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Married Women's Decision-Making Power in Family Planning Use and its Determinants in Basoliben, Northwest Ethiopia. 埃塞俄比亚西北部Basoliben地区已婚妇女计划生育使用决策权及其影响因素
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-06-18 eCollection Date: 2020-01-01 DOI: 10.2147/OAJC.S250462
Berhanu Alemayehu, Getachew Mullu Kassa, Yohannes Teka, Liknaw Bewket Zeleke, Amanuel Alemu Abajobir, Addisu Alehegn Alemu

Background: Women's decision-making power influences the use of family planning. It is one of the denied fundamental rights of women, particularly in developing countries.

Objective: This study was aimed to assess married women's decision-making power in the use of family planning and its associated factors among married reproductive age women in Basoliben, Amhara, Ethiopia, 2018.

Methods: A community-based cross-sectional study was conducted among married reproductive age women from March 1 to 30, 2018. A multistage simple random sampling technique was employed in selecting study participants. Data were collected using structured questionnaires and analyzed through SPSS 20 software. The binary and multiple variable logistic regression models were fitted to identify factors associated with women's decision-making power on family planning use. Statistical significance was declared at p-value less than 0.05.

Results: A total of 734 married women aged 18-49 years are making a 98% response rate included in this study. The level of married women's decision-making power in family planning among married women was 80%; 95% CI (76.9, 82.8). Monthly income (AOR=2.2; 95% CI: 1.1, 4.2), husband's desired number of children of <3 (AOR=9.9; 95% CI: 3.6), husband's desired time for additional child after 3 years postbirth (AOR=4.0; 95% CI: 1.9, 8.5) and women's information on any contraceptive (AOR=9.6; 95% CI: 2.4, 39.0) were factors significantly associated with married women's decision-making power in family planning.

Conclusion: Married women's decision-making power in family planning use was optimal. Household monthly income, husband's desired ideal number of children, husband's desired time when to have another child and information about any contraceptive methods were predictors of their decision-making power on family planning use. There should be awareness creation of family planning methods to increase its utilization.

背景:妇女的决策权影响计划生育的实施。这是妇女被剥夺的基本权利之一,特别是在发展中国家。目的:本研究旨在评估2018年埃塞俄比亚阿姆哈拉巴索利本地区已婚育龄妇女在计划生育使用方面的决策权及其相关因素。方法:2018年3月1日至30日,以社区为基础对已婚育龄妇女进行横断面研究。采用多阶段简单随机抽样方法选择研究对象。采用结构化问卷收集数据,并通过SPSS 20软件进行分析。拟合二元和多元logistic回归模型,确定影响妇女计划生育决策权的因素。p值< 0.05,差异有统计学意义。结果:本研究共纳入734名18-49岁的已婚女性,回复率为98%。已婚妇女计划生育决策权水平为80%;95% ci(76.9, 82.8)。月收入(AOR=2.2;95% CI: 1.1, 4.2),丈夫期望子女数的结论:已婚妇女在计划生育使用上的决策权最优。家庭月收入、丈夫期望的理想子女数目、丈夫希望何时再生育和关于任何避孕方法的信息是她们对计划生育使用的决策权的预测因素。提高人们对计划生育方法的认识,提高计划生育方法的利用率。
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引用次数: 15
Roles of Proximate Determinants of Fertility in Recent Fertility Decline in Ethiopia: Application of the Revised Bongaarts Model. 埃塞俄比亚近期生育率下降中生育率的直接决定因素的作用:修正Bongaarts模型的应用。
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-06-03 eCollection Date: 2020-01-01 DOI: 10.2147/OAJC.S251693
Seifadin Ahmed Shallo

Introduction: In Ethiopia, the fertility rate declined from 5.4 in 2005 to 4.6 by 2016. Many factors have been contributing to this decline. Understanding the factors contributing to the fertility decline and their level of fertility inhibiting effect has a paramount policy implication in any country. This study aimed to assess the contribution of the four proximate determinants of fertility, ie, contraception use, postpartum infecundity, marriage and abortion rate, to fertility decline in Ethiopia since 2005.

Methods: This study used publicly available data from the Ethiopia Demographic and Health Surveys (EDHS) of 2005, 2011 and 2016. The EDHS data were the representative data collected from the reproductive-age women through a cross-sectional study. The revised and fine-tuned Bongaarts model of proximate fertility determinants was used for data analysis. The components needed for the analysis were extracted from the full EDHS data using the STAT compiler. Finally, the analysis was done using Microsoft Excel.

Results: Of the four proximate determinants of fertility, postpartum insusceptibility contributed the highest fertility inhibiting effect in all three EDHS, and its level was also more prominent among the poorest women. While post partum infecundity, marriage and abortion had a relatively constant effect on fertility over the last 15 years, the fertility inhibiting effect of contraceptive use significantly increased from 15% to 37%.

Conclusion: In conclusion, fertility variation in Ethiopia is largely due to the three intermediate determinants of fertility. Over the last one and half decades, contraceptive use was the single most important determinant responsible for fertility decline in Ethiopia. To achieve fertility at replacement level, the country needs a contraceptive prevalence rate of 69%, an increment of nearly 100% from its current contraceptive prevalence rate.

在埃塞俄比亚,生育率从2005年的5.4下降到2016年的4.6。许多因素导致了这种下降。了解导致生育率下降的因素及其抑制生育率的作用水平对任何国家都具有重要的政策意义。本研究旨在评估2005年以来埃塞俄比亚生育率下降的四个近似决定因素,即避孕措施的使用、产后不孕、婚姻和堕胎率。方法:本研究使用了2005年、2011年和2016年埃塞俄比亚人口与健康调查(EDHS)的公开数据。EDHS数据是通过横断面研究从育龄妇女中收集的代表性数据。数据分析使用了修正和微调的Bongaarts近似生育决定因素模型。分析所需的组件使用STAT编译器从完整的EDHS数据中提取出来。最后使用Microsoft Excel进行分析。结果:在影响生育的四个近因因素中,产后不敏感对三种EDHS的生育抑制作用最大,且在贫困妇女中更为突出。在过去15年中,虽然产后不孕、婚姻和堕胎对生育率的影响相对稳定,但避孕措施的使用对生育率的抑制作用从15%显著增加到37%。结论:总之,埃塞俄比亚的生育率变化很大程度上是由于生育率的三个中间决定因素。在过去15年里,避孕药具的使用是埃塞俄比亚生育率下降的最重要的决定因素。为了在更替水平上实现生育率,该国需要将避孕普及率提高到69%,比目前的避孕普及率提高近100%。
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引用次数: 1
Utilization of Family Planning Methods and Associated Factors Among Reproductive-Age Women with Disability in Arba Minch Town, Southern Ethiopia. 埃塞俄比亚南部Arba Minch镇育龄残疾妇女计划生育方法的使用及其相关因素
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-08 eCollection Date: 2020-01-01 DOI: 10.2147/OAJC.S240817
Yibeltal Mesfin Yesgat, Feleke Gebremeskel, Wubshet Estifanous, Yordanos Gizachew, Seid Jemal, Natnael Atnafu, Keyredin Nuriye

Introduction: Globally in 2019, there were 1.9 billion reproductive-age women. Around 922 million of them were using either modern or traditional methods of family planning. Women with disabilities comprise 10% of worldwide women and three-quarters of them reside in low- and middle-income countries.

Objective: The purpose of this study was designed to assess the magnitude and associated factors for family planning methods use among reproductive-age women with disabilities in Arba Minch town, southern Ethiopia.

Patients and methods: A community-based cross-sectional study was conducted among 418 reproductive-age women with disabilities. Data were collected with eight women who had completed grade 12 and two of them were proficient in sign language. The data were entered into Epi-info™ version-7 software and exported into SPSS version 20 for analysis. A statistically significant variable in the final model was declared by adjusted odds ratio (AOR), 95% confidence interval (CI) and p-value <0.05.

Results: The magnitude of family planning utilization among reproductive-age women with disabilities was 33.7%. Factors significantly associated with family planning use were being employed (AOR: 2.2, CI: 1.77-4.15), having positive attitudes (AOR: 2.3, 95% CI: 1.21-3.87) and marital status (AOR: 3.9, 95% CI: 2.31-6.63).

Conclusion: The magnitude of family planning use among reproductive women with disabilities was low. Attitude, marital status, and being employed were significantly associated factors with family planning use. Therefore, the governmental and non-governmental organizations should work to change their attitude and creating job opportunities.

导读:2019年,全球共有19亿育龄妇女。其中约9.22亿人使用现代或传统的计划生育方法。残疾妇女占全世界妇女的10%,其中四分之三生活在低收入和中等收入国家。目的:本研究旨在评估埃塞俄比亚南部Arba Minch镇育龄残疾妇女使用计划生育方法的程度和相关因素。患者和方法:对418名育龄残疾妇女进行了以社区为基础的横断面研究。数据收集自8名完成12年级的女性,其中2名精通手语。数据输入Epi-info™version-7软件,导出到SPSS version 20进行分析。通过调整优势比(AOR)、95%置信区间(CI)和p值,最终模型中有一个具有统计学意义的变量:育龄残疾妇女计划生育利用率为33.7%。与计划生育使用显著相关的因素有:工作(AOR: 2.2, CI: 1.77-4.15)、态度积极(AOR: 2.3, 95% CI: 1.21-3.87)和婚姻状况(AOR: 3.9, 95% CI: 2.31-6.63)。结论:生育障碍妇女计划生育使用率较低。态度、婚姻状况、就业状况与计划生育相关。因此,政府和非政府组织应该努力改变他们的态度,创造就业机会。
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引用次数: 15
Decision-Making Power of Married Women on Family Planning Use and Associated Factors in Dinsho Woreda, South East Ethiopia. 埃塞俄比亚东南部Dinsho worda地区已婚妇女计划生育使用决策权及其影响因素
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-02-07 eCollection Date: 2020-01-01 DOI: 10.2147/OAJC.S225331
Dinku Dadi, Daniel Bogale, Zenebe Minda, Sintayehu Megersa

Background: Women's decisions on family planning use have multiple benefits to the family and community at large. In developing countries like Ethiopia, the choice of women to use a contraceptive is challenged by social and environmental factors that mitigate their ability to decide independently and freely. This study therefore determined the level of women's decision-making power on family planning use and associated factors among married women in the study area.

Methods: A community-based cross-sectional study was conducted in Dinsho woreda from March to April 2017. A simple random sampling technique was used to select 373 married women. A structured and pre-tested questionnaire was used to collect data by trained data collectors under continuous supervision. Multivariable logistic regression was performed to identify factors associated with women's decision-making power on family planning use. Crude and adjusted odds ratios with 95% confidence interval were used and p-value of <0.05 was considered as statistical significance.

Results: A total of 344 (92.2%) women participated in the study. Of the total respondents, 179 (52%) of women had good decision-making power on modern family planning use. Multivariable analysis showed that younger age (adjusted odds ratio [AOR] =8.59 [1.61, 45.80]), good participation in household decision-making (AOR =2.65 [1.46, 4.79]), positive attitude towards family planning (AOR =2.34 [1.31, 4.19]), and better knowledge towards family planning (AOR =3.04 [1.49, 6.22]) were factors statistically significantly associated with married women's decision-making power on family planning use.

Conclusion and recommendation: Women's knowledge and attitudes toward family planning and their participation in household decision-making increased the likelihood of women's decision-making power for modern family planning use. There is a need to adopt a more comprehensive approach to reach men and women on modern family planning, to help women to decide freely without any restriction.

背景:妇女决定使用计划生育对家庭和整个社区有多重好处。在埃塞俄比亚等发展中国家,妇女使用避孕药具的选择受到社会和环境因素的挑战,这些因素削弱了她们独立和自由决定的能力。因此,本研究确定了研究地区已婚妇女在计划生育使用方面的妇女决策权水平及其相关因素。方法:于2017年3 - 4月在丁绍县开展以社区为基础的横断面研究。采用简单的随机抽样方法,选取了373名已婚妇女。由训练有素的数据收集人员在持续监督下使用结构化和预先测试的问卷来收集数据。采用多变量logistic回归来确定与妇女计划生育使用决策权相关的因素。采用95%置信区间的粗比值比和校正比值比,结果的p值为:共有344名(92.2%)女性参与了该研究。在所有被调查者中,179名(52%)妇女对现代计划生育的使用有良好的决策权。多变量分析显示,年龄较小(调整后比值比[AOR] =8.59[1.61, 45.80])、较好的家庭决策参与程度(AOR =2.65[1.46, 4.79])、积极的计划生育态度(AOR =2.34[1.31, 4.19])、较好的计划生育知识(AOR =3.04[1.49, 6.22])是影响已婚女性计划生育使用决策权的因素,有统计学意义。结论和建议:妇女对计划生育的认识和态度以及她们对家庭决策的参与增加了妇女决策权用于现代计划生育的可能性。有必要采取一种更全面的办法,使男子和妇女了解现代计划生育,帮助妇女不受任何限制地自由作出决定。
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引用次数: 30
Utilization of Maternity Services and Its Relationship with Postpartum Use of Modern Contraceptives Among Women of Reproductive Age Group in Nigeria. 尼日利亚育龄妇女产妇服务的利用及其与产后使用现代避孕药具的关系
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-01-06 eCollection Date: 2020-01-01 DOI: 10.2147/OAJC.S215619
Innocent Anayochukwu Ugwu, Imose Itua

Background: Utilization of maternity services (UMS) exposes mothers to family planning (FP) counseling and other FP promotional activities. Uptake of postpartum modern contraceptives (PPMC) reduces both infant and maternal mortalities by reducing unwanted pregnancies and promoting good child spacing. Understanding the relationship between UMS and uptake of PPMC was therefore very important.

Purpose: To determine the association between UMS and uptake of PPMC among women of the reproductive age group in Nigeria taking into consideration the influence of the place of access to the maternity services.

Patients and methods: This study was a descriptive epidemiological study design. Secondary data obtained from the 2013 Nigerian Demographic Health Survey (NDHS) was analyzed to achieve the above aim. The uptake of PPMC was the dependent variable (DV). The independent variables (IDV) selected were the number of antenatal care (ANC) visits, place of access of ANC, place of delivery, timing of postnatal care (PNC) and place of access of PNC. Other control variables include socio-demographic factors. Descriptive statistics, chi-square testing, and logistic regression analyses were conducted to determine the association between the PPMC uptake and the IDV/other control variables. Statistical significance was claimed at p<0.05.

Results: Utilization of maternity services was associated with higher uptake of PPMC among the women (>/= 4 ANC visits OR = 2.08, 95% CI=1.65-2.62, P<0.001; public facility delivery OR= 1.80, 95% CI= 1.54-2.10, P< 0.001; private facility delivery OR =1.54, 95% CI 1.28-1.85, P< 0.001; PNC OR=1.21, 95% CI= 1.02-1.43, P=0.029). Accessing postnatal care in private health facilities was associated with increased uptake of PPMC (OR= 1.46, 95% CI =1.05-2.02, P= 0.024). The number of children alive, educational attainment, wealth index and having information about FP remained significant predictors of PPMC uptake.

Conclusion: The utilization of maternity services was positively associated with postpartum use of modern contraceptives among women of reproductive age in Nigeria. There was increased uptake of PPMC among women who utilized maternity service compared to their counterparts who did not. Regarding the place of access, accessing antenatal care as well as delivering in either private or public health facilities was not a significant predictor of PPMC use. However, accessing postnatal care in private facilities was associated with higher uptake of PPMC.

背景:利用生育服务(UMS)使母亲能够接受计划生育(FP)咨询和其他计划生育推广活动。采用产后现代避孕药具(PPMC)可通过减少意外怀孕和促进良好的生育间隔来降低婴儿和孕产妇死亡率。因此,了解UMS与PPMC摄取之间的关系非常重要。目的:考虑到获得产科服务的地点的影响,确定尼日利亚育龄妇女综合护理与服用PPMC之间的关系。患者和方法:本研究采用描述性流行病学研究设计。为实现上述目标,分析了2013年尼日利亚人口健康调查(NDHS)获得的二手数据。PPMC的摄取是因变量(DV)。选取的自变量为产前护理(ANC)就诊次数、ANC就诊地点、分娩地点、产后护理时间和PNC就诊地点。其他控制变量包括社会人口因素。采用描述性统计、卡方检验和逻辑回归分析来确定PPMC摄取与IDV/其他控制变量之间的关系。结果表明,孕产妇服务的利用与妇女PPMC的较高使用率相关(>/= 4次ANC就诊OR = 2.08, 95% CI=1.65-2.62)。结论:尼日利亚育龄妇女孕产妇服务的利用与产后现代避孕药具的使用呈正相关。与没有使用产科服务的妇女相比,使用PPMC的妇女增加了。关于获取地点,获得产前护理以及在私人或公共卫生机构分娩并不是PPMC使用的重要预测因子。然而,在私人机构获得产后护理与PPMC的较高摄取有关。
{"title":"Utilization of Maternity Services and Its Relationship with Postpartum Use of Modern Contraceptives Among Women of Reproductive Age Group in Nigeria.","authors":"Innocent Anayochukwu Ugwu,&nbsp;Imose Itua","doi":"10.2147/OAJC.S215619","DOIUrl":"https://doi.org/10.2147/OAJC.S215619","url":null,"abstract":"<p><strong>Background: </strong>Utilization of maternity services (UMS) exposes mothers to family planning (FP) counseling and other FP promotional activities. Uptake of postpartum modern contraceptives (PPMC) reduces both infant and maternal mortalities by reducing unwanted pregnancies and promoting good child spacing. Understanding the relationship between UMS and uptake of PPMC was therefore very important.</p><p><strong>Purpose: </strong>To determine the association between UMS and uptake of PPMC among women of the reproductive age group in Nigeria taking into consideration the influence of the place of access to the maternity services.</p><p><strong>Patients and methods: </strong>This study was a descriptive epidemiological study design. Secondary data obtained from the 2013 Nigerian Demographic Health Survey (NDHS) was analyzed to achieve the above aim. The uptake of PPMC was the dependent variable (DV). The independent variables (IDV) selected were the number of antenatal care (ANC) visits, place of access of ANC, place of delivery, timing of postnatal care (PNC) and place of access of PNC. Other control variables include socio-demographic factors. Descriptive statistics, chi-square testing, and logistic regression analyses were conducted to determine the association between the PPMC uptake and the IDV/other control variables. Statistical significance was claimed at p<0.05.</p><p><strong>Results: </strong>Utilization of maternity services was associated with higher uptake of PPMC among the women (>/= 4 ANC visits OR = 2.08, 95% CI=1.65-2.62, P<0.001; public facility delivery OR= 1.80, 95% CI= 1.54-2.10, P< 0.001; private facility delivery OR =1.54, 95% CI 1.28-1.85, P< 0.001; PNC OR=1.21, 95% CI= 1.02-1.43, P=0.029). Accessing postnatal care in private health facilities was associated with increased uptake of PPMC (OR= 1.46, 95% CI =1.05-2.02, P= 0.024). The number of children alive, educational attainment, wealth index and having information about FP remained significant predictors of PPMC uptake.</p><p><strong>Conclusion: </strong>The utilization of maternity services was positively associated with postpartum use of modern contraceptives among women of reproductive age in Nigeria. There was increased uptake of PPMC among women who utilized maternity service compared to their counterparts who did not. Regarding the place of access, accessing antenatal care as well as delivering in either private or public health facilities was not a significant predictor of PPMC use. However, accessing postnatal care in private facilities was associated with higher uptake of PPMC.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":"11 ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2020-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S215619","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37611369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
The Association of Public Insurance with Postpartum Contraception Preference and Provision. 公共保险与产后避孕偏好和提供的关系。
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2019-12-19 eCollection Date: 2019-01-01 DOI: 10.2147/OAJC.S231196
Emily Verbus, Mustafa Ascha, Barbara Wilkinson, Mary Montague, Jane Morris, Brian M Mercer, Kavita Shah Arora

Background: Prior studies have noted that public insurance status is associated with increased uptake of postpartum contraception whereas others have pointed to public insurance as a barrier to accessing highly effective forms of contraception.

Objective: To assess differences in planned method and provision of postpartum contraception according to insurance type.

Study design: This is a secondary analysis of a retrospective cohort study examining postpartum women delivered at a single hospital in Cleveland, Ohio from 2012-2014. Contraceptive methods were analyzed according to Tier-based effectiveness as defined by the Centers for Disease Control and Prevention. The primary outcome was postpartum contraception method preference. Additional outcomes included method provision, postpartum visit attendance, and subsequent pregnancy within 365 days of delivery.

Results: Of the 8281 patients in the study cohort, 1372 (16.6%) were privately and 6990 (83.4%) were publicly insured. After adjusting for the potentially confounding clinical and demographic factors through propensity score analysis, public insurance was not associated with preference for a Tier 1 versus Tier 2 postpartum contraceptive method (matched adjusted odds ratio [maOR] 0.89, 95% CI 0.69-1.15), but was associated with a preference for Tier 1/2 vs Tier 3/None (maOR 1.41, 95% CI 1.17-1.69). There was no difference between women with private or public insurance in terms of method provision by 90 days after delivery (maOR 0.94, 95% CI 0.75-1.17). Public insurance status was also associated with decreased postpartum visit attendance (maOR 0.54, 95% CI 0.43-0.68) and increased rates of subsequent pregnancy within 365 days of delivery (maOR 1.29, 95% CI 1.05-1.59).

Conclusion: Public insurance status does not serve as a barrier to either the preference or provision of effective postpartum contraception. Women desiring highly- or moderately effective methods of contraception should have these methods provided prior to hospital discharge to minimize barriers to method provision.

背景:先前的研究指出,公共保险状况与产后避孕的增加有关,而其他人则指出公共保险是获得高效避孕形式的障碍。目的:评价不同保险类型在计划避孕方法和提供产后避孕方面的差异。研究设计:这是对2012-2014年在俄亥俄州克利夫兰一家医院分娩的产后妇女进行回顾性队列研究的二次分析。根据疾病控制和预防中心定义的分层有效性来分析避孕方法。主要结局为产后避孕方法偏好。其他结果包括方法提供、产后访问出勤率和分娩365天内的后续妊娠。结果:在研究队列中的8281例患者中,1372例(16.6%)为私人保险,6990例(83.4%)为公共保险。在通过倾向评分分析调整了潜在的混杂临床和人口因素后,公共保险与对一级产后避孕方法和二级产后避孕方法的偏好无关(匹配调整优势比[maOR] 0.89, 95% CI 0.69-1.15),但与对一级1/2对三级/无避孕方法的偏好相关(maOR 1.41, 95% CI 1.17-1.69)。在分娩后90天,私人保险和公共保险的妇女在方法提供方面没有差异(maOR 0.94, 95% CI 0.75-1.17)。公共保险状况也与产后就诊率下降(maOR 0.54, 95% CI 0.43-0.68)和产后365天内妊娠率增加(maOR 1.29, 95% CI 1.05-1.59)相关。结论:公共保险状况不会成为孕妇选择或提供有效产后避孕措施的障碍。希望获得高度或中等有效避孕方法的妇女应在出院前获得这些方法,以尽量减少提供方法的障碍。
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引用次数: 0
Unmet Need for Contraception Among Young Married Women in Eastern Ethiopia. 埃塞俄比亚东部年轻已婚妇女未满足的避孕需求。
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2019-12-17 eCollection Date: 2019-01-01 DOI: 10.2147/OAJC.S227260
Tariku Dingeta, Lemessa Oljira, Alemayehu Worku, Yemane Berhane

Purpose: Addressing the contraceptive needs of young married women is critical to improve their health and well-being. In patriarchal societies, young married women are under intense pressure to demonstrate their fecundity. Therefore, research that specifically address the needs for contraception of young married women have been generally given less emphasis in Ethiopia. This study assessed the extent of unmet needs for contraception and its associated factors among young married women in Eastern Ethiopia.

Methods: A community-based cross-sectional study was conducted among young married women (14-24 years of age) in Eastern Ethiopia. Data were collected using a structured questionnaire. The prevalence ratio (PR) with 95% confidence intervals (CIs) was calculated, and factors associated with unmet needs for contraception were identified using log-binomial regression statistical model.

Results: Among 2933 young women interviewed, the unmet need for contraception was 1014 (34.6%; 95% CI, 32.9%-36.4%). The prevalence of unmet needs for contraception decreased with increased young women's household decision-making autonomy score (APR= 0. 76; CI=0.62-0.94). Exposure to family planning (FP) information during the last 12 months (APR= 1.24; CI=1.1-1.42), age 18 or more years (APR=1.25; CI=1.04-1.5), multiparty (APR= 1. 9; CI=1.7-2.1) and desire to have 5 children or lesser than 5 children (APR= 1. 2; CI=1.06-1.32) were associated with higher prevalence of unmet needs for contraception.

Conclusion: One-third of married young women had unmet needs for contraception. More efforts to empower women to make decisions that affect their own life and providing appropriate family planning information are necessary to reduce the burden of unmet needs among young married women in rural settings in Ethiopia.

目的:解决年轻已婚妇女的避孕需求对改善她们的健康和福祉至关重要。在父权社会中,年轻的已婚妇女承受着巨大的压力,要展示她们的生育能力。因此,在埃塞俄比亚,专门针对年轻已婚妇女避孕需要的研究一般不太重视。本研究评估了埃塞俄比亚东部年轻已婚妇女避孕需求未得到满足的程度及其相关因素。方法:在埃塞俄比亚东部的年轻已婚妇女(14-24岁)中进行了以社区为基础的横断面研究。使用结构化问卷收集数据。计算95%置信区间(ci)的患病率(PR),并采用对数二项回归统计模型确定与未满足避孕需求相关的因素。结果:受访的2933名年轻女性中,未满足避孕需求的有1014名(34.6%);95% ci, 32.9%-36.4%)。未满足避孕需求的发生率随着年轻女性家庭决策自主评分(APR= 0)的增加而下降。76;CI = 0.62 - -0.94)。近12个月计划生育信息暴露情况(APR= 1.24;CI=1.1-1.42), 18岁及以上(APR=1.25;CI=1.04-1.5),多方(APR= 1)。9;CI=1.7-2.1),希望生育5个或少于5个孩子(APR= 1)。2;CI=1.06-1.32)与未满足避孕需求的较高患病率相关。结论:三分之一的已婚年轻女性避孕需求未得到满足。必须作出更多努力,使妇女能够作出影响其生活的决定,并提供适当的计划生育信息,以减轻埃塞俄比亚农村地区已婚青年妇女未满足需求的负担。
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引用次数: 18
Are Women In Lomé Getting Their Desired Methods Of Contraception? Understanding Provider Bias From Restrictions To Choice. 伦敦妇女是否得到了她们想要的避孕方法?从限制到选择理解提供者偏见。
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2019-12-05 eCollection Date: 2019-01-01 DOI: 10.2147/OAJC.S226481
Elizabeth Pleasants, Tekou B Koffi, Karen Weidert, Sandra I McCoy, Ndola Prata

Background: Despite improvements in contraception availability, women face persistent barriers that compromise reproductive autonomy and informed choice. Provider bias is one way in which access to contraception can be restricted within clinical encounters and has been established as common in sub-Saharan Africa. This analysis assessed the prevalence of provider restrictions and the potential impact on women's method uptake in Lomé, Togo.

Methods: This sub-analysis used survey data from provider and client interviews collected to assess the impacts of the Agir pour la Planification Familiale (AgirPF) program in Togo. The relationships between provider restrictiveness and women's receipt of their desired method of contraception were modelled using mixed effects logistic regressions looking at all women and among subgroups hypothesized to be at potentially higher risk of bias.

Results: Around 84% of providers reported a restriction in contraceptive provision for the five contraceptive methods explored (pill, male condom, injectable, IUD, and implant). Around 53% of providers reported restricting at least four of the five methods based on age, parity, partner consent, or marital status. Among all women, there were no significant associations between provider restrictiveness and women's receipt of desired method, including among those who desired long-acting methods. In adjusted modeling, marital status was a covariate significantly associated with desired method, with married women more likely to receive their desired method than unmarried women (aOR 2.73, 95% CI 1.45-5.13).

Conclusion: Provider reports of high levels of restrictions in this population are concerning and should be further explored, especially its effects on unmarried women. However, restrictions reported by providers in this study did not appear to statistically significantly influence contraceptive method received.

背景:尽管避孕措施的可获得性有所改善,但妇女仍面临着损害生殖自主权和知情选择的持续障碍。提供者偏见是在临床接触中限制获得避孕措施的一种方式,在撒哈拉以南非洲已被证实是常见的。该分析评估了多哥lomoise地区提供者限制的普遍程度以及对妇女采用避孕方法的潜在影响。方法:这一子分析使用了从提供者和客户访谈收集的调查数据,以评估AgirPF计划在多哥的影响。使用混合效应逻辑回归对所有妇女和假设存在潜在较高偏倚风险的亚组进行建模,研究提供者限制与妇女接受其期望的避孕方法之间的关系。结果:约84%的医疗服务提供者报告称,对所探索的五种避孕方法(避孕药、男用避孕套、注射剂、宫内节育器和植入物)的避孕措施提供限制。大约53%的提供者报告说,根据年龄、胎次、伴侣同意或婚姻状况,限制了五种方法中的至少四种。在所有妇女中,提供者的限制与妇女接受所需方法之间没有显著关联,包括那些希望使用长效方法的妇女。在调整后的模型中,婚姻状况是与期望方法显著相关的协变量,已婚女性比未婚女性更有可能接受他们期望的方法(aOR 2.73, 95% CI 1.45-5.13)。结论:提供者报告的这一人群的高水平限制令人担忧,应进一步探讨,特别是其对未婚妇女的影响。然而,在这项研究中,提供者报告的限制似乎对所采用的避孕方法没有统计学上的显著影响。
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引用次数: 6
Perception And Use Of Intrauterine Contraceptive Devices (IUCD) Among Married Women Of Reproductive Age In Bhaktapur, Nepal 尼泊尔巴克塔普尔已婚育龄妇女对宫内节育器(IUCD)的认知和使用
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2019-11-28 DOI: 10.2147/OAJC.S219188
Bijay Khatri, A. Khadka, A. Amatya, S. Shrestha, R. Paudel
Purpose The copper-T (TCu-380A), an intrauterine contraceptive device (IUCD), is widely available and is highly effective in terms of safety and effectiveness. Despite this fact, there is low utilization of IUCD in Nepal. This paper describes the perception and use of IUCD among married women of reproductive age attending an institutional clinic in Bhaktapur, Nepal. Methods An institution-based cross-sectional study was conducted among 273 married women attending the institutional clinic of Bhaktapur hospital who were interviewed by trained staff nurses using semi-structured questionnaires. Systematic random sampling method was applied to select the participants. Logistic regression analysis was used to determine the relationship between factors associated with utilization of IUCD. Results Just below half (48.7%) of the participants had heard about IUCD. Only 7.0% of the potential users were currently using IUCD, and all of them had discussed using it with their husbands. Among women aware of IUCD, nearly a quarter of them (23.8%) did not want to use it because of their husband’s disapproval and their assumed fear of decreased sexual pleasure. There was a significant association between previous abortion and use of IUCD, where the women who had a history of abortion had increased odds of using the IUCD by 5.45-times compared to those who had not (p=0.01). The women who were counseled about IUCD by health workers were 2.83-times more likely to use an IUCD than those who were not. The women who had a good knowledge level about IUCD as a method of modern contraception had 2.85-times increased odds of using the IUCD compared to those who had poor or no knowledge about it. Conclusion The use of IUCD depends on the support of husbands, knowledge about its safety, efficacy, and counseling.
目的铜- t (TCu-380A)宫内节育器(IUCD)应用广泛,安全性和有效性高。尽管如此,尼泊尔宫内节育器的使用率很低。本文描述了在尼泊尔巴克塔普尔一家机构诊所就诊的育龄已婚妇女对IUCD的认知和使用情况。方法对在巴克塔普尔医院机构门诊就诊的273名已婚妇女采用半结构式问卷进行调查。采用系统随机抽样的方法选择研究对象。采用Logistic回归分析确定与宫内节育器使用相关因素之间的关系。结果不到一半(48.7%)的参与者听说过IUCD。只有7.0%的潜在用户目前正在使用宫内节育器,并且她们都曾与丈夫讨论过使用宫内节育器。在了解宫内节育器的女性中,近四分之一(23.8%)的人不想使用它,因为她们的丈夫不赞成,并且她们认为害怕减少性快感。有流产史的妇女使用IUCD的几率比无流产史的妇女高5.45倍(p=0.01)。得到卫生工作者关于宫内节育器建议的妇女使用宫内节育器的可能性是没有得到建议的妇女的2.83倍。了解宫内节育器作为现代避孕方法的妇女使用宫内节育器的几率是不了解或不了解的妇女的2.85倍。结论宫内节育器的使用取决于丈夫的支持、对其安全性、有效性的了解和咨询。
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引用次数: 5
Improving Voluntary, Rights-Based Family Planning: Experience From Nigeria And Uganda 改进基于权利的自愿计划生育:尼日利亚和乌干达的经验
Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2019-11-01 DOI: 10.2147/OAJC.S215945
K. Hardee, Kaja Jurczynska, I. Sinai, Victoria Boydell, Diana Kabahuma Muhwezi, K. Gray, K. Wright
Background Growing focus on the need for voluntary, rights-based family planning (VRBFP) has drawn attention to the lack of programs that adhere to the range of rights principles. This paper describes two first-of-their-kind interventions in Kaduna State, Nigeria and in Uganda in 2016–2017, accompanied by implementation research based on a conceptual framework that translates internationally agreed rights into family planning programming. Methods This paper describes the interventions, and profiles lessons learned about VRBFP implementation from both countries, as well as measured outcomes of VRBFP programming from Nigeria. Results The intervention components in both projects were similar. Both programs built provider and supervisor capacity in VRBFP using comparable curricula; developed facility-level action plans and supported action plan implementation; aimed to increase clients’ rights literacy at the facility using posters and handouts; and established or strengthened health committee structures to support VRBFP. Through the interventions, rights literacy increased, and providers were able to see the benefits of taking a VRBFP approach to serving clients. The importance of ensuring a client focus and supporting clients to make their own family planning choices was reinforced. Providers recognized the importance of treating all clients, regardless of age or marital status, for example, with dignity. Privacy and confidentiality were enhanced. Recognition of what violations of rights are and the need to report and address them through strong accountability systems grew. Many lessons were shared across the two countries, including the need for rights literacy; attention to health systems issues; strong and supportive supervision; and the importance of working at multiple levels. Additionally, some unique lessons emanated from each country experience. Conclusion The assessed feasibility and benefits of using VRBFP programming and outcome measures in both countries bode well for adoption of this approach in other geographies.
背景人们越来越关注基于权利的自愿计划生育(VRBFP)的必要性,这引起了人们对缺乏遵守一系列权利原则的计划的关注。本文描述了2016年至2017年在尼日利亚卡杜纳州和乌干达进行的两项首次此类干预措施,以及基于概念框架的实施研究,该框架将国际商定的权利转化为计划生育方案。方法本文描述了干预措施,介绍了两国在VRBFP实施方面的经验教训,以及尼日利亚VRBFP规划的衡量结果。结果两个项目的干预成分相似。这两个项目都使用类似的课程建立了VRBFP的提供者和监督员能力;制定设施层面的行动计划,并支持行动计划的实施;旨在通过海报和讲义提高客户在该设施的权利知识;建立或加强卫生委员会结构,以支持VRBFP。通过干预措施,权利普及率提高,提供者能够看到采取VRBFP方法为客户服务的好处。确保以客户为中心并支持客户做出自己的计划生育选择的重要性得到了加强。提供者认识到有尊严地对待所有客户的重要性,例如,无论年龄或婚姻状况如何。隐私和保密性得到加强。人们越来越认识到什么是侵犯权利的行为,以及通过强有力的问责制度报告和解决这些问题的必要性。两国分享了许多经验教训,包括需要普及权利;关注卫生系统问题;强有力的支持性监督;以及多层次工作的重要性。此外,每个国家的经验都有一些独特的教训。结论经评估,在两国使用VRBFP方案和成果衡量标准的可行性和效益预示着在其他地区采用这种方法是好兆头。
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引用次数: 6
期刊
Open access journal of contraception
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