scholarly journals Demand for Family Planning Satisfied With Modern Methods in Urban Malawi: CHAID Analysis to Identify Predictors and Women Underserved With Family Planning Services

2021 ◽  
Vol 2 ◽  
Author(s):  
Nurudeen Alhassan ◽  
Nyovani Janet Madise
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Ethnic Origin ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Chi Square ◽  
Modern Contraceptives ◽  
Modern Methods ◽  
Living Children ◽  
Underserved Groups

Introduction: Family planning progress under the SDGs is measured with a novel indicator, demand for family planning satisfied with modern methods (mDFPS), which provides a better indication of modern contraceptive coverage than unmet need and contraceptive prevalence rate. Yet, few studies have examined the predictors of mDFPS and the sub-groups of women with unsatisfied mDFPS in urban Saharan Africa. The objective of this study was to examine the predictors of mDFPS in urban Malawi and to identify the sub-groups of urban women underserved with modern contraceptives.Methods: The study analysed data from the 2015–16 Malawi Demographic and Health survey. The sample was comprised of 2,917 women in urban Malawi who had a demand for family planning services. We used a Chi-square (χ2) Automatic Interaction Detector (CHAID) model to address the study objectives.Results: The results show that the number of living children a woman had was the most significant predictor of mDFPS. Women with one or more children, who were of Chewa, Lomwe, or Tumbuka ethnic origin and who resided in the central region had the highest mDFPS (87%). On the other hand, women with no children, and who were not exposed to FP information on television, had the lowest mDFPS (41%). Among women in union, ethnicity was the best predictor of mDFPS. Ngoni, Yao, and other ethnic minority women in union who were aged 15–19 and 40 years and above and those who were Catholic, SDA/Baptist, or Muslim had the lowest mDFPS (36%).Conclusion: This study demonstrates significant intra-urban disparities in demand for FP satisfied with modern contraceptives in Malawi. There is a need for policymakers and reproductive health practitioners to recognise these disparities and to prioritise the underserved groups identified in this study.

scholarly journals Demand for Family Planning Satisfied With Modern Methods in Urban Malawi: CHAID Analysis to Identify Predictors and Women Underserved With Family Planning Services

2020 ◽  
Author(s):  
Nurudeen Alhassan ◽  
Nyovani Janet Madise
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Ethnic Origin ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Chi Square ◽  
Number Of Children ◽  
Chaid Analysis ◽  
Modern Methods ◽  
Underserved Groups

Abstract BackgroundFamily planning progress under the SDGs is measured with a novel indicator, demand for family planning satisfied with modern methods (mDFPS), which provides a better indication of modern contraceptive coverage than unmet need and contraceptive prevalence rate. Yet, few studies have examined the predictors of mDFPS and the sub-groups of women with unsatisfied mDFPS in urban Saharan Africa. The objective of this study was to examine the predictors of mDFPS in urban Malawi and to identify the sub-groups of urban women underserved with modern contraceptives.MethodsThe study analysed data from the 2015-16 Malawi Demographic and Health survey. The sample comprised of 2,917 women in urban Malawi who had a demand for family planning services. We used a Chi-square (χ2) Automatic Interaction Detector (CHAID) model to address the study objectives.ResultsThe results show that the number of children a woman had was the most significant predictor of mDFPS. Women with one or more children, who were of Chewa, Lomwe or Tumbuka ethnic origin, and who resided in the central region had the highest mDFPS (87%). On the other hand, women with no children, and who were not exposed to FP information on television had the lowest mDFPS (41%). Among women in union, ethnicity was the best predictor of mDFPS. Ngoni, Yao and other ethnic minority women in union who were aged 15-19 and 40 years and above, and who were Catholic, SDA/Baptist or Muslim had the lowest mDFPS (36%).ConclusionThis study demonstrates significant intra-urban disparities in demand for FP satisfied with modern contraceptives in Malawi. There is the need for policy makers and reproductive health practitioners to recognise these disparities and to prioritise the underserved groups identified in this study.

scholarly journals The relationship between spatial access and modern contraceptive use: is proximity to a healthcare facility a determinant of use among women in Kinshasa, DRC?

2021 ◽  
Vol 5 ◽  
pp. 80
Author(s):  
Saleh Babazadeh ◽  
Julie Hearnandez ◽  
Philip Anglewicz ◽  
Jane Bertrand
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Spatial Access ◽  
Modern Contraceptives ◽  
Contraceptive Services ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Background: Spatial access has a direct effect on health service utilization in many settings. Distance to health facility has proven to affect family planning (FP) service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay. This study analyzed the significance of proximity to family planning services, service availability, and quality of family planning services on modern contraceptive use in Kinshasa, Democratic Republic of the Congo. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa from PMA2020 between 2014 and 2016. We used GPS coordinates to calculate the distance between the health facilities and households. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: 10,968 women were interviewed over four rounds of data collection. Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are strong barriers for women in Kinshasa to use modern contraceptives. Proximity to quality services did not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusions: This study notes that barriers other than proximity to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

scholarly journals The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?

2019 ◽  
Author(s):  
Saleh Babazadeh ◽  
Julie Hernandez ◽  
Philip Anglewicz ◽  
Jane T Bertrand
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Spatial Access ◽  
Modern Contraceptives ◽  
Contraceptive Services ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: Spatial access has a direct effect on health service utilization in many settings. While, all elements of access are usually affected by service delivery points and client characteristics. Distance to facility has proven to affect family planning service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay to observe any association between an increased distance of health facilities and health service utilization. This study to analyze the significance of proximity to family planning services, as well as service availability and quality of family planning services in Kinshasa. Method: We used a pool of four rounds of facility- and population-based survey data in Kinshasa. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Discussion: Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are among the strong barriers for women in Kinshasa to use modern contraceptives. Our analysis shows that proximity to quality services does not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusion: This study indicates that proximity to facilities does not necessarily equate proximity to methods, nor does it necessarily enable current users or women with an unmet need (potential contraceptive users) to easily obtain services for their method of choice. This study notes that other barriers to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

scholarly journals The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?

2020 ◽  
Author(s):  
Saleh Babazadeh ◽  
Julie Hernandez ◽  
Philip Anglewicz ◽  
Jane T Bertrand
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Spatial Access ◽  
Modern Contraceptives ◽  
Contraceptive Services ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: Spatial access has a direct effect on health service utilization in many settings. While, all elements of access are usually affected by service delivery points and client characteristics. Distance to facility has proven to affect family planning service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay to observe any association between an increased distance of health facilities and health service utilization. This study to analyze the significance of proximity to family planning (FP) services, as well as service availability and quality of family planning services in Kinshasa. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Discussion: Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are among the strong barriers for women in Kinshasa not to use modern contraceptives. Our analysis shows that proximity to quality services does not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusion: This study indicates that proximity to facilities does not necessarily equate proximity to methods, nor does it necessarily enable current users or women with an unmet need (potential contraceptive users) to easily obtain services for their method of choice. This study notes that other barriers to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

scholarly journals A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Ontiri ◽  
Lilian Mutea ◽  
Violet Naanyu ◽  
Mark Kabue ◽  
Regien Biesma ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Peer Influence ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background Addressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives. Methods Qualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Results Use of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods. Conclusion This study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.

Analysis the contraception usage and unmet needs of education and reproductive health in Hubei province, China

2020 ◽  
Author(s):  
peng meilin ◽  
kai zhao ◽  
Huiping Zhang ◽  
kunming Tian ◽  
Yiwei Fang ◽  
...  
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Unmet Needs ◽  
Unwanted Pregnancy ◽  
Hubei Province ◽  
Family Planning Services ◽  
Contraceptive Failure ◽  
Modern Contraceptives ◽  
Living Children

Abstract background: In recent years, contraceptives have developed rapidly, which are divided into modern contraceptives and non-modern contraceptives. The use of contraceptives less unwanted pregnancy and sexually transmitted infections(STIs) including HIV. And cause traditional attitudes towards sex, marriage and family have changed. It leads to a lack of caution about sex and pre-marital sex is more acceptable. Hence, the number of miscarriages caused by unwanted pregnancies has increased. People is going to settle many of sexual and reproductive health matters. Methods: This study, was conducted of about 103 counties in Hubei Province from August 2014 to July 2016, which used frequencies, percentage, mean, chi-square, logistic regression to analysis this data that collected from 17555 respondents. (IBM-SPSS v 25.0)Results: The results in this article describe more men (62.6%) received family planning services education than women (37.4%). And people who did not participate in family planning services education, 17.0% and 21.9% did not know about vasectomy and withdrew as a method of male contraception, respectively. Striking, up to 23.9% and 22.8% of people with or without participating in family planning services education had experienced contraceptive failure (pregnancy for example) in couple. Age, educational, occupational status and the number of living children were strongly associated with contraceptive failure within participating in family planning services education. Only age, place of residence and number of living children were significant associated with contraceptive failure without participating in family planning services education. The figure showed greatly unmet needs of education and reproductive health whether or not to accept family planning services educationConclusion: There is a huge difference in Knowledge and use of contraceptives, as well as unmet educational and reproductive health needs between those who participated in family planning services education and those who did not. That means people who participate in family planning services education got more about sexual and reproductive health education and understand the important of the family planning services. Therefore, it is necessary to provide family planning services for more people and regions to obtain a good understanding of contraceptives, sexual intercourse and unintended pregnancy.

Determinants of Modern Contraceptive Methods Use in Piple, Chitwan of Nepal

2019 ◽  
Vol 9 (3) ◽  
pp. 22-28
Author(s):  
Rajani Shah ◽  
Dinesh Kumar Malla
Keyword(s):  
Family Planning ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
Younger Women ◽  
Modern Contraceptives ◽  
Living Children

 Background: Family planning contributes in preventing maternal and child mortality and empowers women. For the past ten years contraceptive prevalence rate has remained stagnant in Nepal. This study aimed at iden­tifying the use and factors associated with modern contraceptive methods in Piple, Chitwan, Nepal. Methods: It was a cross-sectional study. Piple village development com­mittee was selected purposively, in which two wards were randomly se­lected. Married women of reproductive age (n=332) of each household were interviewed. Descriptive, bivariate and multivariate analysis were performed. Results: About half (49%) of the respondents had used a modern contra­ceptive method. Women in the age groups 25-39 years [aOR: 2.39; 95% CI: 1.16 - 4.92] and 40-49 years [aOR: 4.67; 95% CI: 1.71 - 12.70] were more likely to use modern contraceptives compared to the women in the age group 15-24 years. Similarly, women having 3 or more living children [aOR: 2.98; 95% CI: 1.19 - 7.50] were more likely to use the modern contracep­tives than women with upto two children. Women whose husbands would approve of using the contraceptives [aOR: 11.33; 95% CI: 3.93-32.62] were more likely to use the methods than those who got or perceived no ap­proval from husband. Conclusions: Information and service on modern contraceptive methods should be focused to younger women. Involvement of husbands in family planning program would contribute to use of modern contraceptives by women.

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 Persisting Regional Disparities in Modern Contraceptive Use and Unmet Need for Contraception among Nigerian Women

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Chao Wang ◽  
Huimin Cao
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Universal Coverage ◽  
Regional Disparities ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Modern Contraceptives ◽  
Unmet Need For Contraception

Background. Evidence suggests that equitable provision of contraceptive services can help women achieve their reproductive goals and has significant impact on reducing the rates abortion and unintended pregnancy at large. However, regional disparities continue to persist on top of low family planning prevalence which is a critical public health challenge for fast growing populations like Nigeria. Objectives. The present study aimed to explore the prevalence of (1) nonuse of modern contraceptives, (2) unmet need for contraception, and (3) regional disparities in these two. Methods. The present study used cross-sectional data obtained from the Nigeria Demographic and Health Surveys conducted in 2003, 2008, and 2013. Participants were women of reproductive of age (15-49 years) regardless of marital status. Regional disparities of nonuse of modern contraceptives and unmet need were analysed by descriptive and multivariate regression methods. Results. In the pooled sample of 79,656 participants during 2003, 2008, and 2013, 88.6% reported not using any modern methods, and 13.5% reported having unmet need for contraception. The prevalence rates of nonuse were, respectively, 91.8%, 90.6%, and 88.6% and those of unmet need were 14.2%, 16.6%, and 13.5% in the years 2003, 2008, and 2013. Significant differences were observed in the odds of reporting nonuse and unmet need for contraception across the geopolitical zones. Conclusions. The rates of nonuse of contraception are remarkably high among women in Nigeria with significant disparities across the six geopolitical zones. Efforts should be made to address the regional disparities in order to achieve the goals of universal coverage of family planning services in the country.

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.

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