Contraception and reproductive medicine最新文献

Background: Male knowledge and acceptance of modern contraceptive use play a significant role in uptake. This study assessed the factors associated with male acceptance of modern contraceptive methods in Ho Municipality.

Methods: A cross-sectional study with a quantitative approach was employed. Systematic random sampling was used to select 503 participants from households with married men and women. A structured pre-tested questionnaire, including open-ended and closed-ended questions, was researcher assistant administered. Data analysis was conducted using STATA version 17.

Results: The majority of the respondents identified that contraceptives are used to prevent pregnancy (91.19%), and also identified the following as birth control commodities: birth control pills (64.94%), female condoms (15.71%), intrauterine devices - IUDs (4.79%), and implants (4.21%). Factors such as affordability, employment status, income, and access significantly influenced male acceptance of contraceptives. The study revealed that men (84.67%) agreed with their partner to use contraceptives after sexual intercourse while only 37% agreed to use contraceptives before sexual intercourse. Among those who did not accept the use of modern contraceptives, the reason provided was the fear of side effects (65.13%). Men who find modern contraceptives affordable were more likely to use them (AOR = 8.15; 95%CI:3.49-19.02; p-value < 0.001). Also, unemployed men were less likely to use modern contraceptives (AOR = 0.14; 95%CI:0.044-0.44; p-value = 0.001). Men with lower income (50-900 cedis average monthly income level) were less likely to use modern contraceptives (AOR = 0.28; 95%CI:0.07-1.02; p-value = 0.05).

Conclusion: Increasing interventions aimed at continuously reducing the cost of modern contraceptives is essential for improving male acceptance and the overall success of modern contraceptive use in other communities with low male involvement. The government, Healthcare agencies, community leaders, and family planning organizations should work together to actively intervene in lowering the cost of modern contraceptives to improve access by men.

Objective: Surgical sterilization, including vasectomy in males and tubal ligation in females, is a highly effective but underutilized contraception method. Adoption rates vary globally mostly due to misconceptions by both the general public and practicing physicians. Our survey aims to explore physicians' knowledge, attitudes and beliefs about surgical sterilization techniques in Lebanon.

Study design: A web-based survey was sent to residents and attending physicians of different specialties in Lebanon between April 2022 and April 2023. The survey included 21 multiple-choice questions divided in four parts (demographics, knowledge, attitudes and beliefs) and required around 8 min to complete. Data was analyzed using IBM SPSS Statistics. A descriptive analysis was performed using the chi-square test for categorical variables and ANOVA for continuous variables.

Results: One hundred eighty-three physicians specialized in Urology, OB/GYN, Family medicine and Internal medicine filled the survey. The majority were resident physicians (79%), male (57%), single (72%) and did not receive training in family planning (73%). Knowledge assessment showed an average score of 5/7. After setting this as a passing score, 60.7% of participants passed the assessment with higher likelihood of passing among attending physicians (84.6%), OB/GYN physicians (94.4%), married participants (80.8%), and physicians who received training in family planning (91.8%). Lower likelihood of passing was among Family Medicine (60%), and Internal Medicine (72.5%) physicians. Recommendations varied among specialties. Most physicians perceived the general public preferring tubal ligation as a sterilization method (98%).

Conclusion: Lebanese primary care physicians have a lower level of knowledge of surgical sterilization procedures compared to specialists. This, coupled with low levels of family planning training and negative perception of patient beliefs may impact attitudes and recommendations. Ongoing education and family planning training is needed to increase awareness among physicians, especially primary care physicians, to allow them to provide more adequate counseling to patients.

Background: Female Condoms are 90-95% effective against HIV transmission when correctly and consistently used and are also cost-effective. In general, condoms prevent sexually transmitted infections (STIs) and unwanted pregnancies. Although the COVID-19 pandemic had the potential to undermine routine healthcare services delivery and utilisation, there is limited evidence about the pandemic's effect on Female Condom uptake in Gauteng, one of the hardest-hit provinces in South Africa. This study aimed to compare female condom distribution in Gauteng Province, South Africa, before and during COVID-19, to inform decision-making for the attainment of universal access to sexual and reproductive health (SRH) by 2023 as per the sustainable development goal 3.7 and also, to empower women over their SRH during future pandemics.

Methods: This secondary data anslysis examined the percentage change in routine female condom distribution in Gauteng province and its five districts as an indirect effect (lockdown) of the COVID-19 pandemic, by comparing the aggregated District Health Information System (DHIS) data collated from primary health care facilities within the ditrict, before COVID-19 (2018-2019) and during COVID-19 (2020). Analysis in MS Excel 2016 illustrates the changes in the patterns and the trend in female condom distribution over the study period.

Results: In 2020, during the COVID-19 pandemic, Gauteng province experienced a 43.7% increase in female condom distribution compared to the pre-COVID-19 period of 2019. The highest female condom distribution during the pandemic was observed in the Ekurhuleni Metropolitan (150.0%), followed by the Sedibeng (92.8%) and the Johannesburg Metropolitan (67.9%) districts respectively. However, the Tshwane Metropolitan (-8.5%) and the West Rand (-16.6%) districts experienced a decline in female condom distribution during COVID-19.

Conclusion: Gauteng province witnessed a substantial surge in female condom distribution during COVID-19 in 2020, with a disproportionate district variation in demand. Female condom distribution is crucial, necessitating its enhancement and the continuum of distribution and stakeholders stockpiling at all times with particular attention to a potential increase in demand during outbreaks with lockdowns. Undisrupted access to female condoms will enable a consistent and correct use and empower women against HIV, STIs and unintended pregnancies, as a strive towards universal access to SRH.

Background: The unmet need for contraception among adolescent women in India is a significant public health concern, contributing to unintended pregnancies and abortions. This paper seeks to examine the regional variations and factors driving rural-urban disparities in unmet family planning needs in Uttar Pradesh (UP), India's most populous state, where the total unmet need among adolescents is as high as 19%.

Methods: The study is based on 11,018 adolescent women from the recent round of India's DHS, NFHS-5 (2019-21). To fulfil the study's objective, Multilevel logit model and Oaxaca Blinder Decomposition was applied.

Results: The Multilevel logit model results show statistically significant variations at community and district level, implying a strong presence of unobserved factors affecting the unmet demand. Oaxaca decomposition results show that difference in rural and urban adolescent unmet need is explained by factors like wealth, religion and intra-state regions.

Conclusion: The results call for the need to implement culturally appropriate reproductive and sexual health literacy programs to increase uniform access to modern contraception and to raise women's autonomy in the state of Uttar Pradesh.

Background: Premarital sex in India is hugely stigmatized. With the widespread use of mobile phones and the internet, attitudes and behaviors towards premarital sexual activities are inevitably shifting. This study investigates the impact of digital exposure, specifically mobile phones and the internet on premarital sex and contraception use among unmarried Indian youths.

Methodology: Utilizing data from the 5th National Family Health Survey, the analysis includes 172,568 women and 33,397 men aged 15-29 years. The study applies univariate, bivariate, and multivariate statistical methods, such as Chi-square tests and Multiple Logistic Regression. Propensity Score matching addresses selection bias, estimating the impact of digital exposure on premarital sexual activities and condom use.

Results: The findings show that youth exposed to mobile phones and the internet are more likely to engage in premarital sex and use condoms during their first sexual encounter. Specifically, 13.46% of men and 2.83% of women reported premarital sex, with 60.84% of men using condoms at first sex. These behaviors are significantly associated with age, education, urban residence, and mass media exposure.

Conclusion: Digital exposure significantly influences premarital sexual behaviors and contraception use among unmarried Indian youth. Adoption of mobile devices and internet usage in India should be accompanied by the implementation of holistic and culturally appropriate technology-driven interventions to provide sex education in India.

Background: The World Health Organization (WHO) recommends an interval of at least 24 months from the date of a live birth to the conception of the next pregnancy in order to reduce the risk of adverse maternal, perinatal, and infant outcomes. There is limited data about the implementation of this recommendation and its contributing factors in low-land ecologies in Oromia, which is the biggest regional state in Ethiopia.

Objective: To assess the inter-pregnancy interval and determine associated factors among parous women in selected low-land districts of Arsi and East Shoa Zone.

Methods: A community-based cross-sectional study was conducted. Data were collected from a random sample of 563 women using a structured, pre-tested questionnaire. Bivariate and multivariate analysis was conducted, and the magnitude of the association between the inter-pregnancy interval and explanatory variables was measured using adjusted odds ratios and their 95% confidence intervals.

Results: The rate of short inter-pregnancy interval (SIPI) was 28.20% (95% CI: 24.48-31.92%). After multiple logistic regression analysis, women with primary education, women who believed that low contraceptive use contributed to SIPI, women who thought SIPI could impact small for gestational age, and women who thought SIPI could affect birth defects had a lower chance of having SIPI; aOR of 0.54 (95% CI: 0.30-0.79), 0.33 (95% CI: 0.16-0.68), 0.57 (95% CI: 0.32-0.94 and 0.63 (95% CI: 0.40-0.96), respectively.

Conclusion: Women with primary educational status, those who had better contraception literacy, and who knew about the adverse maternal and perinatal health impacts of SIPI were more likely to follow the recommended inter-pregnancy interval. Improving women's family planning literacy is crucial to lowering the rate of SIPI currently observed in the study area.

Background: Modern contraceptives are crucial for reducing maternal and child mortality, yet Mozambique's contraceptive prevalence rate is very low, with significant regional disparities. This study investigates geographic variation in contraceptive use and the individual, community, and regional factors influencing it to guide equitable family planning interventions.

Methods: This study utilized data from the 2022/23 Mozambique Demographic and Health Survey, analyzing a weighted sample of 9,316 women aged 15-49. The outcome variable was modern contraceptive use, with predictors including individual factors such as age, education, wealth, and marital status, as well as community-level factors like residence and region. Data analysis was conducted using Stata 17 and ArcGIS 10.7, employing multilevel logistic regression and spatial techniques (Global Moran's I, Getis-Ord Gi*, interpolation, and SaTScan) to identify patterns and geographic clusters of contraceptive use.

Results: The study found a modern contraceptive prevalence of 34.8% (95% CI: 33.84-35.78). Key factors influencing usage included age, education, wealth, and healthcare access. Women aged 25-34 were 31% more likely to use contraceptives than those aged 15-24 (AOR: 1.31, 95% CI: 1.13-1.53). Secondary education more than doubled the likelihood (AOR: 2.25, 95% CI: 1.82-2.78), and wealthier women had a 74% higher likelihood (AOR: 1.74, 95% CI: 1.39-2.17). Fieldworker visits increased usage by 38% (AOR: 1.38, 95% CI: 1.15-1.64). Regional disparities were significant, with women in Cabo Delgado 81% (AOR: 0.19 95% CI: 0.14, 0.27) less likely to use contraceptives compared to Maputo. Higher usage was concentrated in Maputo and Southeastern Gaza. Spatial analysis revealed significant regional disparities, with hotspots in Maputo and Gaza, where women are 2.52 times more likely to use contraceptives, while rural areas like Cabo Delgado lag behind.

Conclusion: Modern contraceptive use in Mozambique remains low, with regional disparities. Key factors influencing use include age, education, wealth, and healthcare access. Older, educated, and wealthier women are more likely to use contraception. Media exposure and proximity to healthcare facilities also play a role. Regional differences persist, with lower usage in provinces like Cabo Delgado and higher usage in urban areas like Maputo and Gaza. Targeted interventions are necessary to address these disparities.

Background: Women's intention to use contraceptive methods is critical for better visualization of future needs and for making it more likely to translate into actual use. This study sought to examine the determinants of intention to use modern contraceptives among current non-users of reproductive age in Uganda.

Methods: The study used secondary data from the 2016 Uganda Demographic and Health Survey (UDHS) dataset. The sample size consisted of 13,088 women aged 15-49 who were not using contraception. The dependent variable was the intention to use contraceptives. STATA version 17 was used for data analysis. A binary logistic regression model was used to identify the predictors of intention to use contraceptives at the 5% level of significance.

Results: Findings indicated that six in ten (60.2%) non-users of contraceptives had an intention to use them in the future. The odds of intention to use contraceptives were higher among women with secondary education (AOR 1.482, CI = 1.168-1.880), women who desired 3-4 children (AOR = 1.343, CI = 1.135-1.590), women with 3-4 living children (AOR = 1.817, CI = 1.391-2.373), women who have ever used a contraceptive method (AOR = 2.457, CI = 1.686-3.579), and women whose last pregnancy was unwanted (AOR = 1.720, CI = 1.231-2.405). On the other hand, the odds of intending to use contraceptives were lower among women aged 35-44 years (AOR = 0.242, CI = 0.143-0.284) and 45-49 years (AOR = 0.028, CI = 0.017-0.044), Muslim women (AOR = 0.676, CI = 0.559-0.817), Pentecostal women (AOR = 0.708, CI = 0.598-0.837), and formerly married women (AOR = 0.672, CI = 0.517-0.875).

Conclusions: The study found that the intention to use contraceptives among Ugandan women not currently using contraception was associated with having secondary education, a preference for having 3-4 children, having 3-4 living children, prior contraceptive use, and experiencing an unwanted pregnancy. The study recommends enhanced access to and completion of at least secondary education for girls. The study further recommends that policymakers and program implementers sensitise communities about the benefits of smaller family sizes through community dialogues highlighting the health, economic, and educational advantages for families and communities.

Background: Emergency Contraception (EC) is more popular among young people today, yet, there is little research on Over-the-counter procured EC among undergraduate students in African universities. This study's primary goal is to fill that gap.

Methods: This was an exploratory-cross-sequential study conducted in a public university in Ghana, using 145 purposively sampled sexually active undergraduate students. A structured questionnaire and in-depth interview guide designed by the author were used for data collection during the University's 2021/2022 Academic year. The questionnaire was administered online via students' social media platforms. In contrast, four group discussions were held with 20 female participants (5 each from levels 100, 200, 300, and 400). Quantitative data were analyzed using Stata Version 14.0 to generate the Median, Standard deviation, Chi-square, and Fisher Exact Test scores, Whilst Content analysis was done with the qualitative data to generate verbal quotes.

Results: There is demand and abuse of ECs among the students studied with about 99% usage to prevent pregnancy. Friends (81%) played a significant role in providing information about ECs to most participants (96%). About 80% of participants have used an EC at least once during the academic year and upon recommendation by friends (44%) and partners (39%). The most preferred ECs were Postinor-2 (61%) and Lydia post-pills (38%). Pharmacies on campus are the major (86%) suppliers at a cost between ghs5 and ghs15 cedis respectively. There were relationships between gender and choice of ECs (p = 0.001); age group and choice of ECs (p = 0.02); marital status and choice of ECs (p < 0.0001) as well as employment status of students and choice of ECs (p = 0.003). The qualitative findings provided relevant justifications for students' EC choices, sources, dosage, frequency, and motivations for use. The EC pills were taken routinely and soon after sexual intercourse sometimes overdosed for a perceived efficacy to prevent failure, regulate menses, or as an abortifacient. Male partners played a critical role in procuring and supervising the intake soon after sexual intercourse.

Conclusion: There is a high demand, usage, and general abuse of over-the-counter procured ECs among undergraduate students in the study area. These findings suggest that sexually active students are concerned about pregnancy prevention and need health education programs on modern contraceptive methods to prevent unwanted pregnancy and possible STIs. From unprotected sex.