Open access journal of contraception最新文献

Background: Male involvement in family planning use particularly in long-acting and permanent contraceptive methods (LAPCM) is a key strategy to reduce fertility, and promote maternal and child health. Despite this, little is known about male involvement in LAPCM use of their partners in Africa, particularly in Ethiopia. This study aimed to assess male involvement in long-acting and permanent contraceptive method use in west Badewacho district, Southern Ethiopia.

Methods: A community-based cross-sectional study was conducted among 564 participants from April 1 to 30/2019. A multi-stage sampling technique was used to select eligible participants. A pre-tested, structured, and interviewer-administered questionnaire was used. Binary and multivariable logistic regression analysis was done to identify associated factors. The adjusted odds ratio with 95% CI was estimated to show the direction and strength of the association. Variables with p<0.05 were considered statistically significant.

Results: About 108 (19.9%, 95% CI: (16.8, 23.2)) participants were involved in LAPCM use. Being urban dweller [AOR=3.13; 95% CI: (1.58, 6.19)], discussion with wives about LAPCM [AOR=2.81; 95% CI: (1.64, 4.8)], having good knowledge about LAPCM [AOR=2.55; 95% CI: (1.42, 4.57)], and positive attitude towards LAPCM [AOR=2.16; 95% CI: (1.16, 4.02)] were significantly associated factors.

Conclusion: Overall, the male involvement in LAPCM use was low. Enhancing male involvement in family planning use through creating community awareness, encouraging inter-spousal communication to enhance decision making, and increasing positive attitude towards LAPCM in the community is crucial to decrease the problem.

Background: Reproductive health issues are an inclusive concern for both men and women. In order to improve maternal health, strengthening male participation in family planning is an important public health initiative. Yet, men are still the main decision-makers in the family in Ethiopia, especially in the rural community. There is little concrete evidence of the extent of male participation in family planning and its barriers in rural settings.

Purpose: To assess the magnitude of male involvement in family planning utilization and its associated factors in the rural community of northern Ethiopia.

Materials and methods: A community-based cross-sectional study design was carried out on 620 currently married men. A multi-stage sampling technique was used to select the participants of the study. Data were collected using interviewer-administered structured questionnaires. Multivariable logistic regression analysis was performed to identify variables associated with male participation in family planning.

Results: In this study, only 12.5% of males were directly involved in the use of family planning using a male contraceptive method, and about 60.0% of males were involved in family planning through spousal communication and approval. Being educated [AOR=1.64; 95% CI: (1.12-2.62)], having an educated partner [AOR= 1.77; 95% CI: (1.17-2.94)], having a positive attitude towards family planning [AOR=2.27; 95% CI: (1.53-3.36)], discussing with wife [AOR= 2.51; 95% CI: (1.69-3.72)] and having adequate knowledge about family planning [AOR=1.92; 95% CI: (1.28-2.87)] were positively associated with male involvement in family planning utilization whereas having more than three children [AOR=0.32; 95% CI: (0.15-0.70)] was negatively associated with male involvement in family planning utilization.

Conclusion: In general, as compared to the national recommendation, the level of male participation in family planning utilisation was low. In order to improve male participation in family planning, improving male knowledge and attitudes towards family planning is essential.

Introduction: In Uganda, the proportion of women having another live birth before age 20 years (repeat adolescent birth) has not declined in 30 years. More women want to delay the next birth. We determined the prevalence and factors associated with postpartum contraceptive use among teenage mothers in Mbale City.

Patients and methods: We conducted a cross-sectional study in all the six government-supported health facilities within Mbale City. Over a period of 3 months, 511 teenage mothers in the postpartum period were consecutively enrolled by midwives/nurses. Data were collected using a pretested interviewer-administered questionnaire. We used logistic regression in STATA version 14, to determine the association between various sociodemographic characteristics and utilization of contraception. We set the level of significance at 5% and report odds ratios and the corresponding 95% confidence intervals.

Results: Most of the respondents - 314/511 [61.5%, 95% CI= 57.1-65.6%] - were using contraceptives. More than three-fourth (238/314) of the respondents opted for short-term methods of contraception. In the adjusted analyses, intention to resume school [AOR 1.79 (1.16-2.74)], and utilization of maternal Child Heath services such as postnatal care services [AOR 0.40 (0.25-0.63)] were significantly associated with utilisation of postpartum contraception.

Conclusion: We found a high prevalence of postpartum contraceptives use - over 6 in 10 women - although they were using mainly short-term methods. Those with intentions of resuming schooling and utilised postnatal care services were most likely to use contraceptives. This is encouraging and calls for inquiry into why their use is higher than the national averages. Further, the results call for renewed efforts to maintain adolescent mothers in school.

Background: The ability of individuals and couples to anticipate and achieve their desired number of children as well as the spacing and timing of their birth is family planning. Access to family planning and ensuring that needs are met is based on human rights. Nonetheless, for most women, this need has not been met. In addition, in this study field, there was minimal evidence regarding this. Thus, the aim of this study was to assess the prevalence and associated factors of unmet need of modern contraceptive methods among currently married women in Damot Woyde district, southern Ethiopia.

Methods: This community based cross-sectional study was conducted from February 20 to 28, 2019. A multi-stage sampling procedure was employed to select 658 currently married women of child-bearing age in the study areas. A pretested interviewer administered questionnaire was used for data collection. Bivariate and multivariate logistic regression analyses were used to identify the predictors of dependent variables and the adjusted odds ratios with its 95% confidence interval was used to report the level of association. Variables with a P-value<0.05 were considered as statistically significant.

Results: The total unmet need for modern contraceptive methods was 169 (26.3%; 95% CI= 22.9-29.7%) among currently married women for the study participants. In multiple logistic regression analysis, educational status (AOR=4.3; 95% CI=1.1-14.7), women with five or more, and three-to-four children(AOR=4.3; 95% CI=1.4-13.1 and AOR=2.8; 95% CI=1.1-7.8, respectively), little perceived risk of pregnancy due to infrequent sexual intercourse (AOR=2.2; 95% CI=1.3-3.8), and little perceived risk of pregnancy due to breast feeding (AOR=2.3; 95% CI=1.3-4.10) were factors associated with the unmet need of modern contraceptive methods.

Conclusion and recommendation: This study revealed that unmet need for modern contraceptive methods was found to be high compared to the national and regional figures. Therefore, community health workers and health professionals should be strengthening communication and discussion at grass root level in order to promote the right time for using family planning. District health office and other concerned bodies should collaborate with the education office to expand formal and non-formal education for women in order to decrease the unmet need for modern contraceptive methods.

Background: Globally, 95% of women wants to avoid pregnancy for at least two years after giving birth, but 70% of them are not using contraception; majority of them were from developing countries. Postpartum family planning (PPFP) enables families to avoid unplanned pregnancies following 12 months after childbirth. Different studies in Ethiopia showed that the majority of postpartum women do not use PPFP. Moreover, the level of PPFP knowledge and utilization in West Shewa, Oromia region of Ethiopia is unclear.

Purpose: This study aimed to assess the knowledge, utilization and associated factors of postpartum family planning (PPFP) Oromia regional state, Ethiopia.

Methods: A community-based cross-sectional study was conducted in Ambo town, West Shewa Zone of Oromia regional state from April 01 to July 30, 2019. A sample of 367 postnatal women participated in the study. An interview administered questionnaire was used to collect the data and the collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Study participants' characteristics were described using frequency and percentage. Bivariate and multivariate logistic regression was carried out to identify the associated factors with the outcome variables.

Results: A total of 354 women were participated in the study making a response rate of 96.4%. About 249 (70.3%) of the respondents had good knowledge about PPFP and 144 (40.7%) had utilized PPFP services. Higher education level [AOR= 3.4, 95% CI: 1.3-6.9], history of family planning utilization [AOR= 2.8, 95% CI: 2.1-4.4] and having ANC follow-up [AOR=2.1, 95% CI: 1.1-4.0] had showed a positive association with knowledge of PPFP. Meanwhile, knowledge of PPFP [AOR=2.1, 95% CI: 1.6-3.1], a grand multi-para women [AOR=1.7, 95% CI (1.3-3.6)] and received routine PNC service [AOR=2.5, 95% CI: 1.3-5.9] were associated with the utilization of PPFP.

Conclusion and recommendation: Although the majority of the women knew about PPFP, more than half of them did not utilize PPFP. Due emphasis should be given to improve the utilization of PPFP.

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.