Unmet need for contraception among eligible women of urban slums in Chennai

Background: Unmet need for family planning is a crucial indicator to assess demand for family planning programme. It was reported that women from the world’s poorest countries have a high unmet need for contraception. Unmet need is particularly high among immigrants, urban slum dwellers, and women in the post-partum period. The objective of this study was to assess the unmet need and factors influencing the unmet need for contraception among urban slum dwellers in Chennai, South India.Methods: A community-based cross-sectional study of 375 married women was conducted among 50 urban slums of Chennai. Multistage random sampling was employed. About 6-9 women from each slum were interviewed. A semi-structured questionnaire was used to obtain data.Results: The mean age of the participants was 32.1±7.3 years. The total unmet need was 13.8%, which included 9.3% for limiting and 4.5% spacing. The major reasons for contraception non-use among women with unmet need were no preference to use modern contraceptives (30.8%) and preference to get sterilized soon (21.2%). Age, education, religion, and number of living children were the factors associated with unmet need.Conclusions: It was noted that unmet need reduced with age and increased number of living children. Though the unmet need is considerably low compared to other studies it is evident that women are still uncertain to use modern contraceptive methods for spacing and are more likely to undergo sterilization after their desired family size is achieved.

Spatial Heterogeneity and Socio-economic Correlates of Unmet Need for Spacing in India: Evidences From National Family Health Survey, 2015-16

Background:The high unmet need for contraception among women who wants to delay their subsequent births for two or more years is a challenging issue in India. Therefore, the present study aims to display spatial heterogeneity and determine the associated factors underlying the unmet need for contraception among the currently married women aged 15-49 years with a demand for spacing births in India.Methods:The present study used data from the National Family and Health Survey, 2015-16. Unmet need for spacing (UNS) used as outcomes and socio-cultural and demographic factors as explanatory variables. Among the comprehensive family planning, 16.7% (56742 women) of currently married women had demand for spacing births were used for analysis. Univariate, bivariate with chi-square significance test, spatial natural break technique, and multivariate logistic regression were used to accomplish the study objectives. Results:Almost 17% of women had demand spacing out of total demand for family planning in India. High unmet need for contraception found among them except the women with higher-level education and wealth status. District level spatial heterogeneity of UNS shows 119 districts had very high unmet for spacing (69% and above). Results from multivariate logistic regression show that UNS's likelihood was noticeably high among the women with parity three or more (AOR: 1.42 [1.3-1.55]) compared to their counterparts. Similarly, 44% (AOR: 1.44[1.38-1.51]) more likely found among the OBC than General caste. Rural (AOR: 1.24[1.19-1.30]) women compared to urban, women living in South (AOR: 6.19 [5.76-6.65]), Central (AOR: 1.52 [1.43-1.61]), and West (AOR: 1.80 [1.68-1.92]) region compared to those from North had higher odds of UNS. Conclusion:Deal with the UNS in India requires scaling up women education, client choice-based services, campaign on benefits of spacing births and available contraception, and socio-economically backward group centric policies.

Spatial Heterogeneity and Socio-economic Correlates of Unmet Need for Spacing Contraception in India: Evidences from National Family Health Survey, 2015-16

Background:The high unmet need for contraception among women who wants to delay their subsequent births for two or more years (UNS) is a challenging issue in India. Therefore, the present study aims to display spatial heterogeneity and determine the associated factors underlying the UNS among the currently married women aged 15-49 years with a demand for spacing births in India.Methods:The present study used data from the National Family and Health Survey, 2015-16. Unmet need for spacing (UNS) used as outcomes and socio-cultural and demographic factors as explanatory variables. Among the comprehensive family planning, 16.7% (56742 women) of currently married women had demand for spacing births were used for analysis. Univariate, bivariate with chi-square significance test, spatial natural break technique, and multivariate logistic regression were used to accomplish the study objectives. Results:Almost 17% of women had demand spacing out of total demand for family planning in India. High unmet need for contraception found among them except the women with higher-level education and wealth status. District level spatial heterogeneity of UNS shows 248 districts had remarkably high unmet for spacing (68% and above). Results from multivariate logistic regression show that UNS's likelihood was noticeably high among the women with parity three or more (AOR: 1.42 [1.3-1.55]) compared to their counterparts. Similarly, 44% (AOR: 1.44[1.38-1.51]) more likely found among the OBC than General caste. Rural (AOR: 1.24[1.19-1.30]) women compared to urban, women living in South (AOR: 6.19 [5.76-6.65]), Central (AOR: 1.52 [1.43-1.61]), and West (AOR: 1.80 [1.68-1.92]) region compared to those from North had higher odds of UNS. Conclusion:Deal with the UNS in India requires scaling up women education, client choice-based services, campaign on benefits of spacing births and available contraception, and socio-economically backward group centric policies.

Fertility Preferences, Contraceptive Use, and the Unmet Need for Contraception in Papua New Guinea: Key Findings From 1996 to 2016

Expanding access to reliable contraception is a global priority in the fight to lower maternal morbidity and mortality. Papua New Guinea (PNG) continues to face significant challenges in enhancing contraceptive services for women. PNG Demographic Health Survey (DHS) has been undertaken every 10 years since 1996 and describes the major trends in crude birth rates, fertility rates and preferences, contraceptive use, and the unmet needs for contraception. The latest survey in 2016 means that there are now 20 years of data available. Between 1996 and 2016, modern contraceptive prevalence increased from 14% to 29% with a preference for longer acting reversible contraception, though the unmet need for contraception persisted at 32% with minimal change since 1996. Rurally dwelling women as well as those with low literacy, who make up the majority of reproductive age women in PNG, were consistently the least likely to use contraception. Expanding access to reliable contraception should therefore be prioritized for these women.

A study to assess the unmet need for contraception among married women in the rural field practice area of a medical college Jhansi

Background: The concept of unmet need for family planning points to the gap between some women’s reproductive intentions and their contraceptive behaviour.Methods: A community based cross-sectional study was conducted from April 19 to March 20 in rural Jhansi. 520 married women (15-49 years) were interviewed by house to house survey.Results: Out of 520 participants 124 (23.8%) had unmet need, out of them 73 (14.03%) had unmet need for spacing births and 41 (9.8%) of the participants had unmet need for limiting births.Conclusions: The unmet need for contraceptives was 23.8% in the study which is much higher compared to NFHS-4 data for urban UP (19.6%), and it has to be taken in to consideration by policy makers.

KNOWLEDGE ,ACCEPTIBLITY AND COMPLIANCE OF DMPA IN TERTIARY CENTER OF BIHA

In India , a large proportion of women with an unmet need for contraception are within their rst year after childbirth. It is major obstacles for nation social and economic development. The present study concentrates to educate postpartum women for contraception and to study the acceptance and compliance of medroxyprogesterone acetate (DMPA) in Bihar women. METHODS: This is retrospective study with cross sectional data collection from 210 patients for a period of 14 month , from JANUARY 2019 TO FEBRUARY 2020. RESULTS: The study concluded that DMPA is highly effective contraceptive in the immeadiate post partum period with low failure rate .CONCLUSION: It should be available as a rst line method to all who wish to opt reversible method of contraception.

Unmet need for contraception and associated factors among women with cardiovascular disease having follow-up at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: a cross-sectional study

Background Pregnancies complicated by cardiovascular disease carry a high risk of morbidity and mortality. Contraception offers a unique opportunity to avoid unintended pregnancy and/or optimize preconception cardiac health status. Such planning will also allow possible modification of medical therapy that can be detrimental to the growing fetus. However, unmet need for contraception can become a barrier to achieving these goals. This research was aimed to determine the rate of unmet need for contraceptives and associated factors among women with cardiovascular disease. Methods A facility-based cross-sectional study was conducted from February 1 – May 31/2020. A convenient sampling technique was used to enroll 284 reproductive age women with cardiovascular disease having follow-up at Saint Paul’s Hospital Millennium Medical College. Data was collected through an exit interview using a structured and pretested questionnaire. Descriptive, bivariate, and multivariate methods were used to analyze the level of unmet need and its associated factors. Results The overall unmet need for contraception was 36%. The majority of the respondents lack counseling on contraception use. The most common reasons for non-use of a contraceptive method was fear of drug side effects and drug interaction. Unmet need for contraception was found to be more likely among those who have not been counseled on contraceptive utilization (AOR 6.7, CI 1.8–24.7) and those who lack partner support on contraception use (AOR = 6.2, CI: 1.91–19.8). Unmet need was also found to be more likely among women who have never used contraception before (AOR = 3.2, CI 1.12–8.92). Conclusion Unmet need for contraception was high in this high-risk population group. Tailored counseling can alleviate fear and concerns about contraceptive use. Appropriate strategies that enhance male partner involvement should also be implemented.

Towards achieving the family planning targets in the African region: a rapid review of task sharing policies

Background Expanding access and use of effective contraception is important in achieving universal access to reproductive healthcare services, especially in low- and middle-income countries (LMICs), such as those in sub-Saharan Africa (SSA). Shortage of trained healthcare providers is an important contributor to increased unmet need for contraception in SSA. The World Health Organization (WHO) recommends task sharing as an important strategy to improve access to sexual and reproductive healthcare services by addressing shortage of healthcare providers. This study explores the status, successes, challenges and impacts of the implementation of task sharing for family planning in five SSA countries. This evidence is aimed at promoting the implementation and scale-up of task sharing programmes in SSA countries by WHO. Methodology and findings We employed a rapid programme review (RPR) methodology to generate evidence on task sharing for family planning programmes from five SSA countries namely, Burkina Faso, Cote d’Ivoire, Ethiopia, Ghana, and Nigeria. This involved a desk review of country task sharing policy documents, implementation plans and guidelines, annual sexual and reproductive health programme reports, WHO regional meeting reports on task sharing for family planning; and information from key informants on country background, intervention packages, impact, enablers, challenges and ways forward on task sharing for family planning. The findings indicate mainly the involvement of community health workers, midwives and nurses in the task sharing programmes with training in provision of contraceptive pills and long-acting reversible contraceptives (LARC). Results indicate an increase in family planning indicators during the task shifting implementation period. For instance, injectable contraceptive use increased more than threefold within six months in Burkina Faso; contraceptive prevalence rate doubled with declines in total fertility and unmet need for contraception in Ethiopia; and uptake of LARC increased in Ghana and Nigeria. Some barriers to successful implementation include poor retention of lower cadre providers, inadequate documentation, and poor data systems. Conclusions Task sharing plays a role in increasing contraceptive uptake and holds promise in promoting universal access to family planning in the SSA region. Evidence from this RPR is helpful in elaborating country policies and scale-up of task sharing for family planning programmes.