Factors that influence married/partnered women's decisions to use contraception in Zambia.

IF 2.3 Q2 OBSTETRICS & GYNECOLOGY Frontiers in global women's health Pub Date : 2024-02-21 eCollection Date: 2023-01-01 DOI:10.3389/fgwh.2023.1157097
Chilochibi Chiziba, Mwimba Chewe, Peter Hangoma
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Abstract

According to the Demographic and Health Surveys (DHSs), Zambia has shown an increasing trend in the percentage of married women using contraceptives in the last three decades. As of 2018, this percentage increased from 34.2% in 2001 to 40.8% in 2007 and from 45% in 2013 to 48% in 2018. Despite the increasing trend in contraceptive use, the unmet needs remain relatively high. The low percentage of contraception use translates into 20% of women of reproductive age who are either married/partnered and want to stop or delay childbearing but are not using contraception. This study analyzed factors other than availability that influence women's ability to make or influence the decision to use contraception using logistic regression using data from the Zambia 2013/2014 and 2018 DHSs. Furthermore, adjusted odds ratios and predicted probabilities were estimated using the fitted logistic regression. Data on 8,335 women were analyzed, and 13.7% (n = 1,145) had their husband as the sole decision maker for contraception use, while 86.3% (n = 7,189) made the decisions or participated in making the decision. Contrary to most literature, those with primary or secondary school education were less likely to decide than those without education. The data also associate women who contribute to daily household decisions to having a say in deciding to use contraception. Lastly, women using reversible contraception methods, other methods, hormonal methods, and fertility awareness were associated with less likelihood to decide on using contraceptives than those using barrier methods. Women with lower household decision-making powers are less likely to make or influence decisions to use contraception. Consequently, there is a need to prioritize such women in interventions aimed at increasing contraception use decision-making. Furthermore, more studies are required to investigate why uneducated women in Zambia are more likely to choose contraception. Also, the vast odds ratio difference between all other methods compared to barrier methods (condoms) indicates underlying factors that play a role, which warrants further studies.

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影响赞比亚已婚/有伴侣妇女决定使用避孕药具的因素。
根据人口与健康调查(DHS),在过去三十年中,赞比亚已婚妇女使用避孕药具的比例呈上升趋势。截至2018年,这一比例从2001年的34.2%增至2007年的40.8%,又从2013年的45%增至2018年的48%。尽管避孕药具使用率呈上升趋势,但未满足的需求仍然相对较高。避孕药具使用率低意味着有 20% 的育龄妇女要么已婚/已育,要么想要停止或推迟生育,但却没有使用避孕药具。本研究利用赞比亚 2013/2014 年和 2018 年人口与健康调查的数据,通过逻辑回归分析了影响妇女做出或影响其使用避孕药具决定的能力的其他因素。此外,还利用拟合的逻辑回归估算了调整后的几率比和预测概率。对8335名妇女的数据进行了分析,13.7%(n=1145)的妇女由丈夫作为避孕药具使用的唯一决策者,86.3%(n=7189)的妇女由丈夫做出决定或参与做出决定。与大多数文献相反,受过小学或中学教育的妇女比未受过教育的妇女更不可能做出决定。数据还显示,参与日常家庭决策的妇女在决定使用避孕药具方面也有发言权。最后,与使用屏障避孕法的妇女相比,使用可逆避孕法、其他方法、荷尔蒙避孕法和生育意识的妇女决定使用避孕药具的可能性较低。家庭决策权较低的妇女不太可能做出或影响使用避孕药具的决定。因此,有必要在旨在提高避孕药具使用决策的干预措施中优先考虑这类妇女。此外,还需要进行更多的研究,以调查为什么赞比亚未受过教育的妇女更有可能选择避孕。另外,与屏障避孕法(避孕套)相比,所有其他避孕法的几率相差悬殊,这表明有潜在的因素在起作用,需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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审稿时长
13 weeks
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