahdaninia ◽  
Pramod R. Regmi

Abstract Background Sub-Saharan Africa has the highest fertility rate in the world, with the highest unmet need for family planning (FP). Yet, there is a lack of knowledge about the determinants for non-utilisation of modern contraceptive methods among women of reproductive age. This systematic review of literature assessed factors affecting the unmet need and reasons for non-utilisation of modern contraceptive methods during the postpartum period in Sub-Saharan African women. Methods An online literature search was conducted in several databases: MEDLINE, Cochrane Review, PubMed, Elsevier's Science Direct and Web of Science. The search was completed by hand searching. Data were extracted and summarised using the Arksey and O’Malley methodology. Results In total, 19 studies were included; one qualitative study, seventeen quantitative, and one used a mixed-methods approach. Studies were conducted in Ethiopia (n = 11), Nigeria (n = 3), Kenya (n = 2), Malawi (n = 2) and Uganda (n = 1). Factors affecting the unmet need for modern contraceptive methods were described at three levels: (a) individual; (b) household; and (c) healthcare facility level. Reasons for non-use of FP included: fear of side effects; husband’s disapproval; the absence of menses; abstinence; and low perception of risk of pregnancy. Conclusion Unmet needs in postpartum FP in women from Sub-Saharan Africa were associated with health-system and socio-demographic determinants. We suggest that there is a need to improve the awareness of modern contraceptive methods through effective interventions. Further research is needed for under-studied countries in this continent.


2021 ◽  
Author(s):  
Isaac Boadu

Abstract Background: The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age in Sub-Saharan Africa (SSA). Methods: Data for the study was obtained from the latest Demographic and Health Surveys (DHS) conducted between 1995-2020 across 37 SSA countries. Women of reproductive age (15-19 years) was the unit of analysis. Analyses of data was done using STATA version 16 for windows. A bivariate Rao Scott’s chi-square test of independence was done to determine factors associated with the use of modern contraceptives. Factors that showed significance (p<0.05) were included in a multilevel logistic regression to determine significant predictors of modern contraceptives. Clustering, stratification and sample weighting were accounted for in the analyses. Results: The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of contraceptives used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use contraceptive if they: had no education (aOR = 0.4, 95% CI: 0.38-0.44), had no children (aOR=0.27-0.42), not told of family planning at a health facility (aOR = 0.69, 95% CI: 0.67-0.71), not heard of family planning in the media (aOR = 0.77, 95% CI: 0.74-0.79) and being poor (aOR=0.76, 95%CI: 0.73-0.79). On the other hand, women were more likely to use modern contraceptive if they were between the age of 35-39 years (aOR=1.69, 95%CI: 0.73-0.79), married (aOR=2.66, 95%CI: 2.50-2.83), had seven or more children (aOR=1.27, 95%CI:1.17-0.38), had knowledge of any method of contraceptives (aOR=303.8, 95%CI: 89.9-1027.5) and when field worker visited and talked about family planning (aOR=1.53, 95%CI: 1.39-0.68).Conclusion: The study showed a low prevalence of modern contraceptive use in Sub-Sahara Africa. Findings from the study highlight the need to provide education to women to increase uptake of contraceptive use and also re-enforce contraceptive interventions to improve women’s health and well-being.


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.


Author(s):  
Ramesh Devidas Pawar ◽  
Shital Pratapsing Solanke

Background: Unmet need is the discrepancy between reproductive intentions and birth control practices. If the unmet needs remained neglected it leads to population explosion which is one of the greatest threats to India’s economic, social and political development.  A community-based study was carried out in rural areas with the objective to find the prevalence of unmet need for family planning and its socio-demographic determinants among married women of reproductive age.Methods: A community based cross sectional study was conducted between January to June 2019. After calculation of sample size 670 participants were selected by simple random sampling method.  Predesign and semi structured Performa was used for data collection. Data was collected and analyse using Epi Info 7.Results: Unmet needs of family planning among the study subject was 31.19% (57.58% for the spacer and 42.42% for limiter). It was significantly higher among the Muslim (66.67%) and Boudh (40.38) religion. It was higher among Illiterate (40.82%), women residing in joint families (72.16%). Unmet need of family planning was significantly associated with age of women, religion, educational status of women and their husbands, occupation, type of family, no of children the women have and age at marriage.Conclusions: Unmet needs among married women in the reproductive age group was still high and was significantly associated with age of women, religion, educational status of women as well as their husband, occupation, type of family, number of children the women had and age at marriage.


2020 ◽  
Vol 23 (15) ◽  
pp. 2759-2769
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Duanping Liao ◽  
Ping Du ◽  
Kristen H Kjerulff

AbstractObjective:To identify countries in sub-Saharan Africa (SSA) that have not yet achieved at least 90 % universal salt iodization and factors associated with the consumption of non-iodized salt among women of reproductive age.Design:A cross-sectional study using data from Demographic and Health Surveys (DHS). The presence of iodine in household salt (iodized or non-iodized), which was tested during the survey process, was the study outcome. Multivariable logistic regression models were used to determine independent factors associated with the consumption of non-iodized salt among women of reproductive age.Setting:There were eleven countries in SSA that participated in the DHS since 2015 and measured the presence of iodine in household salt.Participants:Women (n 108 318) aged 15–49 years.Results:Countries with the highest rate of non-iodized salt were Senegal (29·5 %) followed by Tanzania (21·3 %), Ethiopia (14·0 %), Malawi (11·6 %) and Angola (10·8 %). The rate of non-iodized salt was less than 1 % in Rwanda (0·3 %), Uganda (0·5 %) and Burundi (0·8 %). Stepwise multivariable logistic regression showed that women were more likely to be using non-iodized salt (adjusted OR; 95 % CI) if they were poor (1·62; 1·48, 1·78), pregnant (1·16; 1·04, 1·29), aged 15–24 years (v. older: 1·14; 1·04, 1·24) and were not literate (1·14; 1·06, 1·23).Conclusions:The use of non-iodized salt varies among SSA countries. The higher level of use of non-iodized salt among poor, young women and pregnant women is particularly concerning.


2011 ◽  
Vol 38 (1-2) ◽  
pp. 61 ◽  
Author(s):  
Gebremariam Woldemicael ◽  
Roderic Beaujot

Eritrea’s contraceptive prevalence rate is one of the lowest in sub-Saharan Africa and its fertility has only started to decline. Using data from the 2002 Eritrea Demographic and Health Survey (EDHS), this study examines the determinants of unmet need for family planning that is the discrepancy between fertility goals and actual contraceptive use. More than one-quarter of currently married women are estimated to have an unmet need, and this has remained unchanged since 1995. The most important reason for unmet need is lack of knowledge of methods or of a source of supply. Currently married women with higher parity, and low autonomy, low or medium household economic status, and who know no method of contraception or source of supply are identified as the most likely to have an unmet need. Addressing the unmet need for family planning entails not merely greater knowledge of or access to contraceptive services, but also the enhancement of the status of women.


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