Differential Factors of Contraceptive Use and Adverse Outcomes of Pregnancy in Women with Ages 15 to 49 in Pretoria, South Africa

Zeleke Worku

doi:10.4236/jdaip.2014.21004

Abstract

Challenges of teenage pregnancy and adverse outcomes of pregnancy constitute a major public health problem in South African women of the childbearing age of 15 to 49 years. This is a 6-year long study that was conducted in Pretoria, South Africa in order to identify factors that affect utilization of modern contraceptives and adverse pregnancy outcomes in women of the childbearing age of 15 to 49 years. Data analysis was conducted by using two-by-two Pearson’s chisquare tests of associations, binary logistic regression analysis, survival analysis, and multilevel analysis. The study showed that the percentage of women who regularly used modern family planning methods such as condoms, pills, injections, intra-uterine devices and sterilization was 41.74%. The average ages of women at first sex and pregnancy were 18.72 and 19.36 years respectively. Adverse outcomes of pregnancy occurred in 12.19% of women. Based on Odds Ratios (OR) estimated from binary logistic regression analysis, utilization of contraceptives was significantly influenced by easy access to family planning services, level of support from sexual partner, and young age at first pregnancy. Based on Hazard Ratios (HR) estimated from the Cox Proportional Hazards Model, the occurrence of adverse outcomes of pregnancy was significantly influenced by easy access to family planning services, unwanted pregnancy, and young age at first pregnancy. Women who experienced adverse outcomes of pregnancy were characterized by poor utilization of reproductive health and modern family planning services. There was a significant difference among the 20 health service delivery wards and 11 health service facilities in which reproductive health services were delivered to women with regards to the quality of service delivery.

Highlights

Objectives and background of study: the aim of the study is to describe the socio-demographic and reproductive characteristics of women who underutilize contraceptives and experience adverse outcomes of pregnancy in and around Pretoria, South Africa
The study had four specific objectives: to identify and quantify factors that affect the degree of utilization of modern contraceptives by women in the childbearing age of 15 to 49 years living in Pretoria, South Africa; to identify and quantify factors that affect the occurrence of adverse outcomes of pregnancy in women; and to find out if women who experienced adverse outcomes of pregnancy failed to effectively utilize reproductive health and modern family planning services that were provided to them by the Health Department of the City of Tshwane Metropolitan Municipality (CTMM)
The research work was motivated by the following key reasons: the lack of reliable scientific studies on the reproductive needs and requirements of the general population, the lack of awareness about family planning services provided by the CTMM, poor utilization of family planning services provided by the CTMM at the various service centers, and a high level of adverse outcomes of pregnancy among women in the childbearing age of 15 to 49 years living in and around Pretoria, especially among poor black women residing in townships

Summary

Introduction

Objectives and background of study: the aim of the study is to describe the socio-demographic and reproductive characteristics of women who underutilize contraceptives and experience adverse outcomes of pregnancy in and around Pretoria, South Africa. The study had four specific objectives: to identify and quantify factors that affect the degree of utilization of modern contraceptives by women in the childbearing age of 15 to 49 years living in Pretoria, South Africa; to identify and quantify factors that affect the occurrence of adverse outcomes of pregnancy in women; and to find out if women who experienced adverse outcomes of pregnancy failed to effectively utilize reproductive health and modern family planning services that were provided to them by the Health Department of the City of Tshwane Metropolitan Municipality (CTMM). The study aims to identify and quantify factors that were responsible for underutilization of modern family planning services in women who have experienced adverse outcomes of pregnancy

Objectives

Methods

Results

Conclusion