Open access journal of contraception最新文献

Background: Worldwide, university students fall in the youth group which is prone to unattended sexual risks, including unintended pregnancies and sexually transmitted diseases. One of the key strategies to prevent these problems is to use contraceptives. Therefore, the study was aimed at assessing contraceptive utilization and factors hindering their utilization.

Objective: The objective of the study was to assess contraceptive demand, utilization, and associated factors among university female students in Amhara region, Ethiopia.

Methods: An institution-based cross-sectional study was conducted. From seven universities, three of them were randomly selected. A multistage sampling method was used. Finally, a simple random sampling method was used to select the respondents. Data were entered via Epi-data version 3.1 and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression analyses were employed. Results are presented using text, tables, and graphs.

Results: A total of 1276 respondents participated in the study with a response rate of 98.8%. The median age of the participants is 21.37 years (SD=1.88 years). About 398 (31.2%) of the respondents had sexual intercourse within the last 12 months. However, only 207 (16.2%) of the respondents were currently using contraceptives. Marital status, year of study, history of having information and previous discussion on contraceptives were found to be significantly associated. Married participants had a 94.4% lower contraceptive utilization compared with unmarried participants [0.056 (0.03- 0.12)]. Third year students were 50% less likely to use contraceptives compared to 2nd year students [0.50 (0.30- 0.82)]. Those having previous information on contraceptives [7.7 (1.01- 59.8)] and discussions with someone else [2.3 (1.5-3.6)] were 7.7- and 2.3-times more likely to use contraceptives than their counterparts, respectively.

Conclusion: Contraceptive utilization among university female students is low. For students, new information, education and communication strategies for sexual and reproductive health issues should be launched.

Background: The postpartum intrauterine contraceptive device (PPIUCD) is an effective, reliable, safe and recommended contraceptive method for the postpartum women. However, only a small proportion of women who gave birth at health facilities in the world have used it. There are limited studies about determinants of PPIUCD utilization. Therefore, this study aimed to assess determinants of postpartum IUCD utilization among mothers who gave birth in Gamo zone health facilities, southern Ethiopia.

Methods: A facility based unmatched case-control study was done at Gamo zone public health facilities, southern Ethiopia. Data were collected using a pretested interviewer-administered questionnaire from March 1 to April 15, 2019. The data were coded, cleaned and entered into Epi-Info version 3.5.1 and exported to SPSS version 25 for advanced analysis. Binary logistic regression was performed to identify the determinants of PPIUCD utilization.

Results: A total of 510 (175 cases and 335 controls) participants were involved in the study yielding a response rate of 95.1%. Partner support for IUCD insertion (AOR [95% CI]: 10 [4.03, 24.3]), birth interval (AOR [95% CI]: 9.7 [1.7, 55.1]), fertility plan (AOR [95% CI]: 4 [1.44, 10.84]), and timing of counseling (AOR [95% CI]:1.25 [0.034, 0.46]) are the determinant factors for postpartum IUCD.

Conclusion and recommendation: Birth interval, fertility plan, timing of counseling, pregnancy plan and partner support were the determinant factors identified in this study. Therefore, counseling of both partners during antenatal follow-up, delivery and immediately after delivery by health professionals are recommended.

Introduction: In Burkina Faso, despite several efforts to improve contraceptive uptake, contraceptive prevalence remains low. Studies suggest that the low levels of family planning (FP) practices can be partially attributed to the low participation of men in reproductive health programmes. Involving men in FP programmes in Burkina Faso is thus imperative, but the obstacles to this are poorly documented. This study has two objectives to explore the perspectives of men and women on barriers to contraceptive use and to identify the strategies to increase male involvement in family planning.

Methods: It is a qualitative study using 20 focus groups and 52 in-depth individual interviews in two regions (North Central Region and Central East Region) with a sample of 29 adult men and 23 women who were married and had children or not. Interviews were conducted in Moore (the national language commonly spoken in both regions). All interviews were recorded and transcribed into French using Microsoft Word. Then, content analysis was carried out using the constant comparison method to identify the major themes.

Results: The results show that men's attitudes are still a significant barrier to women's use of modern contraceptives. The reasons women do not use contraception and men do not adhere to FP programmes include lack of method knowledge, negative beliefs and perceptions about modern contraceptive methods, and the side effects of contraceptives. Cultural norms and preferences for large families are also common barriers to FP. However, the results showed that men's awareness of FP, communication between spouses, and access to FP services can promote men's adherence to FP programmes in the Centre-East and Centre-North regions of Burkina Faso.

Conclusion: Efforts should be made to improve educational standards, especially for men, and reorient FP services to make them more accessible to men.

Context: Provision of high-quality contraceptive counseling and services is essential to ensure family planning (FP) programs are rights-based and voluntary. Togo's modern contraceptive use has steadily increased with almost a quarter of the method mix attributed to long-acting reversible contraceptives (LARC). The purpose of this study is to assess the quality of LARC provision in Togo.

Methods: Data for this study were collected in 2016 as part of a larger research study conducted in Lomé, Togo to assess the effectiveness of the ongoing FP service delivery model. Quality of FP service was assessed in terms of program capacity and program performance. Program capacity was measured with five individual variables and program performance was measured with the Method Information Index (MII). Descriptive statistics and mixed effects models were used to assess likelihood of LARC uptake.

Results: Of the 669 clients included in the study, 19.4% received a LARC method. Multivariable results show that LARC uptake is significantly associated with supervisory visit at the facility in the last three months (program capacity indicator) (OR 1.44; 95%CI 1.48-2.39) and is twice as likely for those with a positive MII score, even after controlling for provider and client characteristics (OR 2.1; 95%CI 1.61-2.51).

Conclusion: This study identified supervisory visits and comprehensive contraceptive counseling as the key quality factors positively associated with uptake of LARC. Continued focus on quality of care and provider-client information exchange is necessary to ensure women's FP needs are met.

Background: Despite improvement in the availability and use of reversible long-acting contraception, discontinuation is becoming a public health concern. A significant proportion of women discontinuing the service before its due date, which is of concern in the health system with regard to its consequences, may lead to a program failure. In addition, there is a paucity of information on discontinuation of reversible long-acting contraceptives and associated factors in the study area. Therefore, this study aimed to assess discontinuation of reversible long-acting contraceptives and associated factors among female users in health facilities of Hawassa city, southern Ethiopia, 2019.

Methods: Institution-based cross-sectional design was used. Systematic sampling was used to select study participants. Women who were users of long-acting contraceptives and had come to selected health facilities for method-related reasons were included in the study. Data collectors approached and recruited participants before they contacted their care providers. Data were collected from study subjects using a pretested, structured questionnaire through face-to-face interviews after participants had contacted care providers. Results are presented using the crude and adjusted ORs with corresponding 95% CIs.

Results: The overall proportion of reversible long-acting contraceptive discontinuation was 56.6% (95% CI 52.30%, 61.10%). Maternal education at primary level (AOR 2.33, 95% CI 1.15-4.74), lack of counseling (AOR 2.50, 95% CI 1.01-6.18), side effects (AOR 2.10, 95% CI 1.31-3.34), and desire to be pregnant (AOR 2.22; 95CI 1.50-3.30) were the major factors in discontinuation.

Conclusion: In this study, the overall proportion of discontinuation of reversible long-acting contraceptives was high. Maternal education at primary level, lack of counseling, side effects, and desire to be pregnant were the key factors associated with discontinuation of the contraceptives. Health professionals should provide counseling on the side effects before insertion.

Background: Long-acting and permanent family planning methods (LAPMs) are modern contraceptive methods that can prevent pregnancy for greater than one year and include long-acting reversible contraceptive methods (LARCs) (Intrauterine device and subdermal implants), and permanent contraceptive methods (Tubal ligation and Vasectomy). The current study aimed to assess the utilization pattern of long-acting and permanent contraceptive methods and factors associated with their utilization in Lay-Armachiho district, Amhara regional state, Ethiopia.

Methods: A community-based cross-sectional study was conducted. Data were collected by using an interview method and the collected data were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Both binary logistics and multivariable logistic regression analyses were used to analyze predictive variables with the utilization of contraceptives. A 95% confidence interval (CI) and a P-value of <0.05 were used to declare statistical significance.

Results: A total of 460 women have participated in the study. The proportion of women that utilize long-acting and permanent contraceptives was found to be 65.4%. Educational statuses, residence, attitude towards long-acting contraceptives, discussion, and joint decision-making with their spouse were factors significantly associated with the utilization of long-acting contraceptive methods.

Conclusion: The current study showed that there is high utilization of LAPMs. Women's attitude, educational status, residency, frequent discussions, and a joint decision with their partners about LAPMs were significantly associated with the utilization of long-acting and permanent contraceptives. There is a significant impact of husbands (sexual partners) on the utilization and choice of contraceptive methods by women.

Purpose: The aim of the study was to assess the effectiveness of focused family planning counseling (FFPC) in increasing postpartum intrauterine contraceptive device (PPIUCD) uptake among mothers who gave birth in the public health facilities of the towns of Adama and Olenchiti from April 1 to May 30, 2017.

Methods: A quasi-experimental study design was employed, taking a sample of 726 postpartum mothers: 484 in the non-intervention group (NIG) and 242 in the intervention group (IG). Focused family planning counseling was given to the IG using a newly designed cue card adapted from World Health Organization (WHO) guidelines and developed based on the constructs of the health belief model. Counseling based on a routine counseling approach was given to the NIG. The interviewer administered a semi-structured questionnaire for data collection. Data were analyzed using SPSS software, version 20. Descriptive statistics were used to characterize the study participants. The difference in the proportion of PPIUCD uptake in the two groups was tested using an independent Z-test at an alpha level of 0.05. Binary logistics regression was used to identify factors associated with the odds of taking IUCD. The significance of association was declared for P-values less than 0.05.

Results: The proportion of PPIUCD uptake in the IG [12.4%; 95% CI: 8.6, 17.4] was significantly higher than in the NIG [4.8%; 95% CI: 2.9, 6.7] with a P-value = 0.000. The odds of IUCD uptake among the IG was about 6 times higher (AOR: 5.92; 95% CI: 2.79, 12.60) than in the NIG. In addition, being unmarried women (AOR: 12.96; 95% CI: 4.30, 34.56), having higher education (AOR: 3.07; 95% CI: 1.13, 8.36), grand multiparity (AOR: 3.76; 95% CI: 1.58, 8.95), making a mutual decision (AOR: 0.16, 95% CI: 0.07, 0.38) and having a better knowledge of family planning (AOR: 5.92, 95% CI: 2.79, 12.60) were factors associated with uptake.

Conclusion: Providing FFPC immediately increases PPIUCD uptake. The uptake was also associated with marital status, education, parity, decision and knowledge on family planning.

Background: The sharp fertility drop-off in the Amhara region between 2000 and 2011 was due to an increase in modern contraceptive utilization of rural women. However, long-acting contraceptive method utilization was higher among urban than rural women. Therefore, this study aimed to assess rural-urban differentials of long-acting contraceptive method utilization and the contributing factors among reproductive-age women in the Amhara region: analysis of the 2016 EDHS.

Methods: The 2016 EDHS data were used. A weighted sample of 2188 (1675 rural and 513 urban) fecund reproductive-age women was used, and a mixed-effects logistic regression model was fitted. Multivariable logistic regression analysis at a P-value <0.05 and adjusted odds ratio with a 95% confidence interval were used to declare significant associations.

Results: The overall long-acting contraceptive method use was 13.3% (95% CI=11.6-15.8), and it was 14.8% (95% CI=12.4-17.2) among rural and 8.3% (95% CI=4.5-12.4) among urban women. Among urban women, the odds of long-acting contraceptive method use was higher for women living with a partner (AOR=6.83; 95% CI=1.23-37.84), married women (AOR=5.21; 95% CI=1.95-13.89), women living in a male-headed household (AOR=5.29; 95% CI=1.26-22.38), and women whose partner wanted fewer children (AOR=11; 95% CI=3.46-16.2). Among rural women, the odds of long-acting contraceptive use was higher for women in the richest wealth index (AOR=6.69; 95% CI=3.02-14.83), married women (AOR=30.26; 95% CI=8.81-42.9), women with good knowledge of LACMs (AOR=1.75; 95% CI=1.25-2.46), and women who had no correct knowledge of their ovulatory cycle (AOR=1.93; 95% CI=1.16-3.19).

Conclusion: Long-acting contraceptive method use was lower than the national target. LACM use was 8.3% (95% CI=4.5-12.4) among urban and 14.8% (95% CI=12.4-17.2) among rural women. Overall, marital status, educational level, the total number of children, knowledge of LACMs, and correct knowledge of the ovulatory cycle were significantly associated with LACM use.

Introduction: Client satisfaction influences the use of family planning and other reproductive health services. This study aimed to assess the magnitude of client satisfaction with family service and its associated factors among reproductive-age women.

Patients and methods: We conducted a facility-based cross-sectional study. A total of 411 clients, nested in four health facilities, were included in the analysis. Systematic sampling was employed to select study units for the exit interview. Data collection instruments for this study were pre-tested structured questionnaires. Client satisfaction was assessed using fifteen Likert-scaled question items. Each item of question has 5 points ranging from 1 (strongly disagree) to 5 (strongly agree) and, finally, mean was computed. The pre-coded data were entered into Epi Data version 4.2.0 and exported to SPSS version 25 for analysis. Logistic regression analysis was carried out to identify independently associated factors at a confidence interval of 95% and a significance level of p-value less than 0.05.

Results: Magnitude of client satisfaction with family planning service was 46% [95% CI: 41-50.8]. Rural residence [AOR=3.07; 95% CI: 1.10-8.62], educational level of college and above [AOR=0.22; 95% CI: 0.07-0.70] as compared to the educational level of primary education, waiting time of less than half an hour [AOR=7.80; 95% CI: 2.48-24.48], maintaining privacy [AOR=7.16; 95% CI: 2.89-17.69], describing side effects of methods [AOR=3.14; 95% CI: 1.02-9.76] were factors significantly associated with client satisfaction.

Conclusion: The overall magnitude of client satisfaction with the services was found to be low. Many of the factors that attributed to the low level of client satisfaction are modifiable. There is a need for organizing the family planning room as per standards, maintaining privacy, minimizing waiting time, and describing the side effects during the provision of service.

Background: Family planning is defined as the ability of couples or individuals to attain their desired number of children, spacing, and timing of their births with the use of contraceptive methods. Ethiopia is one of the most populated countries in Africa with a high fertility rate, a highly unmet need for family planning, and low contraceptive utilization.

Objective: This study aims to assess modern contraceptive method utilization and associated factors among women of reproductive age in Gondar City, Northwest Ethiopia.

Materials and methods: A community-based cross-sectional study design was undertaken with 708 women in the reproductive age in Gondar City, using a structured questionnaire combined with face-to-face interviews. Descriptive analysis, binary, and multivariable logistic regression analyses were applied to analyze the data.

Results: In this study, 41.2% of the respondents utilized modern contraceptive methods. Of the study participants, 52.1 % had good knowledge and 45.3% had a favorable attitude towards modern contraceptive methods. After adjusting for covariates, the odds of using modern contraceptive methods were 3.6 times, 4.7 times, 2.4 times, and 4 times higher among women of the age 20-24, 25-29, preparatory education, and degree holders, respectively. In addition, for the women having up to six desired children [AOR (Adjusted Odds Ratio) = 2.4 (95% CI: 1.1, 5.3)], a history of no-child death experience [AOR= 4.4 (95% CI: 1.03, 19.1)], good knowledge [AOR= 4.1 (95% CI: 2.7, 6.0)], and favorable attitude [AOR= 3.5 (95% CI: 2.4, 5.1)] were positively associated with modern contraceptive utilization.

Conclusion: The majority of participants had good knowledge about, but the unfavorable attitude towards the utilization of modern contraceptive methods. Therefore, the authors recommended that special awareness creation with the help of health education interventions should be employed in the community.