Contraceptive Prevalence Research Articles

AWARENESS REGARDING DIFFERENT FAMILY PLANNING METHODS AMONG MARRIED WOMEN OF REPRODUCTIVE AGE GROUP IN URBAN SLUMS OF BERHAMPUR, ODISHA: A CROSS SECTIONAL STUDY

Background: Family planning services have the potential to improve the quality of the lives of people and their economic welfare. Objectives: To determine knowledge and practice of contraception and to find out the association between contraceptive practices and different variables. Methods: A cross-sectional, community-based study was conducted among 300 married women of 15–49 year age group of urban slums of Berhampur, Odisha, using a pretested and predesigned schedule. Results: Majority of women (93%) were aware of different types of FP methods but only 79.7% of females had known where the services are available. Health worker females (77.3%) act as the most influential source of information about contraceptive practices followed by the ASHA (71.6%). The contraceptive prevalence rate was 78.7%. Out of 236 Current users, temporary methods were being adopted by 65.3% and permanent methods by 34.7% respectively. Among the temporary method users, 24.1% of women used oral contraceptive pills, IUCD and injectables were being used by 6.4% each and condoms were being used by the partners of 28.4% of women as a means of contraception. Acceptance of family planning methods was significantly associated with variables such as increasing age, nuclear family, and level of literacy. Conclusion: The prevalence of contraceptive use was high among the study population, but the use of a modern and safe method of contraception was low. Continuous IEC activities by the service providers such as ASHAs, AWWs, and HWFs with support from the supervisor matters for better adherence to contraceptive methods.

Addressing barriers to accessing family planning services using mobile technology intervention among internally displaced persons in Abuja, Nigeria

Inadequate access to sexual and reproductive health services is prevalent among women of reproductive age in internally displaced people's camps. To address this, we implemented a mobile technology intervention, known as the Linking Underserved Populations to Sexual and Reproductive Health Services, in the Wassa Internally Displaced People's camp, Abuja, Nigeria. This study aimed to assess the impact of the Linking Underserved Populations to Sexual and Reproductive Health Services Intervention in improving sexual and reproductive health services among women of reproductive age in Wassa Internally Displaced People's camp. A baseline survey was conducted among 105 women of reproductive age in the Wassa camp, followed by the deployment of the Linking Underserved Populations to Sexual and Reproductive Health Services intervention, which delivered family planning messages to camp residents between September 2020 and June 2021. This was followed by an endline survey. The FP utilization data in the camp health post were mined during the period of the intervention and were analyzed using Stata version 15 with a chi-square test performed at a significance level of 5%. Awareness of family planning among women of reproductive age in Wassa camp increased from 54.2% at baseline to 98% at endline. The major reason for refusal of family planning at baseline, which was a lack of spousal consent reduced from 29.5% to 7% at endline. Contraceptive prevalence rate increased from 18.1% at baseline to 26.2% at endline. In addition, 133 new family planning users were recorded at the endline. The uptake of family planning services recorded a strong association with family planning consultations (P<.05; χ2=6.41) and receipt of bulk short message service (P<.05; χ2=4.90). Mobile technology interventions are a recommended strategy that can increase family planning awareness and address barriers to family planning uptake.

Family planning unmet need among women attending primary healthcare clinics in Western Region, Saudi Arabia.

The gap between some women's reproductive intention and their contraceptive behavior clearly poses a challenge to the ongoing family planning program. Unmet need has generated much interest, both among academics and policymakers over the years. This study aims to estimate the prevalence, subgroups, and reasons of unmet need for family planning among married Saudi women in Military Hospitals in Taif city. A cross-sectional study was adopted in Taif city, Saudi Arabia. It included a random representative sample of married women in the childbearing age (18-49 years) who attended the Family Medicine center in Prince Mansour military hospital (n = 8 clinics), Family medicine clinics at Al-Hada Armed Forces hospital (n = 3 clinics), and Al-Razi center in Prince Sultan hospital throughout the study period (March-June, 2022), provided that they had at least one child. A self-created validated questionnaire in the Arabic language was used to collect data regarding socio-demographic variables, reproductive history, and contraceptive practice including reasons of either using or never using contraceptive methods. Four hundred women participated in the study out of a targeted 431 with a response rate of 92.8%. The age of the participating women varied from 20 to 50 years (34.2 ± 7.5 years). Slightly less than half of the participant married women (48.5%) were contraceptive users. Spacing between children was mentioned by majority of those used/using contraceptives (82%), whereas limiting the number of children was mentioned by 9% of them. The commonest reported method of contraception used by women was oral contraceptive pills (58.3%), followed by intrauterine device (IUD) (41.6%). History of unintended pregnancy was reported by more than one-third of the participants (37%). Regarding contraceptive method used during unintended pregnancy, oral contraceptives (39.2%), safety period (21.6%), and condom (21.6) were the most frequent methods. Unmet contraceptive need prevalence was 49.9%. Unmet contraceptive need was significantly associated with husband's educational level (P = 0.008), husband's job (P = 0.011), family income (P = 0.001), age of marriage (<0.001), age of pregnancy (<0.001), number of pregnancy (<0.001), and parity (<0.001). The prevalence of unmet need of contraception use among women in Taif city is high. Husband-related factors were significantly associated with unmet contraception use.

Back to Square One: Attempted Legal Amendments and Abortion Practices in Sri Lanka

The Sri Lankan law only permits induced or iatrogenic abortion to save the life of the mother. Despite the restricted law, law enforcement mechanisms, and reported high national contraceptive prevalence rate, a significant proportion of pregnant women terminate their pregnancy outside the law. Despite the existence of restrictions and inertia, numerous stakeholders concerned about women’s health have made several attempts to liberalize the abortion law in Sri Lanka. Although several amendments were proposed to rationalize the abortion law in Sri Lanka, nothing has been successful – we are back to square one.&#x0D; Expansion of legal exceptions for induced abortions and improved safe abortion with the revolutionized medical abortion (MA) were observed in numerous countries globally during the past decade. On the other hand, some countries with broadly liberal laws, including the United States, have added restrictions. How these global changes have affected countries like Sri Lanka is worth studying. This article assesses the response of the Sri Lankan government and the society towards those global changes in terms of the policies and practices on induced abortion. Authors argue that the paradigm shift in abortion practices in Sri Lanka, driven by the emerging occurrence of medical abortion, has highlighted the disparity between the existing legal status and the aspirations of most Sri Lankans. Given the widespread support for legalizing abortion in cases of rape, incest, and fetal abnormalities, it is imperative the government seriously consider legal amendments.

Task shifting and community engagement as the keys to increasing access to modern contraception: Findings from mixed methods operational research in coastal Kenya.

Kilifi County, Kenya, has a modern contraceptive prevalence of 44%, compared to the national prevalence of 61%. In 2018, the Government of Kenya and Population Services Kenya implemented a pilot project in Kilifi to improve contraceptive awareness and access. The Riziki Demonstration Project task shifted contraceptive injectable and implant provision to community health extension workers (CHEWs) and supported community engagement led by community health volunteers (CHVs). This mixed methods evaluation examined the effect of Riziki on contraceptive service provision and identified drivers of the intervention's success in increasing public sector contraceptive uptake. We obtained monthly contraceptive service provision data from DHIS2 for intervention and comparison facilities from June 2018 to July 2020. Controlled interrupted time series analyses were used to assess difference-in-differences effects on the levels and trends in service provision. Qualitative data included key informant interviews with health workers, community-based focus group discussionsand contraceptive journey mapping. Topics included contraception-related shifts in the health system and social environment and changes to contraceptive accessibility and demand. We found positive difference-in-differences effects for levels of provision for implant (adj. β = 7.4 per month, per facility, 95% confidence interval [CI]: 2.8-12.0) and all methods combined (adj. β = 12.2, 95% CI: 3.0-21.3). The health system provided a legal framework and management support for the pilot. Community engagement by CHVs and CHEWs, including with men and religious leaders, bolstered supportive social norms by emphasizing birth spacing and family wellbeing. Awareness and supportive social norms were strengthened among women and their husbands through counselling that leveraged CHEW and CHV community embeddedness. Findings demonstrate the potential for task sharing combined with community engagement efforts to improve contraceptive awareness, knowledgeand supply. Community engagement should include men, traditional leadersand other influencers to strengthen norms that position family planning in alignment with community values.

Spatial distribution and factors influencing modern contraceptive practice among tribal married women in India: evidence from National Family Health Survey 5 (2019–2021)

BackgroundThe unmet need for family planning has been a public health concern in developing countries, especially in the south-east region. In India, the expanding roles of women has led to a growing need for family planning and contraception. However, tribal women still struggle with reproductive and sexual health issues. Unfortunately, most tribal women are not informed about the potential health risks associated with contraceptive use, as service providers often neglect to provide this information. As a result, tribal women often suffer in silence, which can lead to serious health problems. Thus, the present study aimed to understand the patterns and factors associated with modern contraceptive usage as well as the district level variation in usage among tribal married women.MethodsWe included 91,976 tribal married women participants aged 15 to 49 years from National Family Health Survey 5 conducted during the years 2019 to 2021. Descriptive statistics were used to compute the prevalence of modern contraceptive usage along with 95% confidence interval (CI) as a measure of uncertainty. The association between various socio-demographic predictors and modern contraceptive usage were assessed by multivariable logistic regression and presented as an adjusted odds ratio (AOR).ResultsThe overall prevalence of modern contraceptive practices was found to be 53% among tribal married women, which was below the national average. Sterilization was the most preferred method of modern contraceptive, whereas injectables were the least preferred method. More than 80% of the married women get the family planning information from the public health facility and health workers. Districts of eastern and north-eastern states have comparatively less modern contraceptive prevalence than central and southern states. Age, education, parity and access to media were significantly associated with the use of modern methods of contraception.ConclusionImproving contraceptive use and reducing unmet needs for contraception among tribal women requires sustained efforts from healthcare workers, including Information Education and Communication (IEC) through mass media to raise awareness. A tailored family planning strategy is crucial to address the specific needs of tribal women at both the local and national levels, with adequate resources and monitoring for impact with this India can achieve Total Fertility Rate (TFR) 2.1 among tribals.

Relationship between history of hormonal contraceptive use and anaemia status among women in sub-Saharan Africa: A large population-based study.

Anaemia among women has been reported to be a significant contributor to hemorrhage, exacerbated risk of stillbirths, miscarriages, and maternal mortalities. Hence, understanding the factors associated with anaemia is imperative to develop preventive strategies. We examined the association between history of hormonal contraceptive use and risk of anaemia among women in sub-Saharan Africa. We analyzed data from the recent Demographic and Health Surveys (DHS) of sixteen countries in sub-Saharan Africa. Countries with recent DHSs conducted from 2015 to 2020 were included in the study. A total of 88,474 women of reproductive age were included. We used percentages to summarize the prevalence of hormonal contraceptives and anaemia among women of reproductive age. We used multilevel binary logistic regression analysis to examine the association between hormonal contraceptives and anaemia. We presented the results using crude odds ratio (cOR) and adjusted odds ratios (aOR), with their respective 95 percent confidence intervals (95% CIs). On the average, 16.2% of women are using hormonal contraceptives and this ranged from 7.2% in Burundi to 37.7% in Zimbabwe. The pooled prevalence of anaemia was 41%, ranging from 13.5% in Rwanda to 58.0% in Benin. Women who used hormonal contraceptives were less likely to be anaemic compared to those who were not using hormonal contraceptives (aOR = 0.56; 95%CI = 0.53, 0.59). At the country-level, hormonal contraceptive use was associated with a reduced likelihood of anaemia in 14 countries, except for Cameroon and Guinea. The study underscores the importance of promoting the use of hormonal contraceptives in communities and regions that have a high burden of anaemia among women. Specifically, health promotion interventions aimed at promoting the use of hormonal contraceptives among women must be tailored to meet the needs of adolescents, multiparous women, those in the poorest wealth index, and women in union as these sub-populations were at significantly higher risk of anaemia in sub-Saharan Africa.

Determinants and prevalence of modern contraceptive use among sexually active female youth in the Berekum East Municipality, Ghana.

Contraceptive use among sexually active women in Ghana remains low despite the efforts by the Ghana Health Service. This development has negative consequences on reproductive health care, particularly among adolescents. This study assessed the prevalence and factors influencing contraceptive use among sexually active young women in the Berekum Municipality, Ghana. A community-based cross-sectional analytical study was carried out in Berekum East Municipality among young women between the ages of 15 to 24 years. Using a probabilistic sampling technique, we recruited 277 young women from the four selected communities in the Berekum Municipality based on data available from the Municipal Health Administration. We applied a univariate and multivariate logistic regression analysis to test the associations between the dependent and independent variables at a 95% Confidence interval (CI) and 5% significance (p value = 0.005). The modern contraceptive prevalence rate among the study participants was 211 (76%). Contraceptives ever used were emergency contraceptive pills 88 (41.7%) condoms 84 (39.8%), injectables 80 (37.9%) and the rest used the Calendar method 16 (7.58%), withdrawal 15 (7.11%), and implants 11 (5.21%). In the adjusted multivariate logistic regression, Age (AOR = 2.93; 95% CI; 1.29-7.50) p = 0.023, marital status (AOR = 0.08; 95%CI; 0.01-0.91) p = 0.041 and religion (AOR = 0.17; 95% CI; 0.05-0.64) p = 0.009 were significantly associated with contraceptive use. Other determinants such as hearing about contraceptives (AOR = 9.44; 95%CI; 1.95-45.77) p = 0.005, partner opposition (AOR = 33.61; 95%CI; 1.15-985.39) p = 0.041, side effects (AOR = 4.86; 95%CI; 1.83-12.91) p = 0.001, lack of knowledge (AOR = 5.41; 95%CI; 1.15-25.42) p = 0.032, and respondents receiving counselling on family planning were significantly associated with contraceptive use (AOR = 4.02; 95% CI;1.29-12.42), p = 0.016. Contraceptive use among sexually active women in the Berekum Municipality is higher than the national conceptive prevalence rate. However, factors such as knowledge about the side effects of contraceptive influences contraceptive use among women. Healthcare providers must explore avenues to enhance partner involvement, intensify health education and detailed counselling about contraceptive use to address misconceptions and myths surrounding the side effects of contraceptives.

Scoping review on the use of South-South learning exchange to scale up evidence-based practices in family planning

BackgroundSouth-South learning exchange (SSLE) is an interactive learning process where teams from low-income and middle-income countries exchange knowledge and experience to support one or both team’s work towards a change...

A Review of Contraceptive Prevalence Rates in Afghanistan

Background and Objective: Family planning programs and the use of contraceptives are among the priorities of maternal and child health. Adequate information about the prevalence of family planning programs and contraceptive use in Afghanistan is not readily available. This review attempts to provide an appropriate perspective on the prevalence rates of contraceptive use based on existing data and suggests practical measures to improve the prevalence of contraceptive usage.&#x0D; Research Method: In this review, data from Google Scholar, PubMed, the Ministry of Public Health website, the World Health Organization, and the National Family Planning Program were utilized. Seven articles published between 2001 and 2023 were selected and analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.&#x0D; Findings: A narrative summary of the results of the selected articles is presented in this paper. According to studies conducted in the country, statistics on the prevalence of contraceptive use show significant differences in comparison to demographic structures. The lowest figure reported in these studies is 10.4%. The utilization of contraceptives is reported as follows: oral contraceptives 38.5%, condoms 30.3%, medroxyprogesterone 17.0%, intrauterine contraceptive devices (IUCD) 15.6%. Overall, the prevalence rate of contraceptive use in the entire country reaches 15.4%.&#x0D; Conclusion: In Afghanistan, due to numerous barriers, the use of contraceptives and the gap between pregnancies have not been promoted. Conversely, according to the conservative beliefs of the illiterate segments of society, the use of contraceptives is considered contrary to their religious beliefs and even in conflict with divine instructions. Therefore, it is imperative for policymakers to develop comprehensive and inclusive programs in this regard and seek assistance from religious leaders to align the community with these programs. Ultimately, the entire society needs to be mobilized.

Understanding fertility behavior of the Forcibly Displaced Myanmar Nationals in Bangladesh: A qualitative study.

Rohingya- the Forcibly Displaced Myanmar Nationals (FDMN)- are largely characterized by a high total fertility rate (TFR) and a low contraceptive prevalence rate. This study aimed to explore the reasons behind their high fertility behavior by utilizing the Theory of Planned Behavior. We adopted a cross-sectional qualitative research approach. Fifteen semi-structured, face-to-face in-depth interviews were conducted with the Rohingya husbands, wives, and community leaders (Majhi and Imam/Khatib) living in Camps 1 and 2 of Ukhiya Refugee Camp, Cox's Bazar, Bangladesh. We analyzed the qualitative data using the thematic analysis approach. The Muslim-majority FDMN predominantly constructed the fertility outcome as the will and order of Allah. On the one hand, the Rohingya parents highlighted various religious, political, economic, and social advantages of having more children, especially sons. On the other hand, beliefs about religious restriction, fear of side effects, and community pressure against contraception sustained the reality of the low contraceptive prevalence rate in the community. Alarmingly, the Rohingya religious leaders and mass people were found highly politically motivated to continue the practice of high fertility with a view to 'expanding the Rohingya community' or 'to increase Muslim soldiers', so that they may fight back and take control of their ancestors' place in Myanmar in the future. Furthermore, these pronatalist attitudes and beliefs translated into high TFR through various high-fertility-supportive social norms and practices widely prevalent in the Rohingya community. These include child marriage, gendered division of labor, women's subordinate nature, the Purdah system, and joint-family members' support during childbirth and rearing. Religion, ethnic identity, and the unique political context and experiences of the Rohingya people jointly explain their high fertility behavior. This study warrants the urgency of initiating social and behavior change communication programs to change the religiopolitically-motivated high-fertility notions that prevailed in the Rohingya community.

Determinants of Low Modern Contraceptive Prevalence in the Health District of Markala/ Case of the Community Health Center of Diamarabougou

The level of use of MCMs remains low in our country. The objective of this study was to analyze the factors associated with the low use of modern contraceptive methods in the Diamarabougou health area. It was a cross-sectional study with an analytical focus conducted among 150 PAFs selected through random sampling. The study established the following: -Modern contraceptive prevalence was 35%. -The majority of women knew about family planning (99%). -The main source of information was health personnel (34.7%). -The reasons for the low use of MCM were The low level of education of the woman and/or her spouse, the desire to have many children and the unfavorable opinion of the spouse. -Both men and women believe that lack of control over the menstrual cycle, jealousy, and lack of distraction are the reasons for many unplanned pregnancies; - The main disadvantage of contraception is infertility. -The main disadvantage of contraception is sterility. For the ATRs, contraception is an effective way to fight against maternal and infant mortality. They also believe that the use of contraception and the choice of a smaller family are also accompanied by significant economic and material advantages, as expenses related to health, education and family maintenance are reduced. Conclusion : The use of modern contraceptive methods remains low in the Diamarabougou health area. The correct information to women and the identification of associated factors: the low level of education of the woman and her spouse, the desire to have many children, insufficient discussion with the spouse and the lack of involvement of traditional birth attendants in family planning programs.

Quality of family planning services and associated factors among reproductive age women attending family planning unit at public health facilities in Dire Dawa, Eastern Ethiopia, 2021

IntroductionImproving the quality of care has been a necessary goal for family planning programs worldwide. Even though extensive work has been done, the contraceptive prevalence rate is still low (41% in Ethiopia, 30.5% in Dire Dawa) and the unmet need for contraception is high (26%) in Ethiopia. Moreover, quality of care in family planning services has an important role in increasing coverage of services and program sustainability. Therefore, the objective of this study was to assess quality of family planning services and associated factors among reproductive age women attending family planning unit in public health facilities in Dire Dawa, Eastern Ethiopia.MethodsA facility-based cross-sectional study was conducted among reproductive-age women attending a family planning unit in Dire Dawa, Eastern Ethiopia, from September 1–30/2021. A total of 576 clients were selected by systematic random sampling and interviewed using a pre-tested structured questionnaire. SPSS version 24 was used to analyze the data, which included descriptive statistics, bi-variable and multivariable logistic regression analyses. To determine the presence of an association between dependent and independent variables, AOR, P-value 0.05, and 95% CI were used.ResultsA total of 576 clients participated in the study and provided a response rate of 99%. The overall satisfaction of clients with FP services was 79%[95% CI:75.2%, 82.9%]. Having primary education (AOR = 2.11, 95% CI(1.11–4.24), convenient facility opening hours (AOR = 3.13, 95% CI (2.12–5.75), maintaining privacy (AOR = 4.1, 95% CI(2.50–8.12), demonstrating how to use F/P method (AOR = 1.98, 95% CI (1.01–5.20), and discussing F/P issues with husbands (AOR = 5.05, 95% CI: 3.33–7.64) were positively significantly associated with client satisfaction.Conclusion and recommendationThis study revealed that about four-fifth of the clients was satisfied with the service they received. Clients’ education, facility opening hour, maintained privacy, discussion with husband, and demonstration of how to use the methods were associated with client satisfaction. Therefore, health facility heads should improve facility opening hour. Health care providers should maintain client privacy every time, and should consistently utilize information, education, and communication materials during consultation sessions by giving more attention to client who has no education. Partner’s discussion on family planning issues should also be encouraged.

Trends and determinants of modern contraceptive utilisation among adolescent girls aged 15-19 years in Sierra Leone: an analysis of Demographic and Health Surveys, 2008-2019

Background Modern contraceptives are effective interventions for preventing unwanted pregnancies, but their use remain low among adolescent girls in sub-Saharan Africa. First, we aimed to assess the trends of modern contraceptive use among adolescent girls aged 15-19 years in Sierra Leone in the period 2008-2019. Second, we explored how individual and contextual determinants of their use changed during this period. Methods We used a combined sample of 8,774 adolescent girls aged 15-19 years from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys (SLDHS), respectively, to estimate the modern contraceptive prevalence rate (MCPR) and unmet need for family planning. We described the method mix and sources of contraceptives among modern method users. We then conducted a multivariable logistic regression to examine the determinants of modern contraceptive use among sexually active adolescent girls, separately for 2008 and 2019. Results MCPR increased from 5.9% (95% CI=4.5-7.8) in 2008 to 21.0% (95% CI=19.2-22.9) in 2019. Most of the increase had occurred by 2013. Norplant (48.8%) and injectables (39%) were the common methods in 2019. Unmet need for family planning declined from 15.4% (95% CI=13.2-17.9) in 2008 to 11.3% (95% CI=9.9-12.7) in 2019, while the prevalence of modern contraceptive use among sexually active adolescent girls increased from 13.1% (95% CI=10-17.0) in 2008 to 43.5% (95% CI=40.2-46.9) in 2019. In both the 2008 and 2019 surveys, the adjusted odds of using modern contraceptives among sexually active adolescent girls were higher among those with more than one sexual partner in the past 12 months, and with secondary or tertiary education. In 2019, the adjusted odds of using a modern contraceptive were also lower among adolescent girls who were married or living with a partner, had more than one child, and lived in the Western province. Conclusions The increase in contraceptive use among adolescent girls in Sierra Leone had stalled since 2013. Interventions, including increasing awareness and accessibility to modern contraceptives, are urgently needed, particularly for adolescents without formal education. Comprehensive and affordable community and school-based interventions, including adolescent-friendly services, would be helpful.

Benefits, anxieties, acceptance, and barriers to the new injectable contraceptive DMPA-SC (Sayana Press): Clients’ perceptions in Sindh, Pakistan

Background: Injections are Pakistan's third most preferred contraceptive method because of their convenience. They represent a 2.5% share of the contraceptive prevalence rate (CPR) and contribute 10% to the current CPR. However, injections require a clinical setting or a healthcare provider for administration. A new method of subcutaneous presentation of depot medroxyprogesterone acetate (DMPA-SC), namely Sayana Press in Uniject™, has been introduced, which can be administered in nonclinical settings or self-administered by trained women. This study examined clients’ perceptions of the current depot medroxyprogesterone acetate-intramuscular injection (DMPA-IM) and its accessibility, availability, affordability, advantages, and disadvantages. In addition, it explored the benefits, barriers, and challenges regarding the new method of DMPA-SC (Sayana Press), especially considering self-injection. Methods: The study was conducted in Sindh, Pakistan. Three focus group discussions were conducted with 9–13 female participants with different demographic characteristics. A semi-structured questionnaire was used. The discussion was recorded, transcribed, and translated from Urdu or Sindhi to English. Transcripts were coded precisely, and data analysis was performed using NVivo software. Results: Participants expressed moderate fear of self-injection and risk of an inaccurate prick, suggesting that DMPA-SC acceptance may not be challenging at a community level. They appreciated free services at public health facilities, as the affordability of private facilities may be challenging for those with low income. Most participants agreed to pay PKR 50–300 (approximately 1 USD or less) as service charges for a private facility, while some agreed to pay for transportation costs when lacking alternative methods. Conclusions: DMPA-SC is a valuable alternative, provided its challenges are adequately addressed. Information about self-injection contraceptives is currently limited, and shared self-administration may be difficult without adequate training and counseling. Nevertheless, clients prefer the self-injection method for family planning to avoid transportation and private service charges.

Trends of Contraceptive Usage among Women in Tertiary Hospital in Nnewi, Nigeria: A Five-Year Retrospective CrossSectional Study

Background: Maternal and infant mortality can be reduced with use of contraceptives which protects against unplanned pregnancies, high parity and high fertility and ensuring proper spacing between child births. Nigeria’s fertility rate is high, with 5.7 children per woman while the contraceptive prevalence rate is low, with a rate of 15%. Studying the trend will provide information on the uptake of diverse contraception approaches and provide information for counseling. Objective: To determine the trend and preferred methods of contraceptive usage among patients who attend the family planning clinic at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Nigeria. Method: This is a retrospective cross-sectional study involving collection of data from the family planning register of women who attended family planning clinic at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, from 1st April 2014 to 1st March 2019. The information obtained from the case files were socio-demographic data such as the age and parity including the contraceptive methods, and yearly uptakes. The data obtained were analysed using statistical package SPSS version 26. Result: The total number of deliveries at the study center in the studied period was 3457, while the total number of contraceptive methods used was 578, giving an overall contraceptive prevalence rate of 16.7%. The prevalence rate showed a rise from 15.7% in 2014/2015 to as high as 19.1% in 2018/2019. The age group with most of the women from the study was 30 to 34 (29.2%) years. Majority of the women (251; 43.4%) used sub-dermal implants, 219 (37.9%) women used intrauterine contraceptive device (CUT380A), and this was followed by 96 (16.6%) women that used injectable hormonal contraceptive. We also observed an increase in preference for use of hormonal contraceptive methods (implants) as compared to the non hormonal methods (CUT380A). Conclusion: The trend so far, shows a rise in contraceptive use with the sub-dermal implants in the study center, with a notable improvement in the prevalence of contraceptive use within the last 5 years of the study. There is need for health information on the use of contraceptives to improve the uptake.

Role of Guidance and Counseling in Addressing Commonly Used Forms of Cannabis among University Students in the South Rift Region of Kenya

Modern family planning methods are widely believed to influence fertility reduction worldwide. Family planning had a clear effect on the health of women, children, and families worldwide especially those in developing countries. It has been shown that there are many instances in which women might discontinue contraception or switch methods that put women at risk of unwanted pregnancies. In addition, studies showed that in countries with moderate to high contraceptive prevalence, the majority of unintended pregnancies are the result of contraceptive discontinuation or failure. This study intends to assess and identify determinants of reversible modern hormonal contraceptive method utilization among women of reproductive age group in Dire Dawa city, Dire Dawa Administration, Eastern Ethiopia. A cross-sectional study design was employed. A total of 811 women one year history of modern hormonal contraceptive method usage was studied. A stratified random sampling method was used to select the study subjects. Data was collected using structured questionnaire and to analyze the data descriptive statistics and binary logistic regression was employed. Result . This study showed that 574 (70.8%) of them continue using the method that they used before one year without changing. However, 237 (29.2%) of women discontinued using the method within a year. Switching account 97 (40.9%) of the discontinuation. Factors such as: age, number of children, who made the decision on choice of the used method, the type of contraceptive method used and taking training/ counseling before using the method were found to be significant at 5% level of significance. Women who are young, have no or small number of children and not the decision maker on the choice of the method are more likely to discontinue. Whereas women who didn’t took training/counseling are less likely to discontinue. And compared to women who used implant those, women who used pills and injectables are more likely to discontinue. This study showed the factors that contribute to utilization of modern contraception methods. Keywords: modern hormonal contraceptive method; binary logistic regression DOI: 10.7176/DCS/13-3-01 Publication date: March 31 st 2023

Prevalence and determinants of Contraceptive practice in Women Attending Tikrit Teaching Hospital

Background: Family planning assist in achieving the optimal growth and development of each member in the family and protect the women from the side effects of multiple pregnancies. The aim of this study is to determine the prevalence, awareness and practice of contraceptives, and the determinants of contraceptive use among women attending Tikrit teaching hospital.Subjects and Methods: a cross sectional hospital based study was conducted in Tikrit teaching hospital from February to May 2011. A total of 280 married women aged between 15-50years were participated in this study.Results: The prevalence of family planning practice among them was 77.1%. Despite that all of women (100%) knew about contraception but only (80%) were in favor it. Favor and practice of contraception inversely related to educational level. Among users, the modern methods were the most common methods used by women (64.3%) while only (35.7%) used the natural traditional methods. Conclusion: this study revealed high awareness about family planning methods, in the same time the prevalence of practicing it was high. Favor and practice of contraception were more pronounced in low educated and unemployed women.

The impact of child mortality on fertility in South Africa: Do child support grants and antiretroviral treatment matter?

This paper investigates the effect of under-five mortality, child support grant (CSG) coverage and the rollout of antiretroviral therapy (ART) on fertility in South Africa. The study employs the quality-quantity trade-off framework to analyse the direct and indirect factors affecting fertility using the two stage least squares fixed effects instrumental variable approach. The analysis uses balanced panel data covering nine provinces from 2001-2016. This period was characterised by significant increases in the child support grant coverage and ART coverage. Furthermore, this period was characterised by a significant decline in the under-five mortality rate. We find no evidence to support the hypothesis that increases in the CSG coverage are associated with an increase in fertility. This finding aligns with previous literature suggesting that there are no perverse incentives for childbearing associated with the child support grant. On the other hand, results indicate that an increase in ART coverage is associated with an increase in fertility. Results also show that a decrease in under-five mortality is associated with a decline in fertility over the sample period. HIV prevalence, education, real GDP per capita, marriage prevalence and contraceptive prevalence are also important determinants of fertility in South Africa. Although the scale up of ART has improved health outcomes, it also appears to have increased fertility in HIV-positive women. The ART programme should therefore be linked with further family planning initiatives to minimise unintended pregnancies.

Prevalence and Knowledge of Family Planning among Women of Reproductive Age Group in Primary Healthcare Centers in Abuja, Nigeria

The contraceptive prevalence rate (CPR) is a key indicator for measuring improvements in access to reproductive health. In Nigeria, the average CPR remains low at 17%, with wide variability in the knowledge of family planning (FP) methods across the states and communities. Thus, this study set out to 1. Determine the Contraceptive prevalence rate among women of the reproductive age groups (WRAGs) in Primary Healthcare Centers (PHCs) in Abuja. 2. Assess the knowledge of family planning and its methods among WRAGs in PHCs in Abuja. This is a descriptive cross-sectional study conducted among WRAG in two PHCs in Abuja. A simple random method was used to select 400 WRAGs, and the information from participants was captured with a pre-tested structured questionnaire. SPSS version 21.0 was used for data analysis, the hypothesis was tested with chi-square, and the results were significant at p-value &lt; 0.05. The study analyzed 375 valid and complete questionnaires; the mean age was 30 ± 6.29 years, and 90.7% of respondents had at-least secondary school education. The CPR was 36%, and the most common FP methods were male condoms (11.6%), injectable birth control (5.4%), female condoms (4.7%), and implants (4.0%). About 66% of participants had good knowledge of FP methods, and this was associated with increased uptake of contraceptives. The CPR found in this study is considerably higher than the Nigeria national average. The finding aligns with the reported good knowledge of family planning and high literacy level. Furthermore, good knowledge of FP methods was significantly associated with increased contraceptive uptake. Keywords: Abuja, Contraceptive prevalence, Knowledge of family planning, Primary healthcare centers, Women of reproductive age group.