Health Inequalities in Unmet Need for Family Planning Among Ugandan Women: Repeated Cross Sectional Surveys in the Years 2014 to 2018.

2021 ◽  
Author(s):  
Mercy Wendy Wanyana
Keyword(s):  
Family Planning ◽  
Health Inequalities ◽  
Performance Monitoring ◽  
Unmet Need ◽  
Geographical Location ◽  
Wealth Status ◽  
Cross Sectional ◽  
Relative Index ◽  
Age Related ◽  
Value Range

Abstract Background: Health inequalities in unmet need for family planning have been documented in Uganda, however, little is known about their magnitude and whether these have remained the same. Objective This study sought to examine health inequalities in unmet need for family planning among Ugandan women between 15-49 years of age in the years 2014 to 2018. Methods: Five data sets of the Performance Monitoring Accountability 2020 family planning cross-sectional surveys were used to assess health inequalities in unmet need for family planning across four socio-economic position variables (age, education, wealth status and geographical location) at five time points (2014 to 2018).Chi-square (χ 2 ) test and a logistic regression-based measure, the Relative Index of Inequality (RII) were used to assess differences and relative health inequalities respectively. Results: The data of 19,670 women aged 15 to 49 years were analysed. Between 2014 and 2018, unmet need for family planning (limiting, spacing and total) were 2 or more times more prevalent among the uneducated (RII value range:1.94 to 2.73), and poorest women(RII value range:1.90 to 3.78), in comparison with women with post-secondary education and richest women respectively. Unmet need for family planning was more prevalent among women older than 35 years (RII between 0.41 and 0.63). No geographic-related health inequalities were observed. Education-related inequalities reduced, wealth-related health inequalities increased, while age-related inequalities remained fairly consistent. Conclusion: Age, education and wealth related health inequalities were observed in unmet need for family planning. The magnitude of health inequalities varied between 2014 and 2018, with largest inequalities based on wealth status variable.

scholarly journals Prevalence of contraceptives and unmet need for family planning: does geographical location play a role?

2017 ◽  
Vol 3 (2) ◽  
pp. 175-181
Author(s):  
Palas Dutta ◽  
Sumon Chandra Debnath ◽  
Md Alamin ◽  
Ropak Chandra Roy
Keyword(s):  
Family Planning ◽  
Family Income ◽  
Unmet Need ◽  
Geographical Location ◽  
Cross Sectional Study ◽  
Married Women ◽  
Reproductive Age ◽  
Single Family ◽  
Low Literacy ◽  
Cross Sectional

Coastal women are the most socio-economically disadvantaged clusters with low literacy and deprived economic and living conditions. The study aims at measuring contraception and unmet need for contraceptive need among married women in the reproductive age group. A cross-sectional study was carried out among222 married women of in a coastal area of Bangladesh. The majority of the respondents (33.8%) were 31 years and above with mean (± SD) age at marriage was 16.2 ± 2.3 years. Most (85.6%) of the study sample were housewives and maximum (84.7%) were literate. About half (50.9%) of them belongs to the single family and about two-thirds (60.4%) monthly family income between 5000 and 10000 Taka. The mean age of women at marriage was 16.2± 2.2 SD, out of which, about two third (63.9%) experienced marriage below 18 years. The average number of pregnancies was 1.9 ± 1.0 SD, out of which, 39.6% experienced two pregnancies. The current contraceptive prevalence rate among married women was 80.2%. The prevalence of unmet need for family planning was 13.5%. The major reason for non-use of contraception among women with unmet need was the husband’s opposition.Asian J. Med. Biol. Res. June 2017, 3(2): 175-181

scholarly journals Factors Affecting Unmet Need of Family Planning Among Married Tharu Women of Dang District, Nepal

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Chet Kant Bhusal ◽  
Sigma Bhattarai
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Strategic Behavior ◽  
Universal Access ◽  
Unmet Need ◽  
Decisive Role ◽  
Secondary Level ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Communication Program

Background. Increase in population plays a decisive role in providing universal access to reproductive health; however, there is very limited evidence about the reason of unmet need among marginalized and tribal communities such as Tharus. This study aimed to determine the factors affecting unmet need of family planning among married Tharu women of Dang, Nepal. Methods. Community-based cross-sectional household survey among 650 married Tharu women of age group 15-49 in October 2015 to April 2016 was conducted in Dang district, Nepal. Randomly 3 wards were selected from each Tulsipur municipality, Hekuli Village Development Committee, and Pawan Nagar VDC. Results. The mean age and parity were 30±7.31 and 2±0.69, respectively. Out of 650 women, 47% were using contraceptives. Westoff model was used for calculating total unmet need which is 49%, where unmet need for limiting and spacing was 27% and 22%, respectively. Hence after combining the current users and total unmet need, total demand for family planning was 96%. After adjustment, significant relation was observed between number of living sons ≥ 1 and unmet need of family planning (OR= 0.4; CI=0.2-0.8, p=0.01 ), similarly for women education; lower secondary level (OR=0.3; CI=0.1-0.6, p=0.01) and secondary (OR=0.1; CI=0.03-0.4, p=0.01); husband education, lower secondary level (OR=0.3; CI=0.1-0.6, p=0.01) and secondary (OR=0.4; CI= 0.2-0.9, p=0.04); and husband occupation, wage labor (OR=0.6; CI=0.4-0.99, p=0.05). In addition, having very good knowledge about method was also significantly associated (OR=0.49; CI= 0.2-0.97, p= 0.04). Conclusion. Unmet need of family planning was significantly higher among less than secondary educated women. It is also predisposed by spouse education, partner’s occupation, and number of living sons. This study concerns the need for all stake holders to focus on strategic behavior communication program regarding reproductive health.

scholarly journals Stigma as a barrier to family planning use among married youth in Ethiopia

2018 ◽  
Vol 51 (4) ◽  
pp. 505-519
Author(s):  
Aparna Jain ◽  
Hussein Ismail ◽  
Elizabeth Tobey ◽  
Annabel Erulkar
Keyword(s):  
Family Planning ◽  
Supply And Demand ◽  
Unmet Need ◽  
Principal Component ◽  
Principal Component Factor Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Adolescent Groups ◽  
Anticipated Stigma ◽  
Youth Friendly Service

AbstractNearly 33 million female youths have an unmet need for voluntary family planning (FP), meaning they are sexually active and do not want to become pregnant. In Ethiopia, age at marriage remains low: 40% and 14% of young women aged 20–24 were married by the ages of 18 and 15, respectively. Despite increases in FP use by married 15- to 24-year-olds from 5% in 2000 to 37% in 2016, unmet need remains high at 19%. Supply-and-demand factors have been shown to limit FP use, yet little is known about how stigma influences FP use among youth. This study validates an anticipated stigma (expectation of discrimination from others) index and explores its effect on unmet need. A cross-sectional survey was implemented with 15- to 24-year-old female youth in Ethiopia in 2016. The analytic sample included married respondents with a demand (met and unmet need) for FP (n=371). A five-item anticipated stigma index (Cronbach’sα=0.66) was developed using principal component factor analysis. These items related to fear, worry and embarrassment when accessing FP. The findings showed that 30% agreed with at least one anticipated stigma question; 44% had an unmet need; 58% were married before age 18; and 100% could name an FP method and knew where to obtain FP. In multivariate regression models, youth who experienced anticipated stigma were significantly more likely to have an unmet need, and those who lived close to a youth-friendly service (YFS) site were significantly less likely to have an unmet need. Interventions should address anticipated stigma while focusing on social norms that restrict married youth from accessing FP; unmet need may be mitigated in the presence of a YFS; and the anticipated stigma index appears valid and reliable but should be tested in other countries and among different adolescent groups.

scholarly journals Factors Associated with Unmet Need for Family Planning among Married Reproductive Age Women in Toke Kutaye District, Oromia, Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Abebe Tadesse G/Meskel ◽  
Habtamu Oljira Desta ◽  
Elias Teferi Bala
Keyword(s):  
Family Planning ◽  
Maternal Education ◽  
Health Workers ◽  
Unmet Need ◽  
Married Women ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Factors Associated ◽  
Reproductive Age Women ◽  
Living Children

Background. It is estimated that more than 142 million married women in developing countries have an unmet need for family planning. This study is aimed at identifying factors associated with the unmet need of family planning among married women of reproductive age in Toke Kutaye district, Ethiopia in 2019. Methods. A community-based cross-sectional study was conducted in Toke Kutaye district from March 1–30, 2019. A systematic random sampling technique was used to select 494 reproductive-age women who were married during data collection. Data were collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were used to assess factors associated with the unmet need of family planning at 95% CI with a p value of ≤ 0.05. Result. The prevalence of unmet need for family planning in the Toke Kutaye district was 23.1% [95% CI (19.2-26.7)], with 15.2% for spacing and 7.9% for limiting. Women’s education [AOR, 3.64, 95% CI: 1.43-9.25], number of living children [AOR, 2.63, 95% CI: 1.37-5.05], husband disapproval of family planning [AOR, 3.68, 95% CI: 2.20-6.16], and discussion with healthcare providers on family planning [AOR, 0.20, 95% CI: 0.13-0.37] were significantly associated with unmet need for family planning. Conclusion. The prevalence of unmet need for family planning was high. Therefore, program managers, partners, and health workers should work to address the gaps in maternal education, the number of living children, partner disapproval of family planning, and discussion on family planning issues through enhancing female education, awareness on family planning, and male involvement in family planning services.

scholarly journals Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034675 ◽  
Author(s):  
Amrita Namasivayam ◽  
Sarah Lovell ◽  
Sarah Namutamba ◽  
Philip J Schluter
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Secondary Data ◽  
Population Level ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Logistic Regression Models ◽  
Modern Contraceptive Use

Objective(s)Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.Study designA nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).SettingUganda.ParticipantsAll women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.Primary outcome measuresModern contraceptive use.ResultsOverall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).Conclusion(s)Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.

scholarly journals Improving sexual and reproductive health knowledge and practice in Mozambican families with media campaign and volunteer family health champions

2019 ◽  
Vol 7 (4) ◽  
pp. e000089
Author(s):  
Paulo Henrique Pires ◽  
Ronald Siemens ◽  
Martins Mupueleque
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Health Knowledge ◽  
Unmet Need ◽  
Family Health ◽  
Media Campaign ◽  
Planning Practice ◽  
Cross Sectional ◽  
Before And After

ObjectiveTo increase knowledge, attitudes and practice of sexual and reproductive health and family planning and to reduce maternal and neonatal mortality rates in Mozambique.DesignAn implementation research project’s intermediate evaluation, applying two cross-sectional surveys. The surveys were planned for 316 subjects before and after interventions.SettingResearch performed in Natikiri district of Nampula province in northern Mozambique, targeting a suburban and rural populations in their homes.Participants452 people were surveyed (91 before, 361 after), all belonging to the Macua ethnic group.InterventionsA media campaign (2 weekly radio spots, bimonthly theatre performances) was performed for 8 months (2017 to 2018) and family health champions’ teachings (monthly home visits) performed for 3 months, on sexual and reproductive health and family planning. Outcome measures planned and measured were adolescent’s and adult’s knowledge, attitudes and practice about those. Data were analysed by gender, age group and frequencies, using a CI of 95% (p<0.5 statistically significant).ResultsRadio spots, community theatre and volunteer champions increased population’s knowledge about sexual and reproductive health and led to a more positive attitude toward family planning. Concerning attitude, results show differences between adults’ proportions before and after: (1) did you hear about sexual and reproductive health (p=0.0425); (2) knows project key messages (p<0.001); (3) knows prenatal visits importance (p=0.0301); (4) access to contraceptives was easy (p<0.001). Adolescents showed statistically significant differences before and after: (1) knows project key messages (p<0.001); (2) access to contraceptives was easy (p=0.0361). Family planning practice did not increase in both groups.ConclusionA health education intervention, using a media campaign and local volunteers, is useful to promote mother and child health. There is an unmet need for family planning and the use of modern contraception is below desired practice, needing further research about cultural barriers. Communication for behaviour change activities will pursue and impact will be assessed to document family planning practice improvement.

scholarly journals Family planning KAP survey in the Southern Region of Saudi Arabia

2017 ◽  
Vol 6 (11) ◽  
pp. 4798
Author(s):  
Enas A. Dhaher
Keyword(s):  
Saudi Arabia ◽  
Family Planning ◽  
Unmet Need ◽  
Armed Forces ◽  
Cross Sectional Study ◽  
Southern Region ◽  
Cross Sectional ◽  
Number Of Children ◽  
Positive Attitudes ◽  
The Individual

Background: Family planning practices could be determined through adopting proper knowledge and positive couple attitudes towards the use of family planning which would most likely result in favourable family decisions which would benefitted both the individual and the overall country welfare.Methods: A cross sectional study has been conducted using a structured questionnaire administered through face-to-face interview to a convenient sample of 151 pregnant women attending the obstetrics and gynaecology outpatient clinic at the Armed Forces Hospital in the southern region of Saudi Arabia in December 2014.Results: The results revealed that modern methods were popular among women. In general we found positive attitudes towards family planning among the sampled women as two third of the women have ever used contraceptives. However, the present study showed that 34% of women had unmet need of family planning. Women’s age, marriage years and number of children were all found to be associated factors with unmet need.Conclusions: National organized family planning programs might help satisfying the family planning needs for the families. Further studies regarding southern men’s knowledge and attitudes towards family planning is recommended. 

Study of Unmet Need for Family Planning in Urban Slum Population of Davangere- A Cross Sectional Study

2013 ◽  
Vol 4 (4) ◽  
pp. 20 ◽  
Author(s):  
L Hamsa ◽  
SP Rajashri ◽  
V Vijayanath ◽  
DK Mahesh ◽  
BN Sandhyalakshmi ◽  
...  
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Urban Slum ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Slum Population
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