Abstract
BackgroundTotal fertility rate (TFR) is high and at a static level for the last two decades in Bangladesh. Reduction of fertility by increasing contraceptives use could reduce maternal and neonatal mortality. To achieve the targeted contraceptive prevalence rate (CPR) of Family Planning 2020 (FP2020) Initiative, it is important to increase CPR in all regions of the country. However, it is lower in Sylhet Division compared to other divisions in Bangladesh. This study looked into the methods, source and determinants of contraceptives use in this division.MethodsData from the Bangladesh Demographic and Health Survey 2014 (BDHS 2014) were analyzed. After reporting the sources of obtaining contraceptives and choice of methods, distributions of contraceptives use were reported by selected characteristics. Logistic regression was applied to calculate the odds ratios.ResultsA total of 599 women were analyzed. CPR was lower in rural areas compared to urban areas, 45.4% and 58.5%, respectively. The majority of the women received services from governmental sectors. The birth control pill was the most common contraceptive method. The proportion of women using long-acting permanent methods was low (<10%) in both urban and rural areas.In the multivariate analyses, number of alive children (adjusted odds ratio (AOR) of ≥5 children: 1.6, 95% confidence interval (CI): 1.1–2.2), presence of a male child (AOR: 1.7; 95% CI: 1.1–2.6), higher education level of the husband (AOR: 1.7; 95% CI: 1.1–2.6), receiving a visit from a family planning worker (AOR: 2.4; 95% CI: 1.6–3.4) and membership in a non-governmental organization (AOR:1.4, 95% CI: 1.1–1.8) were positively associated with contraceptives use in Sylhet after controlling for age, education level and other contextual factors. Conversely, rural women had the lower likelihood of using contraceptives (AOR: 0.6; 95% CI: 0.4–0.8) than urban women. Women’s education level and religion were not statistically significant.ConclusionsA comprehensive strategy is required for this division to address multiple factors which simultaneously influence contraceptives use. In addition to more awareness programs to increase contraceptives use, providing contraceptive distribution services through family planning workers, involving women with non-governmental organizations and prioritizing rural areas could increase contraceptives use in Sylhet Division.
Highlights
Total fertility rate (TFR) is high and at a static level for the last two decades in Bangladesh
The contraceptives prevalence rate (CPR) is lowest and total fertility rate (TFR) is highest in Sylhet Division
Our analysis revealed that the number of alive children, presence of a son, husbands’ education level, working status of the women, receiving a visit by an family planning worker (FPW), and nongovernmental organization (NGO) membership positively impact contraceptive use while living in a rural area is inversely associated with contraceptives use when adjusted for other factors
Summary
Total fertility rate (TFR) is high and at a static level for the last two decades in Bangladesh. Reduction of fertility by increasing contraceptives use could reduce maternal and neonatal mortality. To achieve the targeted contraceptive prevalence rate (CPR) of Family Planning 2020 (FP2020) Initiative, it is important to increase CPR in all regions of the country. It is lower in Sylhet Division compared to other divisions in Bangladesh. Despite global reduction of fertility, total fertility rate (TFR) remains high in several countries including Bangladesh [1]. Scaling up contraceptives use could help meet the maternal and neonatal mortality targets of the United Nations’ Sustainable Development Goals (SDGs) [9]
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