The Impact of Underutilization of Modern Family Planning Methods on Adverse Outcomes of Pregnancy in Women Aged 15 to 49 in Pretoria, South Africa

Abstract

This paper is a result of a 6-year long follow-up study that was conducted in Pretoria, South Africa between 2004 and 2009 in order to assess the impact of underutilization of modern family planning methods on adverse outcomes of pregnancy in women of the childbearing age of 15–49 years. The Cox Proportional Hazards Model was used for estimating hazard ratios. Multilevel analysis was used for estimating variability in the utilization of modern family planning methods at service delivery wards and health service facilities. The study showed that women who experienced adverse outcomes of pregnancy were characterized by poor utilization of reproductive health and modern family planning services. 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 (ORs) estimated from binary logistic regression analysis, utilization of contraceptives was significantly influenced by the degree of access to family planning services, level of support from sexual partner, and young age at first pregnancy. 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. 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.