Contraception and reproductive medicine最新文献

Background: Male partners predominantly make reproductive health decisions in northern Nigeria. There is a need to investigate the extent of husbands' involvement in contraceptive decision-making in this geographical setting and understand the factors that influence their participation.

Method: We collected quantitative data from a cross-section of 154 married men residing within Kano Metropolis using an adapted interviewer-administered questionnaire. We evaluated male involvement in contraceptive decision-making using five domains. Multivariable binary logistic regression modeling was employed to identify sociodemographic variables independently associated with the husband's involvement.

Results: Over half of the husbands (57.5%) were found to be actively involved in contraceptive decision-making. The most common activities performed by the husbands were discussing the use of contraceptives with their partners and providing financial support to access contraceptive services. Participants with tertiary education (OR: 2.4, 95% CI: 1.4-4.8, 0.01), civil servants (OR: 3.2, 95% CI: 1.6-7.2, < 0.001) and those with good knowledge of contraception (OR: 6.0, 95% CI: 4.1-18.9, < 0.001) demonstrated a higher likelihood of involvement. Additionally, the number of children was inversely related to involvement, with participants with five or more children being less likely to participate in contraceptive decision-making (OR: 0.2, 95% CI: 0.4-0.6, < 0.001) compared to those with fewer children.

Conclusion: The study demonstrated that despite good knowledge of contraception among respondents, direct involvement in contraceptive practices remained relatively inadequate. It provides valuable insights by identifying key factors that influence involvement, offering relevant information for policymakers and health programs.

Background: Sexual dysfunction is a common but under-recognized problem in fertility care with potential implications on treatment outcomes. We determined the prevalence, forms and factors associated with sexual dysfunction among patients seeking fertility care at two tertiary Hospitals in Uganda.

Methods: A cross-sectional study was conducted at Jinja and Kayunga Regional Referral Hospitals from May to August 2025. A total of 226 participants (113 males and 113 females) seeking fertility care were consecutively recruited. A validated Arizona Sexual Experiences Scale with a cutoff of ≥ 19 was used to define sexual dysfunction. Demographic data were collected using a pre-tested questionnaire. Data was analyzed using Stata version 19. Bivariate and Multivariate analysis for associations was done with statistical significance set at p < 0.05.

Results: The mean age was 34.1 years (SD ± 8.3); most had secondary education, unemployed, middle income status, had no living child with Infertility for more than five years. The prevalence of sexual dysfunction was 42.5% (96/226), higher in females (52.2%, 59/113) than in males (32.7%, 37/113). Among women, the most common dysfunctions were reduced sexual desire (33.6%), orgasm difficulties (32.7%), and painful intercourse (27.4%). Among men, reduced desire (27.4%), painful intercourse (23.8%), and erectile difficulties (23.0%) predominated. Independent predictors of sexual dysfunction included age 40-49 years (aOR 2.9; 95% CI: 1.24-6.80, p = 0.014), low household income (aOR 10.7; 95% CI: 2.14-52.92, p = 0.004), absence of a living child (aOR 2.8; 95% CI: 1.28-5.10, p = 0.021), and infertility duration ≥ 5 years (aOR 7.4; 95% CI: 3.38-16.32, p = < 0.001). Being male was associated with a 52% lower likelihood of sexual dysfunction (aOR 0.48; 95% CI: 0.37-0.89, p = < 0.023).

Conclusions: Sexual dysfunction was common among patients with infertility, especially women thus integrating routine screening, counseling and targeted support for high‑risk groups should be prioritized in fertility care.

Background: Globally, the use of modern contraceptives has increased, yet progress remains slow in Sub-Saharan Africa, particularly among reproductive-aged women. In Ghana, acceptance of family planning is influenced by personal, traditional, and socio-cultural factors. This study aimed to identify predictors of modern contraceptive acceptability and utilization among women of reproductive age attending selected health facilities in Northern Ghana, to inform policies and strategies for improving uptake.

Methods: A facility-based cross-sectional study was conducted from January to April 2023 among 421 women aged 15-49 years, recruited through systematic random sampling across three public health facilities in the Tamale Metropolis. Data were analyzed using multivariable logistic regression in IBM SPSS version 25, with statistical significance set at p < 0.05.

Results: While acceptability of modern contraceptives was relatively high (75.3%), actual utilization was lower (40.1%). More than half (57%) reported experiencing contraceptive failure. Key determinants of contraceptive utilization included age (21-30 years: AOR = 6.82, 95% CI: 1.25-37.09; 31-40 years: AOR = 10.91, 95% CI: 1.90-62.66), marital status (AOR = 0.19, 95% CI: 0.05-0.74), paternal education (basic: AOR = 2.01, 95% CI: 1.06-3.82; secondary: AOR = 2.86, 95% CI: 1.43-5.70), household wealth (medium: AOR = 1.93, 95% CI: 1.18-3.16; rich: AOR = 2.19, 95% CI: 1.34-3.61), and health worker attitudes (AOR = 0.23, 95% CI: 0.14-0.36). Acceptability was predicted by occupation (civil servant: AOR = 4.47, 95% CI: 1.50-13.29; farmer: AOR = 2.14, 95% CI: 1.00-4.55), husband's number of wives (AOR = 0.61, 95% CI: 0.10-0.29), household wealth (rich: AOR = 2.11, 95% CI: 1.21-3.67), source of information (health workers: AOR = 2.38, 95% CI: 1.35-4.20), and contraceptive knowledge (AOR = 3.67, 95% CI: 2.23-6.05).

Conclusions: Despite high acceptability, modern contraceptive use among women in Northern Ghana remains low. Utilization was shaped by demographic, socioeconomic, and provider-related factors, while acceptability was driven by occupation, knowledge, and exposure to health worker information. Targeted interventions should engage less educated, poorer, and married women, while also involving men in family planning decisions. Strengthening community-based sensitization and empowering women in reproductive health decision-making are crucial for inclusive and sustainable improvements in contraceptive uptake and for meeting global reproductive health goals.

Background: Contraceptive adoption is crucial for reducing unplanned pregnancies and maternal mortality and improving reproductive health outcomes. However, the unmet need for family planning remains high in developing countries. This study examines the prevalence and factors influencing contraceptive use and non-use among women of advanced reproductive age (35-49) in Nigeria.

Methods: This was a cross-sectional study of 11,248 women of advanced reproductive age (35-49 years), from the most recent Nigeria Multiple Indicator Cluster Survey (MICS). This study utilised secondary data and information on socio-demographic characteristics, reproductive history, and contraceptive use. We employed a multinomial logistic regression in examining the bivariate relationship between the use and non-use of contraceptives and explanatory variables. Relative risk ratios (RRR) were calculated to indicate influence of the selected socio-demographic variables on the use and non-use of contraceptives. Analysis was performed using Stata version 17.

Results: The prevalence of contraceptive non-adoption among women of advanced reproductive age was 71%. Among those who use contraceptives, 21% practice modern methods, and 7% rely on traditional methods. Factors such as ethnicity, region, marital status, media exposure and experience of child mortality all had a significant positive association with contraceptive adoption rate. Additionally, a significant positive association was found between age, education, parity, wealth index, fertility desire and contraceptive use. At the multivariate level, education (RRR = 1.49; p = 0.050), ethnicity (RRR = 0.298; p = 0.001), region (RRR = 4.173; p < 0.001), and wealth status (RRR = 0.568; p = 0.002) were significantly associated with contraceptive non-use.

Conclusions: The study highlighted a high prevalence of contraceptive non-adoption among women of advanced reproductive age, with more than two-thirds not using any method of family planning. Socio-demographic factors, importantly, maternal education consistently emerged as a strong predictor of contraceptive use, underscoring the critical role of female empowerment and access to education in improving reproductive health outcomes. These findings suggest the need for targeted interventions that address regional and socio-cultural disparities, strengthen health education, and promote equitable access to family planning services to reduce unmet needs and enhance reproductive health among older women in Nigeria.

Clinical trial number: Not applicable.